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Microbiology - Clinical Infectious Disaese > HIV > Flashcards

HIV Flashcards

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1
Q

What does the acute retroviral syndrome of HIV look like?

A

fever, fatigue, LAD, HA, pharyngitis, n/v/d, +/- aseptic meningitis.

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2
Q

How long after exposure does the acute retroviral syndrome present?

A

2-3 weeks s/p exposure.

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3
Q

Other HIV clues?

A
  • young pt new b/l Bell’s palsy
  • young pt w unexplained thrombocytopenia + fatigue
  • young pt unexplained weight loss >10%
  • young pt w Thrush, zoster, kaposi
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4
Q

If known exposure to HIV?

A

AZT, lamivudine, and nelfinavir for 4 weeks

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5
Q

When to start HAART?

A

CD4 55,00

Preggos if viral load > 1000

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6
Q

What HIV med causes GI issues, leukepenia, macrocytic anemia?

A

Zidovudine

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7
Q

What HIV med causes HS rash, fever, n/v, muscle aches, SOB in 1st 6 weeks? What should you do?

A

Abacavir. D/C and never use again!

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8
Q

What HIV med causes nephrolithiasis and hyperbilirubinemia?

A

indinavir (protease inhibitor)

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9
Q

What HIV med causes sleepiness, confusion, psycho sx?

A

Efavirenz

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10
Q

HIV+ patient w/ DOE, dry cough, fever, chest pain

A

Think p. jirovecci pneumonia.

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11
Q

What CD4 count to be concerned w/ p. jirovecci ?

A
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12
Q

CXR for p. jirovecci shows?

A

bilat diffuse symmetric interstitial infiltrates.

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13
Q

Best test for p. jirovecci ? possible lab value finding?

A

After CXR, do bronchoscopy w/ BAL to visualize bug. May see elevated LDH.

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14
Q

1st line treatment for p. jirovecci pneumonia?:

A

trim-sulfa

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15
Q

2nd line treatment for p. jirovecci pneumonia?:

A

trim-dapsone, or primaquine-clinda, or pentamidine.

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16
Q

When to add steroids to p. jirovecci pneumonia treatment?

A

PaO2 35

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17
Q

When to add prophylaxis against p. jirovecci?

A

When CD4

18
Q

Three causes of HIV diarrhea?

A

CMV, MAC, Cryptosporidium. CD4 count

19
Q

Sx of CMV diarrhea?

A

Can be bloody

20
Q

Dx of CMV diarrhea?

A

Colonoscopy/biopsy.

21
Q

Treatment of CMV diarrhea?

A

gangiclovier (se: neutropenia), or foscarnet (se: renal tox).

22
Q

Sx of MAC diarrhea?

A

Diarrhea, wasting, fevers, night sweats.

23
Q

Tx of MAC diarrhea?

A

clarithromycin, ethambutol +/- rifampin. Prophylax w/ azithromycin weekly.

24
Q

Sx of cryptosporidum diarrhea?

A

transmitted via dog poo, swimming pools. Water diarrhea w/ mucus, oocysts are acid fast.

25
Q

HIV pt w/ neurologic sx and multiple ring enhancing lesions?

A

Toxoplasmosis.

26
Q

Treatment of HIV toxo?

A

pyramethamine + sulfadiazine + folic acid for 6 weeks. If no imporvement after 1 week, consider biopsy.

27
Q

HIV pt w/ neurologic sx and 1 ring enhancing lesions?

A

CNS lymphoma.

28
Q

What virus is CNS lymphoma associated with?

A

EBV infection of b-cells.

29
Q

Treatment of CNS lymphoma?

A

HAART.

30
Q

If HIV+ patient has seizure w/ de ja vu aura and 500 RBCs in CSF? Treat?

A

HSV encephalitis (temporal lobe). acyclovir ASAP.

31
Q

If HIV+ patient w/ s/s of meningitis? DX & TX?

A

think crypto, + india ink. Tx w/ ampho IV for 2 weeks then fluconazole maintenance.

32
Q

If HIV+ patient has hemisensory loss, visual impairment, + babinski?

A

PML. JC polyomavirus demyelinates at grey-white jxn.

33
Q

Dx of PML?

A

Brain bx.

34
Q

If memory problems or gait disturbance in HIV patient?

A

AIDS-Dementia complex. Check serum, CSF and MRI to r/o treatable causes.

35
Q

HIV+ patients with exophytic purple lesions that look vascular?

A

Bartonella sp. Bacillary angiomatosis.

36
Q

Other sx of bacillary angiomatosis?

A

visceral lesions to. Prone to hemorraghe. Also non specific symptoms like malaise, fever, weight loss, abd pain, etc.

37
Q

What HIV med causes pancreatitis?

A

didanosine

38
Q

What HIV med causes liver failure?

A

nevirapine

39
Q

What class of HIV meds cause SJS?

A

NNRTI

40
Q

What class of HIV meds cause lactic acidosis

A

NRTI

Microbiology - Clinical Infectious Disaese (11 decks)

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