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HIv Flashcards

1
Q

MC strain

A

HIv1 M group

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2
Q

MC transmitting strain

A

R5

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3
Q

MC strain in brain

A

R5

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4
Q

Antibodies order of appearance

A

Gp41
P24
Gp120

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5
Q

3 targets in the brain

A

Pero valvular astrocytes
Peri valvular macrophage
Microglia

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6
Q

5 reasons for false positive EIA

A 
HAPIT
Hepatic disease
Acute viral illness 
Pregnancy
Influenza vaccine
Transfusion
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7
Q

Stages

1-3

A

Stage 1 CD4 >500 26%
CD4 200-499 14-25%
CD4

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8
Q

Gag gene

A

Core + p24

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9
Q

Pol gene

A

Protease

Rev transcription

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10
Q

Env gene

A

Envelope

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11
Q

First cytokines

A

IFN alpha

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12
Q

HIV lipodystrophy

A

IL18

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13
Q

3 tests of western blot indeterminate

A

P24 capture
HIV rbs
HIV DNA PCR

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14
Q

When to use cd4 %

A

IFN alpha treatment

Hypersplenism

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15
Q

Infections CD 4

A

PCP

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16
Q

Infections CD4

A

Mac
Toxoplasma
CMV

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17
Q

3 stages of HIV

A

Acute infection 3-6 mos
A symptomatic 10 yrs
AIDS if

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18
Q

CD4 level to start ART

A

CD4

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19
Q

Most potent and safest ARTs

A

Integrate inhibitors

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20
Q

Treatment monitoring

A

HIV RNA at 6 MOA

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21
Q

4 NNRT

A 
NEED
Nevirapine
efavirenz 
Etta
Delav
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22
Q

Major co receptors for HIV1

A

CCR5

CXCR4

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23
Q

HIV type that dominates the global pandemic

It is more transmissible than the others

A

HIV 1 M group subtype C

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24
Q

Predominant HIV type in Asia

A

HIV1 isolates of the CRF01_AE

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25
Q

Predominant HIV in US Canada Europe

A

Subtype B

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26
Q

Natural reservoir of HIV M and N subgroups

A

Pan troglodytes troglodytes

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27
Q

Natural reservoir of HIV O and P groups

A

Cameroonian gorillas

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28
Q

Structural proteins of the HIV virus

A

Gag- core of the vit ion
Pol- protease
Env- envelope glycoprotein

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29
Q

HIV replication cycle

A

Gp120 binds with Cd4 in Th
Co factor CcR5 and CxCR4

Conformational change: fusion with host cell membrane via gp41

Uncoating of the capsid protein, facilitates reverse transcription and formation of pre integration complex (viral RNA, accessory proteins, capsid and matrix proteins)

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30
Q

Risk for HIV transmission with unprotected receptive anal intercourse (URAI)

A

1.4%

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31
Q

Primary determinant of HuV 1 transmission

A

Quantity of HiV1 in the plasma

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32
Q

Transmission of the HIV virus is rare when how many copies RNA/ milliliter

33
Q

What is TasP (treatment as prevention)?

A

Initiation of antiretroviral therapy even before CD4 levels go below 250 is assoxiated with 96% reduction of HIV transmission

34
Q

HIV infection following skin puncture

35
Q

HIav infection following mucous membrane exposure

36
Q

Maternal transmission of HIV Occurs most commonly in the

A

Perinatal period

37
Q

Probability of transmission of HIV from mother to infant fetus

A

23-30% before birth
50-65% during birth 😄
12-20% breast feeding

38
Q

MC form of heart disease assoc with HIV Infection

39
Q

White frond like lesions along lateral borders of the tongue and adjacent buccal mucosa

A

Oral hairy leukoplakia

Florid replication of EBV

40
Q

Reactivation pulmonary in HIV

A

Coccidiosis immitis

41
Q

MAC prophylaxis

When and how?

