HIV Flashcards

(48 cards)

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

25
what does PEP consist of?
combination of ART therapy currently Truvada + Raltegravir for 28 days
26
testing for HIV in asymptomatic patients should be done how long after possible exposure?
1 month | offer repeat test at 3 months if negative
27
the HIV antibody test usually consists of both a screening ____ test and a confirmatory ___ ___ Assay
ELISA | western blot
28
what accounts for 50% of cerebral lesions in HIV?
cerebral toxoplasmosis
29
Toxoplasmosis 1) presentation 2) appearance on CT? 3) Management?
1) constitutional symptoms: HA, confusion, drowsy 2) multiple ring enhancing lesions 3) pyrimethamine and sulfadiazine (toxoPlaSmosis)
30
Primary CNS lymphoma 1) associated with what virus 2) appearance on CT? 3) will be positive on which scan?
1) EBV 2) single homogenous enhancing lesion 3) thallium SPECT
31
Encephalitis in HIV 1) due to? 2) CT?
1) CMV or HIV | 2) oedematous brain
32
most common fungal CNS infection?
cryptococcus
33
Cryptococcus infection 1) presentation? 2) CSF? 3) CT?
1) HA, fever, malaise, nausea/vomiting, seizures, focal neurological deficit (think meningism) 2) high opening pressure, India ink 3) meningeal enhancement
34
Progressive multifocal leukoencephalopathy (PML) 1) causes widespread ____ 2) caused by infection of ____ by what virus? 3) symptoms? 4) preferrred imaging?
1) demyelination 2) Oligodendrocytes with John cunningham (JC) 3) behaviour, speech, motor, visual impairment (multifocal indeed) 4) MRI (demyelinating white matter lesions seen)
35
AIDS dementia complex 1) pathogen? 2) symptoms? 3) CT?
1) HIV 2) behaviour changes, motor impairment 3) cortical and subcortical atrophy
36
T/F: NICE recommend offering HIV screening to all pregnant women
true
37
T/F: pregnant women should should not be commenced on antiretroviral therapy if they were not taking it previously
false- all should be offered regardless of whether they were taking it previously
38
Kaposi's sarcoma 1) caused by which pathogen 2) presentation? 3) treatment?
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
hairy leukoplakia can occur secondary to infection with what?
EBV
40
what opportunistic infection can occur with CD4<50?
cytomegalovirus retinitis
41
most common opportunistic infection in AIDS?
PCP
42
Pneumocystis jiroveci pneumonia 1) features? 2) common pulmonary complication? 3) T/F: CXR may be normal 4) treatment?
1) dyspnoea, dry cough, fever, few chest signs, exercise-induced desaturation 2) pneumothorax 3) true 4) co-trimoxazole
43
commonest cause of oesophagitis (dysphagia, odynophagia) in HIV patients? treatment?
oesophageal candidiasis Fluconazole and itraconzaole first line
44
commonest infective cause of diarrhoea in HIV patients?
Cryptosporidium
45
ART involves a combination of at least ___ drugs Typically two ____ and either a ____ or a ____
3 NRTI PI NNRTI
46
NRTIs 1) examples 2) side effect
1) zidovudine (AZT), abacavir, emtricitabine, tenofovir | 2) peripheral neuropathy
47
NNRTI 1) examples 2) side effect
1) nevirapine | 2) P450 enzyme inducer, rash
48
PI 1) examples 2) side effect
1) 'VIR' e.g. indinavir | 2) diabetes, hypelipidaemia, central obesity