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HIV Flashcards

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1
Q

Define localized infection

A

infections limited to small areas

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2
Q

define disseminated infection

A

infection that has spread to areas of the body beyond initial location

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3
Q

define systemic infection

A

infections that have spread throughout the body- often via blood

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4
Q

describe bacteria

A

bacteria are one celled organisms common throughout nature and within the body

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5
Q

how do bacteria cause disease in the body

A

entering the body and growing inside human cells

secreting toxins that damage cells

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6
Q

what are the shapes of bacteria?

A

cocci, bacilli, curved rods, vibrio, spirochetes

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7
Q

What is the structure of viruses

A

they are infectious particles consisting of RNA or DNA and a protein coat

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8
Q

What are protozoa

A

single-celled microorganisms that normally live in soil and water. Malaria

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9
Q

What are prions

A

infectious particles that contain abnormally shaped proteins
typically affect nervous system
Creutzfeldt-jakob disease

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10
Q

define emerging infections

A

an infectious disease that has recently increased in incidence or that threatens to increase in the immediate future

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11
Q

where do emerging infections originate

A

unknown sources, contact with animals, changes in known disease, biologic warfare

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12
Q

What are some examples of emerging infections

A

West nile virus, Ebola, H1N1, lyme disease, PUD, E.coli, HIV, Hepatitis

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13
Q

Examples of Reemerging infections

A

Diptheria, Pertussis, Plague, TB,

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14
Q

What is resistance

A

occurs when pathogenic organisms change in ways that decrease the ability of a drug to treat disease

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15
Q

How do microorganisms resist antimicrobial agents?

A

Mutation
Acquisition of new DNA or RNA
producing enzymes that destroy or inactivate drugs
changing drug target sites

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16
Q

Examples of emerging strains of antibiotic resistant organisms

A

Methicillin- Resistant S. Aureus (MRSA)
Vancomycin Resistant Enterococci (VRE)
Penicillin-resistant Streptococcus Pneumonia

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17
Q

How do health care providers contribute to the development of drug-resistant organisms

A

1- administering antibiotics for viral infections
2- succumbing to pressures from pt to prescribe unnecessary antibiotic
3- using inadequate drug regimens to treat infections
4- using broad-spectrum or combination agents that should be treated with first-line medications

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18
Q

How do patients contribute to resistant development

A

1- skipping doses
2-not taking antibiotics for the full duration
3- saving unused antibiotics

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19
Q

What are Health-care associated infections (HAI)

A

infections that are acquired as a result of exposure to a microorganism in a health care setting
- up to 10% of pt will get an HAI

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20
Q

how much HAIs are preventable

A

up to 1/3

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21
Q

What is the first line of defense against an HAI

A

hand washing, PPE

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22
Q

What is the most common HAI in the elderly population

A

UTIs especially in patients in nursing homes

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23
Q

Infections in older adults often present what?

A

atypical symptoms- behavior and cognitive- before normal symptoms (fever/pain) and laboratory findings

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24
Q

when should standard precautions be used?

A

when in contact with, blood, body fluids, nonintact skin, mucous membranes

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25
Q

What population is HIV more prevelent

A

men who have sex with men.

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26
Q

How is HIV transmitted?

A

sexual intercourse, exposure to HIV blood/blood products, perinatal transmission during pregnancy, delivery or breastfeeding

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27
Q

When can an HIV positive person transmit the virus

A

a few days after becoming infected until death

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28
Q

What are the variables that influence HIV transmission?

A

duration and frequency of contact with virus
volume, virulence and concentration of organism
host immune status

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29
Q

What is the most common way HIV is transmitted?

A

through unprotected sex

30
Q

how has the greater risk of developing HIV during sex

A

the receiving partner- although the “inserting partner” is still at risk

31
Q

Why is the receiving partner more at risk of developing HIV during sex

A

due to prolonged contact with infected fluid

32
Q

how is HIV transmitted through contact with blood and blood products?

A

contaminated equipment- sharing equipment

transfusions

33
Q

What is the most common means of work-related HIV transmission?

A

puncture wounds- although the risk is till very low

34
Q

How does the HIV virus enter normal cells?

A

The gp120 “knobs” on the virus attach to the specific CD4 and chemokine receptors

35
Q

Once in the cell (usually CD4 T cells) what does the HIV virus do?

A

viral RNA enters the cell where it is transcribed with the help of a reverse transcriptase into a single strand of viral DNA

36
Q

What happens next to the single strand of viral DNA?

A

it copies it self becoming a double strand of viral DNA and enters the cell’s nucleus with the help of the enzyme integrase

37
Q

Once the double stranded viral strand of HIV is in the nucleus what happens?

