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Kumar Mada > Hiv > Flashcards

Hiv Flashcards

1
Q

Semne clinice de imunosupresie

A

Cadran 37.15
Candidoza orală
Leucoplazie păroasă orală

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2
Q

Pt tratament
Ce faci la examen clinic complet

A

Te uiți de RA
Sepsis
Imunosupresie
Neuro de focar sau meningism
Alterarea statusului mental organic sau fct
Examen *genital
*fund ochi
*cav bucala
Sistem ggl

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3
Q

Investigații imediate

A
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4
Q

Evaluarea *formulei leucocitare și a *încărcăturii virale HIV

poate furniza rezultate eronate in cadrul unei infectii acute intercurente(infecție cu criptocous de ex)

A

Da lol de-asta treb sa aștepți pana dai tratament

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5
Q

Când trebuie inițiată terapia antiretrovirală

A

Toți pacienții
Indiferent de CD4

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6
Q

Ce sta la baza deciziei terapeutice

A

încărcătura virală
genotip
CD4
Comorbidități
Medicația curenta
Circumstanțele individuale

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7
Q

Pp riscuri ale terapiei

A

-Ef secundare
-Interacțiuni medicamentoase
-Potențialul de selecție a unor tulpini virale rezistente

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8
Q

De ce au nevoie inhibitorii de revers transcriptaza nucleotidici?

A

De fosforilare INTRACELULULARA
nucleotidici TENO 2 etape
Nucelozidici 3 etape

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9
Q

Ce e TAF Tenofovir alafenamida

A

Un prodrog care are mai puțin tenofovir dar are aceeași putere de omorârea virusologica

Dar cu toxicitate osoasa și renală mai mică

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10
Q

sinergism INRT + IP

A

inh de fuziune

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11
Q

molecule mici

A

INNRT

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12
Q

active la concentratii mici

A

proteaza

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13
Q

bilirubina neconj

A

Atazanavir

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14
Q

sinergism INRT

A

Inhibitorii de proteaza

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15
Q

interactioneaza cu antiacide

A

Rilpivirina

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16
Q

Contraindicat IPP

A

Rilpivirina

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17
Q

1/2 crescut

A

INNRT
special
*Efavirentz
si
*Nevirapina

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17
Q

cea mai frecventa RA =eruptia cutanata

A

Etravirina

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17
Q

nu se foloseste la
CD 4 femei >250
CD 4 barbati >400

A

Nevirapina

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17
Q

Toxic SNC

A

Efavirenz

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18
Q

incrucisat

A

INNRT
IP

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19
Q

boosting

A

IP

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20
Q

sinergism cu inh de revers transcriptaza

A

inh de proteaza

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21
Q

electie

A

Rilpivirina si multe altele

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21
Q

++cobicistat

A

proteaza
si
ElviteGRAVIR

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22
Q

mai degraba ALTERNATIVA decat electie

A

Efavirentz

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22
Q

buni in rezistenta la tulpini cu integraza

A

BigteGRAVIR

23
Q

crestere usoara creatinina

A

Dolutegravir

23
Q

toxicitate mitocondriala

A

INRT
in special cele vechi
STAVUDINA
DIDANOZINA

24
Q

icter

A

Atazanavir

25
Q

metabolism glucidic si lipidic

A

Inh Proteaza (IP)

26
Q

in particular cresterea trigliceridelor

A

inh proteaza

27
Q

tulburari gastrointestinale

A

AtazaNAVIR
DaruNavir

28
Q

citocrom P450

A

INNRT
IP majoritatea
II Elvitegravir (dai C)
Maraviroc

29
Q

competitiv pe enzima

A

inh de proteaza

PC-proteaza=competitiv

30
Q

inh. selectiv

A

inh de integraza

SIda=Selectiv integraza

31
Q

<100.000

A

L+A
Rilpivirin

32
Q

eruptii cutanate si ++ enzime hepatice

A

INNRT

33
Q

complicatii renale + osoase

A

INRT

34
Q

disfunctie renala

A

tenofovir

35
Q

gen 1 de 2xzi

A

RalteGRAVIR

36
Q

gen 2 de 1xzi

A

DoluteGRAVIR

37
Q

experimentati

A

Integraza( ca poti da si exp si naivi)
Etravirina

38
Q

oarecare activitate pe tulpinile virale rezistente

tip! e din INNRT

A

Etravirina

39
Q

linia 2 de 2x/zi

A

Etravirina

39
Q

nu incepi tratamentul cu el

A

Nevirapina

40
Q

cel mai nou integraza

A

Bigtegravir

41
Q

blocheaza secretia tubulara

SECRETIAAAAAAAAAAAAAAAAAAAA

A

Dolutegravir

42
Q

Dezavantaj polipragmazia

+interactiuni medicamentoase, met lipidic in special TGL

A

proteaza

43
Q

polipragmazia

A

proteaza

44
Q

afectarea functie coagulare la pacientii cu hemofilie

A

proteaza

45
Q

bariera inalta

A

inh proteaza
INRT

dolutegravir are bariera mai inalta decat raltegravir

46
Q

Maraviroc
ccr…

A

Mara 5

47
Q

Cum dai maraviroc asa oricum

A

Teste de tropism CCR5

48
Q

tulpini prezente in primele faze

A

ccr5?

49
Q

peptid injectabil din GP 41

A

inh de fuziune —ENFUVIRTIDE

50
Q

fosforilare INTRACELULARA

A

INRT- LATE

51
Q

mecanism de act extracelular

A

inh de fuziune —ENFUVIRTIDE

52
Q

Exista *rezistenta la enfuvirtide?
dar
*rezistenta incrucisata cu alte clase de medicamente

*interactiuni medicamentoase putine/multe?

A

rezistenta la enfuvirtide DA

cruce NU

interactiuni medicamentoase putine

53
Q

atc monoclonal umanizat

A

Bali

ibalizumab

54
Q
A
55
Q

sc.

A

enfuvirtide

56
Q

iv.

A

ibalizumab

57
Q

blocheaza intrarea hiv in celula

A

bali
ibalizumab

58
Q

nu exista dovezi pt rezistenta incrucisata pt alte clase de med

A

enfuvirtide

59
Q
A

Kumar Mada (3 decks)

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