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Y3 Reproduction > HIV > Flashcards

HIV Flashcards

1
Q

what type of virus is HIV?

A

an RNA retrovirus

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2
Q

what enzyme do retroviruses use to replicate?

A

reverse transcriptase

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3
Q

what are the two broad groups of HIV?

A

HIV 1

HIV 2

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4
Q

what group of HIV is responsible for the global epidemic?

A

HIV 1 group M

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5
Q

how long does it take for a new generation of HIV to be produced?

A

6-12 hours

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6
Q

what is infected in HIV?

A

CD4 cells

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7
Q

how long does it take for HIV infection to be established?

A

three days

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8
Q

what is the target site for HIV?

A

CD4+ receptors

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9
Q

what cell types are CD4+ receptors found on?

A

t helper cells
dendritic cells
macrophages
microglial cells

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10
Q

what are HIV patients susceptible to?

A

viral, fungal and mycobacterial infections

infection induced cancers

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11
Q

what is a normal CD4 cell count?

A

500 - 1600

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12
Q

at what CD4 count is there the highest risk of opportunistic infection?

A

<200

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13
Q

what is the average time to death without treatment in HIV?

A

9-11 years

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14
Q

when does the onset of primary HIV infection occur?

A

2-4 weeks post infection

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15
Q

how does primary HIV infection present?

A 
fever
rash 
myalgia 
pharyngitis 
headache
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16
Q

what is risk of transmission like in primary HIV infection?

A

very high

massive viral load

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17
Q

what is an opportunistic infection?

A

an infection caused by a pathogen that does not normally produce disease in a healthy individual

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18
Q

what organism causes pneumocystis pneumonia?

A

pneumocystis jiroveci

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19
Q

what is the CD4 threshold for pneumocystis pneumonia?

A

<200

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20
Q

how does pneumocystis pneumonia present?

A

insidious onset
SOB
dry cough

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21
Q

what sign can be seen in pneumocystis pneumonia?

A

exercise oxygen desaturation

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22
Q

what can be seen on CXR in pneumocystis pneumonia?

A

interstitial infiltrates

reticulonodular markings

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23
Q

how is pneumocystis pneumonia diagnosed?

A

bronchoalveolar lavage (BAL)
immunofluorescence
PCR

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24
Q

how is pneumocystis pneumonia managed?

A

high dose co-trimoxazole +/- steroid

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25
Q

what is the prophylaxis given for pneumocystis pneumonia?

A

low dose co-trimoxazole

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26
Q

who is given prophylaxis for pneumocystis pneumonia?

A

everyone with CD4 count <200

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27
Q

what organism causes cerebral toxoplasmosis?

A

toxoplasma gondii

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28
Q

what is the CD4 threshold for cerebral toxoplasmosis?

A

<150

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29
Q

what does cerebral toxoplasmosis cause ?

A

formation of multiple cerebral abscesses

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30
Q

how does cerebral toxoplasmosis present?

A 
headache 
fever 
focal neurological symptoms 
seizures 
reduced consciousness 
raised ICP
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31
Q

what is the CD4 threshold for cytomegalovirus?

A

<50

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32
Q

what does cytomegalovirus cause?

A

retinitis
colitis
oesophagitis

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33
Q

how does cytomegalovirus present?

A 
reduced VA
floaters 
abdominal pain 
diarrhoea 
PR bleeding
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34
Q

what type of screening should all individuals with CD4 <50 receive and why?

A

ophthalmic screening

complications of cytomegalovirus

35
Q

what organism causes HIV associated neurocognitive impairment?

A

HIV 1

36
Q

what causes increased incidence of HIV associated neurocognitive impairment?

A

reduced CD4 count

37
Q

how does HIV associated neurocognitive impairment present?

A

reduced short term memory +/- motor dysfunction

38
Q

what organism causes progressive multifocal leukoencephalopathy (PML)?

A

JC virus

39
Q

what is the CD4 threshold for PML?

A

<100

40
Q

how does PML present?

A

rapidly progressive
focal neurological symptoms
confusion
personality changes

41
Q

what skin infections can be seen in HIV patients?

