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Summer > HIV > Flashcards

HIV Flashcards

1
Q

HIV transmission

A 
Blood
- transfusion 
- injection drug use 
Sexual intercourse
- heterosexual 
- male to male 
Perinatal 
- intrapartum 
- breast feeding
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2
Q

HIV vs AIDS

A

HIV= virus without AIDS defining illness
AIDS= HIV + AIDS defining illness OR
= HIV + CD4 count <200

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3
Q

Examples of aids defining illnesses

A 
Candidiasis 
Disseminated Isosporiasis 
Kaposi sarcoma 
Lymphoma 
Pneumocystis carinii pneumonia
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4
Q

HIV symptoms

A

Lymphadenopathy
Fever
Unexpected weight loss
Night sweats

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5
Q

Pneumocystis pneumonia gold standard test

A

Silver stain on sputum sample

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6
Q

Pneumocystis pneumonia new test

A

PCR based

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7
Q

Pneumocystis pneumonia CXR pattern

A

bilateral hilar infiltrate- butterfly pattern

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8
Q

Pneumocystis pneumonia symptoms

A

Fever
Dry cough
SOB
Fatigue

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9
Q

Pneumocystis pneumonia treatment

A

high dose trimethoprim/ sulfamethoxazole
15-20mg/kg IV q day / 6-8h dosing

Prednisone if <70% PaO2

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10
Q

Pneumocystis pneumonia ppx

A

at CD4 count <200
trim/sulfa PO- lower dose than tx

Dapsone or pentamidine

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11
Q

Pneumocystis pneumonia ppx alternatives to trim/sulfa

A

Dapsone or inhaled pentamidine

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12
Q

what is kaposi sarcoma

A

purplish brownish lesions

body wide- including mouth

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13
Q

most prevalent HIV in US?

A

HIV 1

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14
Q

HIV enters CD4 via what receptors ?

A

CCR5 and CXCR4

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15
Q

HIV historic test and confirmation

A

ELISA
- HIV ab - 4-12 w
Western blot confirmation

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16
Q

HIV new recommended test and confirmation

A

Combo or 4th gen
- HIV ab and ag - 2-6 w
HIV RNA by PCR

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17
Q

HIV tx typical backbone

A

2 NRTIs

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18
Q

HIV tx typical base

A

either NNRTI or PI

19
Q

NRTIs

TEAL

A 
Zidovudine (AZT) 
Lamivudine (3TC) 
Abacavir (ABC) 
Emtricitabine (FTC) 
Tenofovir (TAF) 
- Disoproxil 
- Alafenamide
20
Q

NNRTIs

NDEER

A 
Nevirapine (NVP) 
Delavirdine (DLV) 
Efavirenz (EFV) 
Etravirine (ETR) 
Rilpivirine (RPV)
21
Q

PIs (-navir)

LARD

A

Ritonavir (RTV)
Lopinavir (LPV)
Atazanavir (ATV)
Darunavir (DRV)- recommended

22
Q

INSTIs (-egravir)

RED

A

Raltegravir (RAL)
Elvitegravir (EVG)
Dolutegravir (DTG)

23
Q

HIV combo meds (once daily dosing)

A

Atripla (Efavirenz + Emtricitabine + Tenofovir Disoproxil)

Stribild (Elvitegravir + Cobicistat + Emtricitabine + Tenofovir Disoproxil)

Genvoya (Elvitegravir + Cobicistat + Emtricitabine + Tenofovir Alafenamide)

Complera (Rilpivirine + Emtricitabine + Tenofovir Disoproxil Fumarate)

Odefsey (Rilpivirine + Emtricitabine + Tenofovir Alafenamide)

Triumeq (Dolutegravir + Abacavir + Lamivudine)

24
Q

Triumeq needs what prior to initiation

A

HLAB 5701 testing

25
Q

HLAB 5701 testing is needed due to what med?

26
Q

CD4 monitoring

A
  • At baseline (x2) + 3-6 m
  • before starting ART
  • q3-6 m first 2 yrs of ART or if CD4 <300
  • after 2 y of ART w HIV RNA consistently suppressed
  • — 300-500= q 12m
  • — >500= optional
27
Q

HIV ART adverse effects

A 
Rash 
Diarrhea 
Pancreatitis 
Hyperlipidemia and lipodystrophy 
Increased cardiac risk 
CNS effect- psychological disturbances
28
Q

NRTIs adverse effects

A

lactic acidosis and hepatic steatosis

29
Q

NNRTIs adverse effects

A

rash including SJS

30
Q

PIs adverse effects

A

hyperlipidemia and lipodystrophy

GI
Bleeding risk

31
Q

Immune reconstitution syndrome is

A

inflammatory reaction in response to rapid reconstitution of CD4 counts- a diagnosis of exclusion

happens after HAART initiation

32
Q

TOXO indication and regimen

A

CD4 <100 + IgG

Tri sulfa or dapsone + pyrimethamine

33
Q

MAC indication and regimen

A

CD4 <50

clarithro/azithro

34
Q

TB indication and regimen

A

+PPD (5mm)

INH- 9 m

35
Q

HIV- Post exposure PPX within ___ and given for ____

Agent = ___

A

72h
1m
Truvada/ Raltagravir

36
Q

HIV Pre exposure PPX

Agent= ____

A

Truvada- 1 daily - M, F, T

Descovy- 1 daily- M, T

Cabotegravir- q 2 m (injection)- M, F, T

37
Q

Indications for PrEP in sexually active

A

Anal or vag sex in past 6 m
HIV + partner or unknown or detectable VL
1 or more sex partners of unknown HIV status and did not use condoms
Bacterial STI in past 6m

38
Q

Indications for PrEP in persons who inject drugs

A

injected drugs past 6m

shared injection equipment

39
Q

Perinatal transmission prevention of HIV

A

AZT (zidovudine) as early as 14w

40
Q

Coccidioidomycosis “valley fever” symptoms, diagnosis and tx

A

Flu like- fever, night sweats
Serology
None - if RFs or persistent/severe- Diflucan

41
Q

Histoplasmosis symptoms, diagnosis and tx

A

bird droppings or bat guano
asymp
antigen test or tissue bx
Itraconazole or Amp B

42
Q

Blastomycosis symptoms, diagnosis and tx

A

soil or dust
asymp
Bx or culture
Itraconazole or Amp B

43
Q

Toxoplasmosis symptoms and imaging characteristic

A

cats
focal neurological findings, fever
punched out lesions on MRI

Summer (7 decks)

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