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Path: Infectious Disease > HIV > Flashcards

HIV Flashcards

1
Q

methods of transmission for HIV

A

blood, semen, vaginal fluid, breast milk

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2
Q

80-85% of men and women contract HIV via this

A

unprotected sex

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3
Q

what is more infective in accidental needle stick: hepatitis B or HIV?

A

Hep B

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4
Q

3 routes of infection in pediatric/perinatal HIV infection

A

transplacental, infected birth canal, ingestion breast milk

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5
Q

this HIV variant appears to be less aggressive

A

HIV-2

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6
Q

glycoprotein that mediates binding of CD4 (located on viral envelope of HIV)

A

gp 120

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7
Q

glycoprotein that mediates fusion to cell membranes (located on viral envelopes of HIV)

A

gp 41

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8
Q

major capsid protein that is diagnostic for antibodies (what we measure in screening tests…Ab to this)

A

p24

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9
Q

viral enzymes necessary for HIV reproduction

A

protease, integrase, reverse transcriptase

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10
Q

HIV binds to this molecule on lymphocytes, MP, and glial cells

A

CD4

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11
Q

cells that have CD4 molecule for HIV to bind

A

lymphocytes, MP, glial

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12
Q

where are HIV viruses latent?

A

unactivated lymphocytes

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13
Q

what causes proliferation of HIV after latent phase?

A

lymphocyte activation (cytotoxic to host cell)

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14
Q

ratio of CD4:CD8 in AIDS; what is normal?

A

.5:1; 2:1

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15
Q

CD4 count less than this = AIDS

A

200

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16
Q

co-receptor for CD4-GP 120 binding in *early* HIV infection

A

CCR5

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17
Q

co-receptor for CD4-GP 120 binding in *late* HIV infection

A

CXCR4

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18
Q

these destroy virally-infected cells and terminates early infection of HIV

A

CD8 (virus-specific)

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19
Q

3 factors responsible for progressive development of immune deficiency

A

loss CD4 and CD8, evolutionary change in virus

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20
Q

neoplastic conditions associated with AIDS

A

Kaposi’s sarcoma, Hodgkins disease, lymphoma

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21
Q

GI opportunistic infections in AIDS patients

A

Giardia, entamoeba, cryptosporidiosis (parasites more common, crypto more deadly)

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22
Q

may see these reactivated latent infections in AIDS patients

A

toxoplasmosis, TB, herpes zoster

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23
Q

Kaposi’s sarcoma is associated with this infection

A

HHV8

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24
Q

opportunistic infection in AIDS that is more common in homosexual/bi males; 15% AIDS patients get it

A

Kaposi’s

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25
Q

cells that proliferate in Kaposi’s

A

endothelial cells, SMC, pericytes

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26
Q

factors that are related to high efficacy of sexual transmission of HIV

A

abundant lymphoid tissue, secretions, concurrent infections (or mucosal breaks), local reservoir (as in uncircumcised pts)

27
Q

HIV may adhere to these cells in mucosa (instead of going directly into blood vessels)

A

dendritic cells

28
Q

these express high amounts of CCR5

A

genital dendritic cells and GI lymphoid

29
Q

CCR5 receptors are located on these cells

A

monocytes and lymphocytes (monocytotropic)

30
Q

CXCR4 receptors are located on these cells

A

T-lymphocytes (lymphotropic)

31
Q

mutation in this switches co-receptor from CCR5 to CXCR4

32
Q

CXCR4 dependent virus causes this in lymphoid tissue –> bind to wide range of T cells (naive and thymocytes) –> rapid loss of lymphoid tissue

A

syncytia formation

33
Q

early in HIV infection, these block co-receptor binding –> therapeutic strategy

A

inflammatory chemokines

34
Q

early in infection…HIV is primarily an infection of this tissue (in establishing viral reservoir)

A

lymphoid tissues

35
Q

these provide transport of virus throughout body –> including CNS

36
Q

viral reservoir for HIV located in these cells

A

follicular dendritic cells

37
Q

entry and transport of HIV occurs in these cells

A

mucosal dendritic cells

38
Q

even with appropriate HAART treatment these cells continue to decline

A

mononuclear cells and lymphocytes

39
Q

early CD4 cell loss in these locations in gut allows gut pathogen products to be released into blood stream –> inflammatory reaction and increase in proliferation –> apoptosis/cytolysis (in HIV)

A

Peyer’s patches

40
Q

upon activation, CD8 cells become sticky due to these molecules being expressed; what happens to the CD8 cells then?

A

CD69; retained in lymph node

41
Q

this is responsible for apoptosis of unaffected lymphocytes in HIV

A

soluble gp 120 (binds to CD4 in absence of virus)

42
Q

2 other mechanisms for decreased immune function in HIV (besides cytolysis)

A

apoptosis (due to soluble gp120) and blocking of immune function (gp120 binds CD4 and interferes with antigen presentation), toxic lymphokines

43
Q

evolution of virus from CCR5 to CXCR4 co-receptor is associated with this (poor prognosis)

A

syncytia formation

44
Q

two treatment protocols that help decrease amount of drug-resistant HIV strains

A

maximal inhibition of viral replication and multiple agents

45
Q

this occurs as a result of initial activation of immune cells by specific and innate (TLR) mechanisms

A

lymphadenopathy (germinal center hyperplasia) and hypergammaglobulinemia

46
Q

4 things to remember in immune system dysfunction due to HIV

A

lymphadenopathy (initially), lymph node burn out, good PMN response, atypical infection presentation

47
Q

time it takes for seroversion of HIV to occur

A

6-12 weeks

48
Q

these HIV tests have specificity and sensitivity >99%

A

HIV serology and western blot

49
Q

RNA at this level in blood is undetectable

50
Q

strongest indicator of HIV disease progression

51
Q

this is expanded in lymph node –> signaling polyclonal activation

A

B cell area

52
Q

occurs when viral particles are found in follicular mantle cells early in HIV infection

A

marked follicular hyperplasia

53
Q

CNS infection of HIV seen with this chronic inflammatory infiltrate –> seen in subacute meningoencephalitis

A

microglial nodules and multinucleated giant cells

54
Q

this occurs as result of proliferating mesenchymal spindle cells that form blood vessels (in HIV)

A

Kaposi’s sarcoma

55
Q

high levels of viral replication, viremia, and widespread seeding of lymphoid tissue are seen in this; when does this develop after infection?

A

acute retroviral syndrome; 3-6 weeks (lasts 2-4)

56
Q

this is responsible for initial drop in viral titers

A

anti-HIV CMI

57
Q

CNS dementia caused when HIV infects these cells; what carries the virus to the brain?

A

microglial cells; infected MP

58
Q

hallmark of original epidemic of AIDS –> nearly universal opportunistic infection

A

Pneumocystis pneumonia

59
Q

cause of Non-hodgkins lymphoma (in 3% AIDS) in 30-50% of cases

60
Q

appearance of this signals deterioration of immune function (in candidiasis)

61
Q

this is probably cause of invasive carcinoma of uterine cervix in AIDS patients

62
Q

stain used for Cryptococcus neoformans

63
Q

has very thick capsule….stained with india ink in CSF

A

Cryptococcus neoformans

Path: Infectious Disease (10 decks)

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