A

The DNA splices itself into the human genome becoming a permanent part of the genetic structure which causes all daughter DNA to have the same DNA and make new HIV

38
Q

What does the initial HIV infection result in

A

viremia- large amounts of virus in the blood for a couple of weeks followed by low levels of HIV

39
Q

what is a major consequence of the rapid replication of HIV

A

errors can occur in the copying process, causing mutations that can contribute to resistance to ART and limit treatment options

40
Q

in the initial stages of the HIV infection, how do B cells and T cells respond?

A

They function normally
B cells make HIV specific antibodies which reduce viral load
T cells mount a cellular response to viruses trapped in lymph nodes

41
Q

What cells does HIV predominately affect?

A

CD4+ T cells- which the T cells play an important role in the detection and defense against pathogens

42
Q

What is the normal CD4+ count in a normal adult

A

800-1200 CD4+ T Cells/ microliter

43
Q

what is the normal life span of a CD4+ T cell

A

100 days

44
Q

What is the life span of a CD4+ T cell an an HIV person

A

2 days

45
Q

When do opportunistic infections occur

A

when CD4+ count is below 500

46
Q

What is the pattern that untreated HIV infections follow

A

1- disease progression is highly individualized
2 treatment can significantly alter this pattern
3- an individual’s prognosis is unpredictable

47
Q

Symptoms of the Acute infection of HIV

A

similar to a mononucleousis syndrome
fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and , diarrhea, rash accompanies seroconversion- development of antibodies

48
Q

When do acute HIV symptoms occur

A

within 2-4 weeks of initial infection and they last 1-3 weeks

49
Q

During acute infection what is the viral load at?

A

the viral load is typically high and CD4+ T cells are low but this quickly returns to normal or baseline

50
Q

what is the interval between initial HIV infection and AIDs

A

about 10 years

51
Q

During the asymptomatic infection phase of HIV what is the viral load

A

the viral load is low and the CD4+ T cell level remains above 500

52
Q

during the asymptomatic phase of HIV what are some symptoms that may appear?

A

fatigue, headache, low-grade fever, night sweats, persistent generalized lymphadenopathy

53
Q

When does symptomatic infection occur in HIV

A

when the CD4+ T cell count drops to 200-500

54
Q

What are the symptoms of HIV in the symptomatic infection stage

A

persistent fever, frequent drenching night sweats, chronic diarrhea, recurrent headaches, and fatigue, localized infections, lymphdenopathy, nervous system manifestations

55
Q

what is the most common infection associated with the symptomatic phase of HIV infection

A

oropharyngeal candidasis- thrush
shingles
outbreaks of herpes
oral hairy leukoplakia

56
Q

What is the diagnostic criteria for AIDS

A 
CD4+ T cells below 200
Opportunistic Infection
Opportunistic Cancer - invasive cervical cancer, kaposis sarcoma, burkitt's lymphoma, immunoblastic lymphoma, primary lymphoma of the brain
Wasting syndrome
AIDS dementia complex
57
Q

How do you diagnose HIV infection

A

testing the blood for HIV antibodies or antigen in the blood- typically detects HIV specific antibodies
typically take several weeks

58
Q

how is the progression of HIV monitored

A

CD4+ T cell counds and viral load

59
Q

As HIV progresses what happens to the CD4+ T cell cound

A

the t cell number decreases

60
Q

If the viral load is undetectable what does that mean?

A

that the viral load is lower than the test is able to report

61
Q

Why are abnormal blood tests common in HIV infections

A

HIV, opportunistic disease, complications of therapy

62
Q

why is anemia common in HIV patient

A

it is associated with the chronic disease process and an adverse effect of ART

63
Q

What are the two types of resistance tests that can determine if a patient is resistant to drugs used for ART

A

Genotype Assay- detects drug resistant viral mutations

Phenotype Assay- measures growth of HIV in various concentrations of ART

64
Q

what is the focus of collaborative care in HIV infected Patients

A

1- monitoring HIV disease progression and immune function
2- initiating and monitoring ART
3- preventing the development of opportunistic disease
4- detecting and treating opportunistic disease
5- managing symptoms
6- preventing or decreasing complications of treatment
7- preventing further transmission of HIV

65
Q

What is the goal of drug therapy in HIV infection

A

1- decrease the viral load
2- maintain or increase CD4+ T cell counts
3- prevent HIV-related symptoms and opportunistic disease
4- delay disease progression
5- prevent HIV transmission

66
Q

How much can ART reduce viral load

A

90-99%

67
Q

What is the advantage of using multiple ART?

A

is that the combination therapy can inhibit viral replication in several ways making it more difficult for the virus to recover and decreasing the likelihood of drug resistance

68
Q

what is truvada

A

truvada is the first drug approved to reduce the risk of HIV in uninfected individuals who are at high risk of HIV

69
Q

Health Promotion of HIV

A 
prevention of HIV 
Decreasing risk related to sex
Decreasing risk of perinatal transmission
decreasing risks at work
HIV testing
70
Q

Acute Intervention of HIV

A

initial response to diagnosis of HIV
antiretroviral therapy
delaying disease progression

Nursing 337 (9 decks)

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