Exam 1 - HIV Pathology

Question 1

When and why was AIDS first recognized?

Answer 1

In mid-81

Because of clusters of PJP (or PCP) - Pneumocystis pneumonia caused by Pneumocystis jirovecii (a fungus)

Question 2

What is the most common strain of HIV?

Answer 2

HIV-1

Question 3

HIV is an RNA retrovirus made up of ____ and ____.

Answer 3

HIV is an RNA retrovirus made up of HIV-1 and HIV-2.

Question 4

How is HIV transmitted?

Answer 4

Direct inoculation with infected blood, body fluids, or secretions

• sexual contact
• direct exposure to contaminated blood/blood products
• direct in utero transmission

Question 5

T/F: HIV results in selective defects in immune function.

Answer 5

TRUE

Question 6

HIV involves primary depletions of ______ (T-helper) cells.

Answer 6

HIV involves primary depletions of CD4+ (T-helper) cells.

Question 7

T/F: B cell dysfunction is not present in patients with HIV.

Answer 7

FALSE - B cell dysfunction is also present with HIV

Question 8

What is a normal CD4 cell count according to Dr. Destache?

Answer 8

~1100-1400

Question 9

The outer envelope of HIV includes a structure known as gp___ and gp___ which interacts with CD4 cell receptor (CCR5 and CXCR4).

Answer 9

The outer envelope of HIV includes a structure known as gp120 and gp41 which interacts with CD4 cell receptor (CCR5 and CXCR4).

Question 10

Name all of the possible symptoms of HIV.

Answer 10

• Fever
• Fatigue/malaise
• Rash
• HA
• Lymphadenopathy
• Diarrhea
• Sore throat
• Arthralgia
• Myalgia
• Aseptic meningitis
• Oral or genital ulcers
• Weight loss
• NIGHT SWEATS

Question 11

What is a symptom that stands out in HIV symptoms?

Answer 11

NIGHT SWEATS

Question 12

Where does the HIV virus seed around the body?

Answer 12

Lymphoid tissue

Question 13

T/F: There is a partial host immune response that down-regulates viral replication.

Answer 13

TRUE

Question 14

Where does sequestration of extracellular virus occur with HIV?

Answer 14

Virus into germinal center of lymph nodes

Question 15

T/F: There is chronic activation of B lymphocytes and secretion of immune system activating cytokines.

Answer 15

FALSE - There is chronic activation of T LYMPHOCYTES and secretion of immune system activating cytokines

Question 16

T/F: HIV causes destruction of lymphoid tissue.

Answer 16

TRUE

Question 17

With destruction of lymphoid tissue, there is escape of viral elements into ____ blood cells.

Answer 17

With destruction of lymphoid tissue, there is escape of viral elements into PERIPHERAL blood cells.

Question 18

T/F: HIV causes direct killing of CD4 cells.

Answer 18

TRUE

Question 19

Name the possible metabolic & morphologic disorders.

Answer 19

• Lipoatrophy
• Mitochondrial disorders
• Lipohypertrophy
• Hypercholesterolemia
• Hypertriglyceridemia
• Insulin resistance
• Impaired glucose tolerance

Question 20

T/F: HIV can cause insulin resistance.

Answer 20

TRUE

Question 21

T/F: HIV can cause impaired glucose tolerance.

Answer 21

TRUE

Question 22

T/F: HIV causes both Lipoatrophy and Lipohypertrophy.

Answer 22

TRUE

Question 23

What is the term(s) that describe a problem with the way the body produces, uses, and stores, fat?

Answer 23

Lipoatrophy/Lipodystrophy

Question 24

What is the medical term(s) for fat redistribution?

Answer 24

Lipoatrophy/Lipodystrophy

Question 25

When can Lipoatrophy occur?

Answer 25

After ~4-5 years

Question 26

Name the 2 types of Lipodystrophy.

Answer 26

1) Fat loss

2) Fat buildup

Question 27

Where do men tend to lose fat?

Answer 27

Arms, legs, face, and buttocks

Question 28

Where do women tend to buildup fat?

Answer 28

Abdomen, breasts, back of neck and shoulders, and lipomas (fatty growths in different parts of the body)

Question 29

Name the 2 risk factors for Lipodystrophy.

Answer 29

1) White
2) Older age
3) Being obese

Question 30

Which labs do you check for Lipodystrophy?

Answer 30

• Increased triglycerides
• Increased LDL
• Decreased HDL
• Elevated blood sugars

Also check BP

Question 31

T/F: HIV wasting syndrome is more common in Sub-Saharan Africa than anywhere else.

Answer 31

TRUE

Question 32

What condition describes HIV-positive patients losing a minimum of 10% of body weight and had 30 days of either diarrhea or weakness and fever?

Answer 32

HIV WASTING SYNDROME

Question 33

T/F: Lipodystrophy is not as common as earlier when patients do not have good therapies.

Answer 33

TRUE

Question 34

Kaposi’s Sarcoma is associated with what virus?

Answer 34

Human herpesvirus 8 (HHV-8)

Question 35

T/F: Kaposi’s Sarcoma-associated herpesvirus (HHV) establishes lifelong infection in latently infected B lymphocytes.

Answer 35

TRUE

Question 36

Where does Kaposi’s Sarcoma replicate?

Answer 36

In the oral epithelium

Question 37

T/F: Kaposi’s Sarcoma-associated herpes virus is only present in the saliva of asymptomatic patients.

Answer 37

TRUE

Question 38

How does transmission of Kaposi’s Sarcoma herpes virus occur?

Answer 38

By exposure to infected saliva

Question 39

T/F: There is no treatment for Kaposi’s Sarcoma.

Answer 39

TRUE

Question 40

What approach can you take for Kaposi’s Sarcoma?

Answer 40

Cytotoxic approaches - cryosurgery (liquid N2)

• Surgery
• Intralesional chemotherapy - directly inject chemotherapy into the lesions (vinblastic)
• Photodynamic therapy
• Radiation therapy
• Immunologic therapy - IFN-alfa (not well-tolerated)