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STEP1 2015 > HIV > Flashcards

HIV Flashcards

1
Q

gag gene encodes for

A

p24 capsid protein

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2
Q

env gene encodes for

A

gp120, gp41 envelope proteins, which allow HIV to bind CD4 receptor, and CCR5/CXCR4 respectively

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3
Q

pol gene encodes for

A

reverse transcriptase

integrase

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4
Q

diagnose AIDS

A

CD4

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5
Q

pneumocystis jirovecii pneumonia (PCP)

A

interstitial infiltrates on CXR with CD4

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6
Q

TB, mycobacterium avium complex (MAC, MAI)

A

CD4

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7
Q

histoplasma capsulatum (immunocompetent)

A

mild pulmonary disease
associated with bird and bat droppings in OH and MS river valleys

in AIDS patients, systemic disease with HSM, fever, cough
CD4

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8
Q

cryptococcal meningitis

A

most common meningitis in AIDS patients

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9
Q

ring-enhancing lesions on MRI

A

toxoplasmosis, or primary CNS lymphoma (more likely to have solid lesions)

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10
Q

CMV retinitis

A

CS4

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11
Q

progressive multifocal leukoencephalopathy (PML)

A

reactivation of latent JC virus

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12
Q

cryptosporidiosis

A

chronic, watery diarrhea

CD4

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13
Q

oral thrush

later, esophageal candidiasis

A

candida albicans

esophageal candidiasis with CD4

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14
Q

oral hairy leukoplakia

A

EBV, CD4

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15
Q

oral infections

A

HSV (herpes), CMV

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16
Q

Kaposi sarcoma

A

HHV8, increased blood vessels

CD4

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17
Q

bartonella henselae

A

bacillary angiomatosis

CD4

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18
Q

Non Hodgkin lymphoma

A

primary CNS lymphoma
large B cell lymphoma
EBV coninfection for both of the above

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19
Q

malignancy associated with HPV in AIDS

A

squamous cell carcinoma of cervix/anus. HPV types 16 and 18

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20
Q

PPX CD4

A

TMP-SMX for PCP

dapsone if sulfa all
pentamidine (aero)

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21
Q

ppx cd4

A

TMP-SMX for toxoplasmosis ppx if positive IgG titer for toxo

dapsone+pentamidine+leucovorin

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22
Q

ppx CD4

A

MAC prophylaxis

azithrymycin

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23
Q

ppx cd4

A

histoplasmosis (endemic area) itraconazole

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24
Q

HAART

A

combination of at least 3 different HIV medications
goal is to treat infection and prevent resistance (attach HIV at different points in its replication/infection cycle in order to control the infection and avoid resistance)

combine 2 NRTIs + 1 from a different class

Consider initiating in everyone with HIV, regardless of CD4 count

should be initiatied in anyone with CD4

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25
Q

protease inhibitors

A

The viral protease clips viral polypeptide into their functional parts. Without a protease, new viruses cannot mature.

saquinavir
ritonavir
indinavir
nelfinavir
fosamprinavir
lopinavir
tipranavir
atazanavir
darunavir
side effects: 
GI intolerance
inhibit CYP450 (esp ritonavir)
hyperlipidemia/hypertriglyceridemia
lipodystrophy
pancreatitis
nephrolithiasis-indinavir, atazanavir
increased bilirubin- atazinavir
26
Q

ritonavir side effects

A

pancreatitis, inhibits CYP450

27
Q

protease inhibitor that causes nephrolithiasis

A

indinavir, atazanavir

28
Q

Atazanavir side effects

A

increased bilirubin, nephrolithiasis

29
Q

Nucleoside reverse transcription inhibitor

A

competitively inhibits HIV reverse transcriptase, keeps the virus from replicating

nucleoside analogs (guanosine or cytosine)

must be phosphorylated or activated by thymidine kinase

zidovudine
didanosine
lamivudine
abacavir
emtricitabine
30
Q

nucleoTide reverse transcription inhibitor

A

tenofovir

competitively inhibits HIV reverse transcriptase, keeps the virus from replicating

nucleotide analog

31
Q

zidovudine (AZT)

A

used in newborns born to HIV+ mothers

can be given to mom at time of delivery if she hasn’t been on a regular regimen already during her pregnancy (otherwise stay on course)

32
Q

how to treat occupational exposures

A

3 drug regimen for 4 weeks

for anyone who has been exposed

33
Q

NRTI zidovudine side effect

A

bone marrow suppression

34
Q

NRTIs that cause pancreatitis and peripheral neuropathy

A

didanosine, zalcitabine, stavudine

35
Q

didanosine, stavudine side effects

A

hepatic steatosis, pancreatitis, peripheral neuropathy

36
Q

Abacavir side effect

A

hypersensitivity reaction

37
Q

NNRTIs

A

Non-competitively inhibit HIV reverse transcriptase at a different site than NRTIs

Do not require phosphorylation to be active

Nevirapine
Delavirdine
Efavirenz
Etravirine
Rilpivirine
38
Q

NNRTI general side effect

A

rash

39
Q

Efavirenz side effects

A

neuropsychiatric symptoms (nightmares, vivid dreams, dizziness, worsening depression)

false- positive drug test to cannabinoids

teratogenic

40
Q

enfuvertide

A

binds gp41, inhibiting viral fusion and entry.

expensive
given by injection
indicated in patient with a lot of drug resistance

side effects: injection site reactions, and increased risk of bacterial pneumonia

41
Q

raltegravir, elvitegravir

A

integrase (from the pol gene) inhibitor

side effects: nausea, rash, myopathy

42
Q

maraviroc

A

CCR5 (cofactor, typically seen on macrophages) antagonist

inhibits gp120 conformational change so virus cannot bind host cell effectively

tropism test before therapy to make sure the virus is not X4

only patients with all R5 virus qualify for treatment

43
Q

ritonavir

A

protease inhibitor

44
Q

didanosine

A

NRTI

45
Q

delavirdine

A

NNRTI

46
Q

zidovudine

A

NRTI

47
Q

abacavir

A

NRTI

48
Q

lamivudine

A

NRTI

49
Q

nelfinavir

A

protease inhibitor

50
Q

efavirenz

A

NNRTI

51
Q

what drug blocks gp41

A

enfuvertide

52
Q

what drug blocks gp120

A

maraviroc

53
Q

side effect: lactic acidosis

A

NRTIs

54
Q

side effect: GI intolerance

A

protease inhibitors

55
Q

side effect: peripheral neuropathy

A

didanosine, stavudine, zalcitabine

56
Q

side effect: megaloblastic anemia

A

zidovudine (AZT)

57
Q

side effect: rash

A

NNRTIs

58
Q

side effect: hyperglycemia, diabetes mellitus, lipid abnormalities

A

protease inhibitors

59
Q

side effect: bone marrow suppression

A

zidovudine

60
Q

given to pregnant women with HIV

A

zidovudine, if the woman is not already on a regimen

STEP1 2015 (30 decks)

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