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MF2 Immunology > HIV > Flashcards

HIV Flashcards

1
Q

This HIV protein binds cell surface proteins CD4 and CCR5

A

p120

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2
Q

What is protein p120?

A

Protein on HIV that binds cell surface proteins CD4 and CCR5
Both proteins needed for infection to occur

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3
Q

People with this homozygous mutation are resistant to HIV infection

A

CCR5
Both CD4 and CCR5 are needed for infection to occur

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4
Q

What is the result of HIV infection of a quiescent T cell?

A

Latent infection
Viral RNA remains linear and cytoplasmic

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5
Q

What is the result of HIV infection of an activated proliferating T cell?

A

Cell death
Viral RNA integrates into host genome

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6
Q

Type of T cell that Proliferating infected cell sheds virus and is killed

A

Th cells

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7
Q

2 cells that are not killed by HIV infection, but serve as reservoirs of infection (important when Th count is very low)

A

Macrophage and Dendritic cell

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8
Q

Probable initial infected cell at mucosal inoculation

A

Dendritic cell

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9
Q

Cell that Brings infection to other tissue sites (microglia, etc)

A

Macrophage

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10
Q

Cell that Brings HIV infection to lymph nodes and more CD4+ T cells

A

Dendritic cell

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11
Q

This begins 3-6 weeks after HIV infection and lasts 2-4 weeks

A

Acute retroviral syndrome

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12
Q

How do you get loss of barrier function at mucosal sites and microbial invasion often with diarrhea in acute retroviral syndrome?

A

Infection and death of memory T cells at mucosal site

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13
Q

How do you get generalized lymphadenopathy and viremia in acute retroviral syndrome?

A

Dendritic cells bring HIV to lymph nodes

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14
Q

Acute retroviral syndrome is characterized by generalized ______ and _______

A

Lymphadenopathy and Viremia

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15
Q

When does seroconversion (making Abs; humoral response) occur in acute retroviral syndrome?

A

3-7 weeks

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16
Q

Fever, sore throat, fatigue, rash, and lymphadenopathy are symptoms of this

A

Acute retroviral syndrome

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17
Q

What affect does the cell-mediated response have on viremia?

A

Decreased

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18
Q

When does the cell-mediated response (and subsequent decreased viremia) occur in acute retroviral syndrome?

A

12 weeks

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19
Q

Does the humoral response or cell-mediated response occur 3-7 weeks in acute retroviral syndrome?

A

Humoral (seroconversion)

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20
Q

Does the humoral response or cell-mediated response occur 12 weeks in Acute retroviral syndrome?

A

Cell mediated (decrease viremia)

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21
Q

Seroconversion takes 3-7 weeks after infection, and these are detectable a little earlier

A

Viral particles or p24 capsid protein

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22
Q

Long period of stable viremia and gradual decreased CD4+ T cells

A

Latency period

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23
Q

CD4 count trend in latency period

A

Gradually decreases

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24
Q

Viral load count trend in latency period

A

Gradually increases

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25
Q

Period where HIV is replicating in spleens, lymph nodes

A

Latency period

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26
Q

Symptoms of HIV during the latency period

A

Usually asymptomatic
May have minor opportunistic infections (Candida, Tb, Herpes)
Occasionally have autoimmune thrombocytopenia

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27
Q

Level of viremia reaches plateau with onset of this

A

Cell mediated response

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28
Q

This level predicts the time course to AIDS

A

Level of viremia that reaches plateau with CMI onset

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29
Q

This count is assessment of current immune deficiency

A

CD4 count

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30
Q

Viremia level of >36k predicts 62% chance of this at 5 years

A

AIDS

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31
Q

Viremia level of <4k predicts 5% chance of this at 5 years

A

AIDS

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32
Q

Viremia level of this predicts 62% chance of AIDS at 5 years

A

> 36k

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33
Q

Viremia level of this predicts 5% chance of AIDS at 5 years

34
Q

When does AIDS occur?

A

Generally 5-10 years after initial infection

35
Q

AIDS is defined by a CD4 count of this

A

<200 cells/ul

36
Q

AIDS is defined by either of these

A

CD4 count <200 cells/ul OR
AIDS defining illnesses

37
Q

This is Often preceded by constitutional SSx, generalized LAD, fever

38
Q

Viral load count trend in AIDS

A

Dramatically increases slope

39
Q

CD4 count trend in AIDS

A

Loss accelerates

40
Q

6 AIDS defining illnesses

A

Viral
Pneumocystic pneumonia
Mycobacteria
Recurrent bacterial pneumonia
Fungal infections
Neoplasms

41
Q

AIDS defining illness:
What cell dysfunction causes bacterial pneumonia?

A

B cell and neutrophil dysfunction

42
Q

AIDS defining illness:
In bacterial pneumonia, what type of bacteria are patients most vulnerable to?

