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Microbiology - Virology > HIV > Flashcards

HIV Flashcards

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1
Q

What is the structure of HIV?

A

Diploid genome - 2 molecules of +ssRNA, enveloped

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2
Q

What are the three structural genes of HIV?

A

env, gag, pol

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3
Q

What does env code for?

A

gp120 and gp41: Formed from cleavage of gp160 to form envelope glycoproteins

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4
Q

What does gp120 do?

A

Docking glycoprotein- Attaches to host CD4+ T cell

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5
Q

What does gp41 do?

A

Transmembrane protein that Fusion and entry into host cell

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6
Q

What does gag code for?

A

p24 - capsid protein

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7
Q

What does pol code for?

A

reverse transcriptase; synthesizes dsDNA from genomic RNA, which then integrates into host chromosome

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8
Q

What does HIV bind?

A

CD4 as well as coreceptor - CCR5 on macs (early infection), CXCR4 on T cells (late infection)

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9
Q

What protein mutation can confer immunity to HIV infection?

A

CCR5. Homozyg = immune. Heterozyg = slower course.

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10
Q

What are tat and rev?

A

Two regulatory genes required for transcription.

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11
Q

What is the ELISA test forHIV used for?

A

Presumptive diagnosis - it is a rule-out test, a sensitive test with a high false positive rate and a low threshold.

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12
Q

What is Western blot assay for HIV used for?

A

Rule in test - Specific, low false-positive rate, and high threshold.

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13
Q

What is viral load used for?

A

Monitor effect of drug therapy. High viral load associated with poor prognosis.

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14
Q

What is the cutoff for immuncompromised, and for AIDS?

A

Immunocomp: CD4+ < 400

CD4+ < 200, CD4+ % <14, or HIV+ with AIDS-defining illness eg Pneuomocystis

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15
Q

When may ELISA/Western blot be falsely negative?

A

First 1-2 months of infection.

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16
Q

When may ELISA/Western blot be falsely negative?

A

Babies born to infected mothers; anti-gp120 crosses the plasma.

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17
Q

What is the presentation of candida albicans in HIV+ with CD4 <500?

A

Oral thrush

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18
Q

What are the associated findings of candida in HIV+?

A

Scrapable white plaque, pseudohyphae on microscopy

19
Q

What the presentation of EBV in HIV+ < 500?

A

Oral hairy leukoplakia

20
Q

What are the associated findings of EBV in HIV+ < 500?

A

Unscrapable white plaque on lateral tongue

21
Q

What the presentation of Bartonella in HIV+ < 500?

A

Bacillary angiomatosis

22
Q

What are the associated findings of Bartonella in HIV+ < 500?

A

Biopsy with neutrophilic inflammation

23
Q

What the presentation of HHV-8 in HIV+ < 500?

A

Kaposi Sarcoma

24
Q

What are the associated findings of HHV-8 in HIV+ < 500?

A

Biopsy with neutrophilic inflammation - spindle cells

25
Q

What the presentation of Cryptosporidum spp in HIV+ < 500?

A

Chronic, watery diarrhea

26
Q

What are the associated findings of Cryptosporidum spp in HIV+ < 500 ?

A

Acid-fast oocysts in stool

27
Q

What the presentation of HPV in HIV+ < 500?

A

Squamous cell carcinoma, commonly of anus
(men who have sex with men) or cervix
(women)

28
Q

What the presentation of toxoplasma gondii in HIV+ < 200?

A

Brain abscesses - multiple ring enhancing lesions on MRI

29
Q

What is the presentation of HIV itself with CD <200?

A

Dementia (ok?)

30
Q

What is the presentation of JC virus reactivation with CD <200?

A

progressive multifocal leukoencephalopathy

31
Q

What are the associated findings of JC virus reactivation with CD <200?

A

Non-enhancing areas of demyelination

32
Q

What is the presentation of Pneumocystis jirovecci CD <200?

A

Ground glass opacities on CXR

33
Q

What is the presentation of Aspergillus with CD <100?

A

Hemoptysis, pleruritic pain - cavitation or infiltrates on chest imaging

34
Q

What is the presentation of Cryptococcus with CD <100?

A

Meningitis

35
Q

What are the associated findings of Cryptococcus with CD <100?

A

Thickly encapsulated/budding years on India ink stain

36
Q

What is the presentation of Candida with CD <100?

A

Esophagitis - white plaques on endoscopy, yeast and pseudohyphae on biopsy

37
Q

What is the presentation of CMV with CD < 100?

A 
Retinitis
Esophagitis
Colitis
Pnuemonitis
Encephalitis
38
Q

What are the associated findings of CMV with CD < 100?

A

retinitis - cotton wool spots/extensive hemorrhage
esophagitis - linear ulcers
bx - cells w/ intranuclear (owl eye) inclusions

39
Q

What is the presentation of EBV with CD < 100?

A

B-cell lymphoma - Non-Hodgkin, CNS lymphoma

40
Q

What are the associated findings of EBV with CD < 100?

A

CNS lymphoma - ring enhancing, may be solitary (vs toxo)

41
Q

What is the presentation of Histoplasma capsulatum with CD < 100?

A

Fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting, diarrhea

42
Q

What are the associated findings of Histoplasma capsulatum with CD < 100?

A

Oval yeast cells within macrophages

43
Q

What is the presentation of Mycobacterium avium-intracellluare with CD < 100?

A

Non-specific systemic symptoms - fever, night sweats, weight loss, or focal lymphadenitis

Microbiology - Virology (13 decks)

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