EXAM #2: HIV II Flashcards
When does most perinatal transmission of HIV occur?
During vaginal delivery
When in a pregnancy is there the highest risk for vertical transmission of HIV? What are the implications?
Late in third trimester
*Screen/ diagnose HIV early in mother and treat her
What are the precautions that are taken to prevent perinatal transmission of HIV?
1) HAART to Mom
2) Post-exposure prophylaxis to baby
3) Consider c-section?
At what CD4 T-cell count can secondary syphilis occur?
Any CD4 count
How does the rash on the thorax/ palms-soles compare to a condyloma lata?
Condyloma lata= raised lesion that is FULL of treponema
How is PCP diagnosed in AIDS patients?
Bronchoalveolar lavage
What is the first line treatment for PCP in AIDS?
TMP-SMX
What is the difference between primary prophylaxis and secondary?
Primary= no disease, trying to prevent it Secondary= had disease, want to prevent it from coming back
What is late diagnosis of HIV?
Patient is diagnosed with HIV when they already have AIDS
Why do you want to have patients with HIV diagnosed early vs. late?
Early diagnosis= normal life-expectancy IF compliant
Late diagnosis= 10-30 years of life-lost
When do you start primary prophylaxis for PCP?
CD4+ less than 200
When do you start primary prophylaxis for toxoplasmosis?
CD4+ less than 100
When do you start primary prophylaxis for MAC?
CD4+ less than 50
What are the guidelines for starting HAART or cART?
Any HIV+ patient should be treated
What drug is the CCR5 inhibitor?
Maraviroc
*Note that this CANNOT be used for a R4 trophic virus
If a drug blocks gp41, what is its mechanism of action?
Fusion inhibitor
What is the general mechanism of action of the NRTIs and NNRTIs?
Inhibition of reverse transcriptase
What two drugs are used for PrEP and post-exposure prophylaxis?
1) Tenofovoir
2) Emtricitabine
What drug requires HLA genomic testing?
Abacavir
*If positive, could develop life-threatening anaphylaxis
What is IRIS?
Immune Reconstitution Inflammatory Syndrome
*Atypical inflammatory disorders associated with immune recovery
What NNRTI is teratogenic?
Efavirenz
What is the adverse effect associated with protease inhibitors?
Decrease the efficacy of birth control
What three things can AIDS increase the risk for?
1) Metabolic syndrome/ dyslipidemia
2) Cardiovascular disease
3) Squamous cell carcinoma of the anus
