FN: HIV Complications

Question 1

Major AIDS - Defining Illness

Answer 1

1. Candidiasis: oesophageal or pulmonary
2. Cryptococcal meningitis
3. Cyprtocsporidiosis
4. CMV retinitis
5. Kapsosi sarcoma
6. Lyphoma: Burkitss, primary brain
7. MAC
8. PCP
9. PML
10. Toxo
11. TB

Question 2

TB and HIV

Answer 2

1. Reactivation of latent TB
2. Increased risk of disseminated TB
3. Higher bacterial loads but increased false -ve smears - fewer bacteria in sputum
4. False -ve skin tests (T cell anergy)
5. Absence of characteristic granulomas
6. Increased toxicity combing anti-TB and anti-HIV drugs
7. IRIS: HAART leads to increased CD4 - paradoxical worsening of TB symptoms

Question 3

PCP organisms

Answer 3

P. Jiroveci fungus

Question 4

PCP presentation

Answer 4

Dry cough
Extertional dyspnoea
Fever

Question 5

PCP CXR

Answer 5

Bilateral perihilar interstitial shadowing

Question 6

PCP Dx

Answer 6

Visualisation frmo sputum, BAL or lung biopsy

Question 7

PCP Rx

Answer 7

1. high -dose co-trimoxazole IV
2. Or, pentamidine IVI
3. Prednisolone if severe hypoxaemia

Question 8

PCP prophylaxis

Answer 8

Co-traimoazole if CD4

Question 9

CMV causes

Answer 9

Mainly retinitis

Question 10

CMV retinitis

Answer 10

reduced acuity
Eye pain, photophobia
Pizza sign on fudoscopy
t

Question 11

CMV retintis Rx

Answer 11

Rx: ganciclovir eye implan

Question 12

CMV can also cause

Answer 12

Pneumonitis
Colitis
Hepatitis

Question 13

toxoplasmosis presentation

Answer 13

Posterior uveitis
Encephalitis
Focal neurology

Question 14

Toxoplasmosis diagnosis

Answer 14

toxoplasma serology

Toxo isolation form LN or CNS biopsy

Question 15

Toxoplasmosis Rx

Answer 15

Pyrimethamine + sulfadiazine + folate

Question 16

Toxoplasmosis prophylaxis

Answer 16

Co-trimoxazole if CD4

Question 17

Candidiasis oral

Answer 17

Nystatin suspension

Question 18

Candidiasis oesophageal

Answer 18

Dysphgia

retrosternal pain

Question 19

Cadidiasis oesophageal Rx

Answer 19

Itraconazole PO

Question 20

Cryptococcal Meningitis presentation

Answer 20

Chronic Hx
Headache
Confusion
Papilloedema
CN lesions

Question 21

Cryptococcal Meningitis Investigations

Answer 21

India ink CSF stain
Raised CSF pressure
CrAg in blood and CSF

Question 22

Cryptococcal Meningitis Rx

Answer 22

Amphotericine B + flucytosine for 2 wks then fluconazole for 6 monthss/until CD4 >200

Question 23

PML

Answer 23

Progressive multifocal leukoencephalopathy

Demyelinating inflammation of brain white matter caused by JC vrus

Question 24

PML presentation

Answer 24

Weakness
Paralysis
Visual loss
Cognitive decline

Question 25

PML Ix

Answer 25

JC viral PCR

Question 26

PML Rx

Answer 26

HAART, mefloquine may halt progression

Question 27

Kaposi’s sarcoma

Answer 27

Neoplasm derived from capillary endothelial cells or fibrous tissue

Question 28

Kaposi’s sarcoma caused by

Answer 28

HHV8 infection

Question 29

Kaposi Rc

Answer 29

HAART

Radiotherapy or chemo

Question 30

Pulmonary presentations

Answer 30

MAI
Fungi: aspergillus, crypto, histoplasma
CMV

Question 31

Raised LFT and Hepatomegaly cuase

Answer 31

Drugs
Viral hepatitis
AIDS sclerosing cholangitis
MAI

Question 32

Chronis diarrhoea causes

Answer 32

Bacteria: Salmonella. shigella, campylobacter
Protozoa: cryptosporidium, microsporidium
Virus: CMV

Question 33

Neuro causes

Answer 33

CMV encephaltiis

Lymphoma