42
Q

Risk of TB Reactivation

HIV VS no HIV

A

HIV 7-10

No HIV 1%

43
Q

Causes ophthalmic lesion of choroid like buergers disease, bone marrow hypo plastic and otic involvement (polyploid mass in external auditory canal)

A

P jiroveci

44
Q

HIV opportunistic infections covered by TMP/SMX DS tablet BID

A

PCP

Toxoplasma

45
Q

Treatment for oral hairy leukoplakia

A

Podophyllin

46
Q

Hallmark of HIV assoc nephropathy

A

Proteinuria

Microalbuminuria found in 20% of AIDS

47
Q

MC presentation of syphilis in HIV

A

Condylomata lata

48
Q

Suphilis

Ulcers ting lesion of the skin due to necrotizing vasculitis

A

Lues maligna

49
Q

Effect of HIV on VDRL and anti TPa

A

False positive VDRL due to polyclonal B call activation

False negative FTA ABs due to immunodeficiency

50
Q

Percent of HIV patients with jarischh herxheimer reaction upon RX

51
Q

HIV patients receiving thymidine analogues and protease inhibitors endocrine disorder

A

Lipodystrophy
Elev TC
Elev TF
Hyperinsulinemia and hyperglycemia

52
Q

Drug associated with FATAL HYPERSENSITIVITY on rechallenge

Associated with the HLA B27 haplotype

53
Q

Hema

Characteristic feature of zidovudine therapy

A

Elevated MCV

54
Q

Most prevalent derma disorder in patients with HIV

A

Folliculitis

Unique form: eosinophilia pustular folliculitis

55
Q

MC cause of meningitis in AIDS patients

A

Crytococcus

56
Q

Most severe form of HIV assoc neuro cognitive disorder (HAND)

A

HIV associated dementia

57
Q

Treatment of cryptococcal meningitis

A

Amphoteric in B

Or liposomal amphoteric in with flucytosine at least 2 weeks

58
Q

Reservoir for smoldering cryptococcal infection

A

Prostate gland

59
Q

MC cause of seizures in HIV patient

A
  1. Mass lesions (toxoplasma> lymphoma)
  2. HIV encephalopathy
  3. Cryptococcal meningitis
60
Q

MC manifestation of yoxoplasmosis

A

Fever
Headache
Focal neurological deficit

61
Q

Treatment of toxoplasmosis

A

Pyrimethamine+ sulfadiazine

With leucovirin for 4-6 weeks

62
Q

Indication for brain biopsy in patient with toxoplasmosis

A

Px who to failed to respond to therapy 2-4 weeks

63
Q

Likelihood that the patient has toxoplasmosis in the setting of negative serology

64
Q

Most common form of polyneuropathy in HIV

A

Distal symmetric

65
Q

Causes of myopathy in HIV

A

HIV itself
Zidovudine
Generalized wasting syndrome

66
Q

Histologic hallmark of zidovudine induced myopathy

A

Red ragged fibers

67
Q

MC abnormal finding ophtha in HIV

A

Cotton wool spots

68
Q

Most devastating ophtha complication of HIV infection

A

CMV retinitis

69
Q

Therapy for CMV retinitis

A

Oral valve cockpit
IV gancyclovir
Foe aren’t

70
Q

Can cause acute retinal necrosis or progressive outer retinal necrosis

A

HSV and varicella

71
Q

Define generalized wasting in AIDS

A

involuntary weight loss of >10% associated with intermittent or constant fever and chronic diarrhea or fatigue lasting >30 days in the absence of a defined cause other than HIV infection

72
Q

Neoplasticism conditions considered to be AIDS defining

A

Kaposi’s sarcoma
NonHodgkins lymphoma
Invasive cervical carcinoma

73
Q

Multi centric neoplasm consisting of multiple vascular nodules appearing in the skin, mucous membranes and viscera

A

Kaposi’s sarcoma

74
Q

First line therapy for advanced KS

A

Liposomal daunorubicin

75
Q

3 main categories of lymphoma seen in patients with HIV infection

A

Grade III or IV Immunoblastic lymphoma
Burkitt’s lymphoma
Primary CNS lymphoma

76
Q

Majority of the Immunoblastic lymphoma in HIV patients

A

Diffuse large B cell lymphomas

77
Q

Management of AIDS associated kaposi sarcoma

A

Radiation
Intraleaional vinblastin
Cryotherapy

78
Q

Lymphoma not commonly seen in the setting of an immunodeficiency other than HIV

A

Burkitts lymphoma

Small noncleaved cell lymphoma

Infectious (20 decks)

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