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Infection > HIV > Flashcards

HIV Flashcards

1
Q

What is primary HIV?

A

The period immediately after exposure to virus

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2
Q

When does primary HIV occur?

A

Usually occurs within 3-12 weeks of exposure

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3
Q

How does HIV progress to AIDs?

A

If it occurs longer than 2 weeks or involves the CNS

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4
Q

How does HIV present?

A
  • Fever
  • Lymphadenopathy
  • Maculopapular rash
  • Mucosal ulcers.
  • Sore throat
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5
Q

Where would you get a maculopapular rash?

A

Upper chest

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6
Q

How is HIV diagnosed?

A

Test for HIV antibody with Elisa

Confirm with western blot

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7
Q

What would you use to confirm the diagnosis?

A

HIV PCR and P24 antigen

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8
Q

What is a CD4 count used to diagnose?

A

AIDs

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9
Q

When should you test asymptomatic patients?

A

4 weeks after exposure

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10
Q

What is the management of HIV?

A

Anti-Retroviral therapy

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11
Q

What does antiretroviral therapy involve?

A
  • Two nucleoside reverse transcriptase inhibitors (NRTI)- Zidovudine, abacavir, tenofovir
  • A protease inhibitor (PI) (-navir)
  • or a non-nucleoside reverse transcriptase inhibitor (NNRTI)
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12
Q

What are examples of 2 nucleoside reverse transcriptase inhibitors?

A

Zidovudine
Abacavir
Tenofovir

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13
Q

What are examples of protease inhibitors?

A

Saquinavir

Indinavir,

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14
Q

What is an example of a non-nucleoside reverse transcriptase inhibitor (NNRTI)?

A

Nevirapine

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15
Q

When do you start treatment for HIV?

A

At the time of diagnosis- don’t wait for symptoms

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16
Q

What is AID’s?

A

Advanced stage of HIV

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17
Q

Why does AIDs develop?

A

cART has not stopped the spread of infection.

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18
Q

How is AID’s defined?

A

Evidence of an AIDS defining illness

Alongside a CD4 count of less than 200. (Normal 500-1200 cells/mm3)

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19
Q

What is the most common opportunistic infection?

A

Pneumocystis Jiroveci Pneumonia

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20
Q

How does Pneumocystis Jiroveci Pneumonia present?

A

Dyspnoea
Cough
Fever
Chest signs

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21
Q

What is a common complication of Pneumocystis Jiroveci Pneumonia?

A

Pneumothorax

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22
Q

How does Pneumocystis Jiroveci Pneumonia stain?

A

With silver stain

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23
Q

What is the main investigation for Pneumocystis Jiroveci Pneumonia?

A

Chest x-ray

Bilateral pulmonary interstitial filtrates

24
Q

What is the management for Pneumocystis Jiroveci Pneumonia

A

Co-trimoxazole

25
Q

Who is prophylaxis co-trimoxazole given to?

A

To patients with a CD4 under 200/mm3 to protect against pneumocystis jirovecii pneumonia (PCP).

26
Q

What is the cause of 50% of cerebral lesions in someone with HIV?

A

Toxoplasmosis

27
Q

How does toxoplasmosis present?

A

Constitutional symptoms
Headache
Confusion
Drowsiness

28
Q

How is toxoplasmosis diagnosed?

A

CT scan

29
Q

What would you see on a CT scan on someone with toxoplasmosis?

A

Multiple ring or nodular enhancing lesions, mass effect may be seen

30
Q

Will a thallium SPECT be positive or negative in someone with toxoplasmosis?

A

Negative

31
Q

What is the management of toxoplasmosis?

A

Sulfadiazine

Pyrimethamine

32
Q

What is the cause of 30% of cerebral lesions in HIV?

A

Primary CNS lymphoma

33
Q

How does Primary CNS lymphoma present?

A

Poorly-defined symptoms of headache and drowsiness

34
Q

What is Primary CNS lymphoma associated with?

A

Epstein- Barr virus

35
Q

How is Primary CNS lymphoma diagnosed?

A

CT head

36
Q

What would you see on a CT scan of someone with Primary CNS lymphoma?

A

Single homogenous enhancing lesions

37
Q

Will a thallium SPECT be positive or negative with HIV?

A

Positive

38
Q

What is the management of Primary CNS lymphoma?

A

Steroids
Chemotherapy (e.g. methotrexate) + possible brain irradiation

Surgical may be considered for lower grade tumours
Commence cART and whole brain irradiation

39
Q

What is the function of steroids in Primary CNA lymphoma?

A

Reduce tumour size

40
Q

What is Kaposi’s sarcoma caused by?

A

HHV-8 (human herpes virus 8)

41
Q

How does Kaposi’s sarcoma present?

A

Purple papules or plaques on the skin or mucosa

42
Q

Where in the body does Kaposi’s sarcoma affect?

A

Gastrointestinal and respiratory tract

43
Q

What might happen to the skin lesions caused by Kaposi’s sarcoma?

A

Ulcerate

44
Q

What might respiratory involvement in Kaposi’s sarcoma cause?

A

May cause massive haemoptysis and pleural effusion

45
Q

What is the management of Kaposi’s sarcoma?

A

Radiotherapy and resection

46
Q

What is less common than Primary CNS lymphoma or Toxoplasmosis?

A

Tuberculosis

47
Q

How is tuberculosis diagnosed?

A

CT scan

48
Q

What would you find on a CT scan of Tuberculosis?

A

Single enhancing lesion

49
Q

What is Progressive multifocal leukoencephalopathy (PML)?

A

Widespread demyelination

50
Q

What is Progressive multifocal leukoencephalopathy (PML) due to?

A

Due to infection of oligodendrocytes by JC virus (a polyoma DNA virus)

51
Q

How does Progressive multifocal leukoencephalopathy (PML) present?

A

Behavioural changes
Speech
Motor
Visual impairment

52
Q

How is Progressive multifocal leukoencephalopathy (PML) diagnosed?

A

CT

MRI

53
Q

What is the best method of diagnosis for Progressive multifocal leukoencephalopathy (PML)?

A

MRI

54
Q

What would you find on a CT scan if someone has Progressive multifocal leukoencephalopathy (PML)?

A

Single or multiple lesions

55
Q

What would you find on an MRI if that person has Progressive multifocal leukoencephalopathy (PML)?

A

Demyelinating white matter lesions are seen

56
Q

What is the JC virus and what does it cause?

A

A polyoma DNA virus

Causes Progressive multifocal leukoencephalopathy (PML)

57
Q

When would a pregnant woman be offered a c-section with HIV?

A

If her viral load is above 50

Infection (25 decks)

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