hematologic infections Flashcards
What are additional complications (besides fever, myalgias, abd pain, vomiting/diarrhea) of P. falciparum infection?
decr. consciousness, pulm edema, renal insufficiency
What prophylactic medications should be given to travelers to sub-saharan africa, tropical South america, and southwest Asia to prevent malaria?
chloroquine, mefloquine
What meds can be used for chloroquine resistant P. falciparum?
atovaquone-proguanil or mefloquine
When after infection do symptoms of mononucleosis appear?
2-5 wks
How long should a pt with mono avoid contact sports?
1 month
What are the key differences btw HIV-1 and HIV-2?
-HIV-2 progresses more slowly, is less infectious early in the disease, is more infectious in late disease, and is less common in the US
When after exposure do pts develop signs of acute HIV infection? How long does it last?
- two to four weeks after infection
- lasts ~2 wks
What is the next step for a health care worker exposed to HIV via needle stick?
prophylactic zidovudine and lamivudine for 4 wks; follow-up HIV tests for up to 6 months after exposure
How is HIV detected?
ELISA detects HIV antibodies. After 2 positive ELISA tests, which are 99% sensitive, confirm with western blot testing
What are common HAART regimens?
- two nucleoside reverse transcriptase inhibitors and either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor
- low dose ritonavir can be added to increase protease inhibitor activity
What is the goal viral load for HAART?
load
What is the treatment for an infant born to an HIV positive mother?
zidovudine for 6 wks after birth. test infants for presence of virus in the first 6 months of life (anti-HIV antibodies will always be present in these kids)
What parasitic diarrheas are seen in HIV+ people and at what CD4 cell count?
isospora, strongyloides, cryptosporidium
seen at CD4 count
What are the pulmonary infections of HIV+ people and how can you tell them apart?
- coccidiomycosis (CD4
What are key neurologic consequences of HIV?
- AIDS dementia: CD4
At what CD4 count does wasting syndrome appear in HIV?
CD410% baseline weight
What is bacilliary angiomatosis?
seen in HIV d/t bartonella henselae or bartonella quintana. fever, weight loss, malaise, abd pain, purple skin masses (large pedunculated granulomas/cherry angiomas) and visceral nodular contrast enhancing lesions that bleed easily.
What are the nucleoside reverse transcriptase inhibitors and what are their adverse effects?
abacavir, didanosine, lamivudine, zidovudine. some are associated with bone marrow toxicity, neruopathy, pancreatitis
What are the non-nucleoside reverse transcriptase inhibitors and what are their adverse effects?
delavirdine, efavirenz, nevirapine. possible neuro/hepatic effects
What are the protease inhibitors and what are their adverse effects?
idinavir, nelfinavir, ritonavir. hyperglycemia, hypertriglyceridemia, drug interactions, lipodystrophy
What is an integrase inhibitor and wat is its negative effect?
raltegravir inhibits the final step of integration of viral DNA into host DNA. can cause neutropenia, pancreatitis, hepatotoxicity, hyperglycemia
What are the fusion inhibitors and what are their side effects?
enfurvutide- prevents viral fusion with CD4 membrane. can cause hypersensitivity at injection site, bacterian PNA
What are the CCR5 antagonists and how to they work?
maraviroc- inhibits CCR5 coreceptor to block viral entry to host cell. may cause fever, cough, URI, neuropathy, dizziness