A

Encapsulated bacteria (due to poor opsonization)
Includes pneumococcus, haemophilus, staph aureus

43
Q

AIDS defining illness:
Occurs early, incidence 10-20x
Due to B cell and neutrophil dysfunction

A

Bacterial pneumonia

44
Q

AIDS defining illness:
Occurs anytime, usually early (CD4 ~ 325)
Restricted to lungs if CD4 count relatively high
(Pneumonia, Cavitary disease, Hilar lymph nodes)
Disseminated disease if CD4 count low
(Bone marrow, adrenals, etc)

A

Tuberculosis

45
Q

AIDS defining illness:
Tuberculosis trend if CD4 count is relatively high

A

Restricted to lungs
Pneumonia, cavitary disease, hilar lymph nodes

46
Q

AIDS defining illness:
Tuberculosis if CD4 count is low

A

Disseminated disease
Bone marrow, adrenals, etc

47
Q

AIDS defining illness:
Kaposi Sarcoma is always associated with this

A

HHV8 (human herpes virus) infection

48
Q

HHV8 (human herpes virus) infection is always associated with this AIDS defining illness

A

Kaposi Sarcoma

49
Q

Blue-violaceous-brown maculopapular skin lesions are characteristic of this AIDS defining illness

A

Kaposi Sarcoma

50
Q

AIDS defining illness:
When does bacterial pneumonia occur?

A

Early
Incidence 10-20x

51
Q

AIDS defining illness:
When does tuberculosis occur?

A

Anytime, usually early (CD4 ~ 325)

52
Q

AIDS defining illness:
When does Kaposi Sarcoma occur?

53
Q

AIDS defining illness:
When does lymphoma occur?

54
Q

AIDS defining illness:
Lymphoma is associated with this coinfection

55
Q

AIDS defining illness that is associated with EBV coinfection

56
Q

Lymphoma is typically this cell lineage

57
Q

AIDS defining illness:
Lymphoma is frequently located

A

Extra-nodal

58
Q

AIDS defining illness:
2 common types of lymphoma

A

Burkitt lymphoma
Diffuse large B-cell lymphoma

59
Q

AIDS defining illness:
When does Pneumocystis occur?

A

CD4 < 200
Begin prophylaxis

60
Q

AIDS defining illness:
Pneumocystis is caused by this

A

Unicellular fungal organism

61
Q

AIDS defining illness characterized by:
Non-productive cough, Fever, and bilateral fluffy infiltrates (not always present with low CD4)

A

Pneumocystis

62
Q

AIDS defining illness:
Involves bilateral fluffy infiltrates (not always present with low CD4)

A

Pneumocystis

63
Q

AIDS defining illness:
Unicellular fungal organism causes this

A

Pneumocystis

64
Q

AIDS defining illness:
When does Cryptococcus infection occur?

65
Q

AIDS defining illness:
2 forms of Cryptococcus

A

Pneumonia or disseminated forms

66
Q

AIDS defining illness:
Encapsulated yeast; visible with mucicarmine or India ink preparations

A

Cryptococcus

67
Q

AIDS defining illness:
Cryptococcus is visible with either of these 2 preparations

A

Mucicarmine or India Ink preparations

68
Q

AIDS defining illness:
When does taxoplasmosis occur?

69
Q

AIDS defining illness:
CNS disease producing abscesses
“Ring enhancing lesions” as seen on brain scans

A

Toxoplasmosis

70
Q

AIDS defining illness:
“Ring enhancing lesions” as seen on brain scans

A

Toxoplasmosis

71
Q

AIDS defining illness:
Toxoplasmosis involves these seen on brain scans

A

Ring enhancing lesions

72
Q

AIDS defining illness:
What is taxoplasmosis?

A

CNS disease producing abscesses

73
Q

AIDS defining illness:
When does Mycobacterium avium-intracellulare occur?

74
Q

AIDS defining illness:
Fever, weight loss, night sweats
Initial pulmonary infection
Disseminated form

A

Mycobacterium avium-intracellulare

75
Q

AIDS defining illness:
When does cytomegalovirus infection occur?

76
Q

AIDS defining illness:
3 characteristics of cytomegalovirus infection

A

Retinitis (painless vision loss, floaters)
Colitis (diarrhea)
Esophagitis (odynophagia, dysphagia)

77
Q

AIDS defining illness:
Characterized by retinitis, colitis, esophagitis

A

Cytomegalovirus

78
Q

AIDS defining illness:
Neoplasms are often associated with this

A

Viral associated
(Cervical or anal squamous cell carcinoma, Non-Hodgkin lymphoma, Hodgkin lymphoma, Kaposi sarcoma)

79
Q

2 tests for initial HIV diagnosis

A

Antibody test
p24 antigen test

80
Q

3 confirmatory tests for HIV diagnosis

A

HIV antibody specific assay
HIV viral RNA
Ab- with RNA+ : recent infection (window period; blood test not positive yet)

MF2 Immunology (21 decks)

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