A

herpes zoster
herpes simplex
HPV

42
Q

name three AIDS related cancers

A

kaposi’s sarcoma
non Hodgkin’s lymphoma
cervical cancer

43
Q

what organism is associated with kaposi’s sarcoma in HIV?

A

human herpes virus 8

44
Q

what is kaposi’s sarcoma?

A

a vascular tumour

45
Q

how is kaposi’s sarcoma managed?

A

anti retrovirals
local therapies
systemic chemo

46
Q

what organism is associated with non-hodgkin’s lymphoma in HIV patients?

A

EBV

47
Q

what test should be offered to all patients with complicated HPV disease?

A

HIV testing

48
Q

what are the three possible methods for transmission of HIV?

A

sexual
parenteral
mother to child

49
Q

what is the most common mode for transmission of HIV?

A

sexual transmission

50
Q

what factors can increase risk for sexual transmission of HIV?

A

anoreceptive sex
trauma
genital ulceration
concurrent STIs

51
Q

what are three possible methods of parenteral transmission of HIV?

A

injecting drugs
infected blood products
iatrogenic

52
Q

when can mother to child transmission of HIV occur?

A

in utero
delivery
breast feeding

53
Q

what three markers can be used to detect HIV infection?

A

viral RNA
p24 antigen
HIV antibody

54
Q

what is the first marker to become positive in HIV?

A

viral RNA

55
Q

when is the p24 antigen positive in HIV?

A

around 6 weeks

56
Q

when is the HIV antibody detectable in HIV?

A

can take three months

57
Q

what do third generation HIV tests test for?

A

antibody

58
Q

what do fourth generation HIV tests test for?

A

antibody and antigen

59
Q

what is needed to perform a rapid HIV test?

A

finger prick blood specimen or saliva

60
Q

how long does a rapid HIV test take?

A

20-30 mins

61
Q

how long is the window period in which you can have HIV but have negative test?

A

45 days

this is for 4th generation tests

62
Q

when should HIV treatment be started?

A

ASAP at all CD4 counts

63
Q

what are the four groups of available anti-retroviral drugs?

A

reverse transcriptase inhibitors
integrase inhibitors
protease inhibitors
entry inhibitors

64
Q

what are the two types of reverse transcriptase inhibitors?

A

nucleoside analogues

non nucleoside analogues

65
Q

what does HAART stand for?

A

highly active anti-retroviral therapy

66
Q

what is HAART?

A

a combination of three drugs from at least two drug classes to which the virus is susceptible

67
Q

what are the four possible groups of anti-retroviral drugs?

A

reverse transcriptase inhibitors

integrase inhibitors

protease inhibitors

entry inhibitors

68
Q

what are the two types of reverse transcriptase inhibitors?

A

nucleoside analogues

non nucleoside analogues

69
Q

what does HAART stand for?

A

highly active anti-retroviral therapy

70
Q

what is HAART?

A

a combination of 3 drugs from at least 2 classes to which HIV is susceptible

71
Q

what does PrEP stand for?

A

pre exposure prophylaxis

72
Q

who is given PrEP?

A

high risk individuals

73
Q

what are the possible dosing schedules for PrEP?

A

daily or on demand

74
Q

what drugs are given as PrEP?

A

tenofovir or emtricitabine

75
Q

what is PEP?

A

post exposure prophylaxis

76
Q

when should PEP be started?

A

within 72 hours of a high risk exposure

77
Q

how long is PEP given for?

A

four weeks

78
Q

what is given as PEP?

A

tenofovir/emtricitabine

raltegravir

79
Q

what should be given to pregnant women with HIV?

A

HAART during pregnancy

80
Q

how can a mother with HIV deliver if she has an undetectable viral load?

A

vaginally

81
Q

how can a mother with HIV deliver if she has a detectable viral load?

A

c section

82
Q

how long should neonates born to HIV positive mothers receive PEP?

A

two to four weeks

83
Q

how can HIV positive mothers feed their babies?

A

exclusively formula feeding

Y3 Reproduction (49 decks)

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