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Y4: Infectious diseases > HIV > Flashcards

HIV Flashcards

1
Q

T/F: AIDS is now mostly referred to as late-stage HIV

A

true

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2
Q

HIV is a(n) RNA/DNA retrovirus

A

RNA retrovirus

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3
Q

HIV enters and destroys which cells of the immune system

A

CD4 T-helper cells

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4
Q

presentation of HIV?

A

3-12 weeks post infection: glandular fever-like infection. Sore throat, lymphadenopathy, malaise, myalgia, diarrhoea, rash, mouth ulcers

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5
Q

how is HIV transmitted?

A

unprotected oral/anal/vaginal sex
vertical (mother>child) during pregnancy, birth or breastfeeding
Mucous membrane, blood or open wound exposure to infected blood or bodily fluids

(not through kissing)

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6
Q

T/F: HIV is a treatable condition

A

true (most are fit and healthy on treatment)

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7
Q

repeat testing is necessary if an initial test is negative within ___ ___ of exposure to the virus

A

3 months

as that’s how long Abs to the virus can take to develop

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8
Q

T/F: written consent is needed prior to HIV testing

A

false- verbal is fine

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9
Q

HIV testing

1) typical screening test?
2) what test can give a positive result earlier in infection compared with the antibody test?
3) what test gives the viral load?

A

1) Ab test
2) p24 Ag test
3) PCR test for HIV RNA

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10
Q

2 tests which can be used for monitoring?

A

CD4 count

viral load (number of copies of HIV RNA)

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11
Q

what CD4 count indicates end-stage HIV (AIDS)

A

<200 (high risk of opportunistic infection)

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12
Q

T/F: ART is offered to everyone with HIV irrespective of viral load or CD4 count

A

true

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13
Q

starting regime for treating HIV?

A

generally 2x NRTIs (e.g. tenofovir and emtricitabine) plus a third agent

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14
Q

aim of treatment?

A

undetectable viral load plus normal CD4 count

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15
Q

T/F: when a HIV patient has a normal CD4 and an undetectable viral load on ART, treat their physical health problems (e.g. routine chest infections) as you would an HIV negative patient

A

true

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16
Q

Pneumocystis jirovecii pneumonia (PCP)

1) tends to develop with what CD4 count
2) treatment?

A

1) <200

2) co-trimoxazole (also given prophylactically if CD4< 200 to prevent PCP)

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17
Q

what additional monitoring do women with HIV require?

A

annual cervical smear (increased risk of HPV and cervical cancer)

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18
Q

T/F: HIV patients should avoid live vaccines

A

true

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19
Q

T/F: barrier protection is still advised if both partners are HIV positive

A

true

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20
Q

mode of delivery in HIV + mother?

A

viral load <50: can SVD

viral load> 50: c/s advised, start zidovudine infusion 4 hours prior

21
Q

T/F: prophylaxis is given post-delivery to the baby of a HIV + mother

A

true
viral load<50: zidovudine for 4 weeks
viral load>50: zidovudine, lamivudine and nevirapine for 4 weeks

22
Q

Can HIV be transmitted during breastfeeding?

A

yes even at undetectable viral loads, therefore not recommended in any HIV + women in UK

23
Q

PEP must be commenced within what timeframe?

A

<72hr (sooner the better)

24
Q

following HIV exposure, tests are done immediately and also a minimum of __ __ post-exposure to confirm a negative status

A

3 months

25
Q

what does PEP consist of?

A

combination of ART therapy

currently Truvada + Raltegravir for 28 days

26
Q

testing for HIV in asymptomatic patients should be done how long after possible exposure?

A

1 month

offer repeat test at 3 months if negative

27
Q

the HIV antibody test usually consists of both a screening ____ test and a confirmatory ___ ___ Assay

A

ELISA

western blot

28
Q

what accounts for 50% of cerebral lesions in HIV?

A

cerebral toxoplasmosis

29
Q

Toxoplasmosis

1) presentation
2) appearance on CT?
3) Management?

A

1) constitutional symptoms: HA, confusion, drowsy
2) multiple ring enhancing lesions
3) pyrimethamine and sulfadiazine (toxoPlaSmosis)

30
Q

Primary CNS lymphoma

1) associated with what virus
2) appearance on CT?
3) will be positive on which scan?

A

1) EBV
2) single homogenous enhancing lesion
3) thallium SPECT

31
Q

Encephalitis in HIV

1) due to?
2) CT?

A

1) CMV or HIV

2) oedematous brain

32
Q

most common fungal CNS infection?

A

cryptococcus

33
Q

Cryptococcus infection

1) presentation?
2) CSF?
3) CT?

A

1) HA, fever, malaise, nausea/vomiting, seizures, focal neurological deficit (think meningism)
2) high opening pressure, India ink
3) meningeal enhancement

34
Q

Progressive multifocal leukoencephalopathy (PML)

1) causes widespread ____
2) caused by infection of ____ by what virus?
3) symptoms?
4) preferrred imaging?

A

1) demyelination
2) Oligodendrocytes with John cunningham (JC)
3) behaviour, speech, motor, visual impairment (multifocal indeed)
4) MRI (demyelinating white matter lesions seen)

35
Q

AIDS dementia complex

1) pathogen?
2) symptoms?
3) CT?

A

1) HIV
2) behaviour changes, motor impairment
3) cortical and subcortical atrophy

36
Q

T/F: NICE recommend offering HIV screening to all pregnant women

A

true

37
Q

T/F: pregnant women should should not be commenced on antiretroviral therapy if they were not taking it previously

A

false- all should be offered regardless of whether they were taking it previously

38
Q

Kaposi’s sarcoma

1) caused by which pathogen
2) presentation?
3) treatment?

A

1) HHV-8
2) purple papules or plaques on the skin or mucosa (e.g. GI, resp)

respiratory involvement > massive haemoptysis and pleural effusion

3) radiotherapy + resection

39
Q

hairy leukoplakia can occur secondary to infection with what?

A

EBV

40
Q

what opportunistic infection can occur with CD4<50?

A

cytomegalovirus retinitis

41
Q

most common opportunistic infection in AIDS?

A

PCP

42
Q

Pneumocystis jiroveci pneumonia

1) features?
2) common pulmonary complication?
3) T/F: CXR may be normal
4) treatment?

A

1) dyspnoea, dry cough, fever, few chest signs, exercise-induced desaturation
2) pneumothorax
3) true
4) co-trimoxazole

43
Q

commonest cause of oesophagitis (dysphagia, odynophagia) in HIV patients?
treatment?

A

oesophageal candidiasis

Fluconazole and itraconzaole first line

44
Q

commonest infective cause of diarrhoea in HIV patients?

A

Cryptosporidium

45
Q

ART involves a combination of at least ___ drugs

Typically two ____ and either a ____ or a ____

A

3
NRTI
PI
NNRTI

46
Q

NRTIs

1) examples
2) side effect

A

1) zidovudine (AZT), abacavir, emtricitabine, tenofovir

2) peripheral neuropathy

47
Q

NNRTI

1) examples
2) side effect

A

1) nevirapine

2) P450 enzyme inducer, rash

48
Q

PI

1) examples
2) side effect

A

1) ‘VIR’ e.g. indinavir

2) diabetes, hypelipidaemia, central obesity

Y4: Infectious diseases (17 decks)

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