DIT HIV Flashcards
Most common artery involved in thrombus?
LAD
HIV genome?
Diploid. 2 molecules of RNA
The three genes in HIV?
Know
env: envelope: gp120 and gp40
gag: p24 capsid protein
pol: reverse transcriptase, aspartate protease and integrase
What do the two things in the env gene do?
gp120: binds to CD4 and CCR5 in macrophage or CXCR4 in CD4 cells
gp41 is fusion and entry
Reverse transcriptase works where?
Reverse transcriptase is in cytoplasm and makes dsDNA which moves to nucleus and the DNA is integrated into dan with integrase
What makes you suspect PCP?
CD4<200 and interstitial infiltrates on CXR
AIDs patient with CD4<50, presents with resp issue. What do you suspect?
PCP
TB
Mycobacterium avium complex (MAC)
Ssytemic disease in HIV with CD4<100?
Histoplasma. Low grade fever, cough, hepatosplenomegaly, tongue ulcer
AIDs with meningitis?
Cryptococcal
If multiple ring abscess, its toxoplasmosis
if single ring, think primary CNS lymphoma
Cotton spots on retina in AIDs?
CMV. needs ganciclovir. “sightomegalovirus”
CD4 less than 50
What is progressive multifocal leukoencephalopathy?
Reactivation of JC virus (less than 200)
Diarrhea that is chronic and watery in AIDs?
Cryptosporidium. Acid fast cysts in stool
When do you see esophageal candidiasis? What is the biggest problem?
Very difficult to eat b/c it is painful
CD4 less than 100
Oral hairy leukoplakia is what?
EBV with HIV
What does primary CNS lymphoma look like on MRI.
Whats it associated with?
Ring lesions. Must differentiate from toxoplasmosis
Associaed with EBV
Squamous cell carcinoma and large B cell lymphoma can both happen in AIDs. What are they associated with?
B lymphoma is EBV
Squamous is HPV
When do you start prophylaxis with HIV?
For what prophylactic treatment?
CD4<50 is azithromycin for Mycobacterium avium
What are the protease inhibitors?
-Navir (Navir tease a proTEASE)
Indinavir side effects
same as other protease inhib + nephrolithisasis and hematuria
Atazanivir side effects?
same as protease inhibitors with also…
Increased bilirubin and nephrolithiasis (kidney and renal)
Protease inhibitors common side effects?
Nausea, diarrhea, hyperglycemia and lypodystrophy
How do NRTIs work?
Nucleoside analogs, and is lacking 3’ OH and stops polymerization
They are competitive inhibitors
THEY MUST BE ACTIVATED by thymidine kinase
Bone marrow suppression is caused by what anti HIV drug?
Zidovudine
Pancreatitis from anti HIV drug?
didanosine
Which NRTI is not a nucleosie but is instead a nucleotide?
Tenofovir is nucleoTide and doesn’t need to be activated
What are the NRTI’s?
Zoos Like Dem African Elephants
Zidovudine Lamivudine Didanosine (pancreatitis) Abacavir (hypersensitivity) Emtricitabine
and other vudines
What anti HIV can cause life threatening hypersensitivity?
Abacavir
Mechanism on NNRTIs?
Noncompetivitely bind reverse transcriptase and don’t need to be phosphorylates
What anti HIV drug can cause neuropsychiatric symptoms?
Efavirenz (also test positive for cannibioids, makes sense)
What is side effect common to all NNRTIs?
Rash and hepatotoxicity
Mechanism of enfuvirtide?
gp41 so prevents enFUsion
Mechanism of Maraviroc?
CCR5 antagonist so gp120 can’t bind macrophage effectively.
Must do tropism test to make sure it is R5 virus (only used in all R5)
Mechanism of raltegravir? side effect?
inhibits integrase. hypercholesterolemia (but she didn’t say it)
What can CMV cause if you have HIV?
Retinitis )
Interstitial pneumonia
