HIV

Question 1

MCC of HIV disease

Answer 1

HIV1

Question 2

2 major envelope proteins of HIV

Answer 2

gp120

gp41

Question 3

Hallmark of RNA virus

Answer 3

Reverse transcription of genomic RNA to DNA by reverse transcriptase

Question 4

Replication cycle of HIV

Answer 4

gp120 > CD4 > CCR5, CXR4 > fusion with gp41 > reverse transcription

Question 5

Responsible for most HIV infections in the world

Answer 5

HIV1 Group M

Question 6

MC mode of HIV transmission

Answer 6

Heterosexual transmission

Question 7

Chief predictor of heterosexual transmission

Answer 7

Level of plasma viremia

Question 8

ARV of choice in the perinatal period

Answer 8

Zidovudine by 2nd trimester of pregnancy through delivery + infant for 6 weeks after birth

Question 9

Hallmark of HIV disease

Answer 9

Profound immunodeficiency due to progressive quantitative and qualitative deficiency of T helper cells
(chronic persistent infection)

Question 10

Primary cellular receptor for HIV

Answer 10

CD4

Question 11

Major factor in the establishment of a chronic and persistent infection

Answer 11

Dissemination of virus to lymphoid organs, particularly the GALT

Question 12

CD4 count patient becomes highly susceptible to opportunistic disease

Answer 12

<200 (AIDS defining)
esp P jiroveci

<50 MAC, CMV, Toxo

Question 13

Major anatomic sites for the establishment and propagation of HIV infection

Answer 13

Lymphoid tissues

level of plasma viremia directly reflects virus production in lymphoid tssue

Question 14

Autoimmune-like phenomenon manifesting as paradoxical deterioration of clinical condition usually compartmentalized to a particular organ system seen after initiation of ARV

Answer 14

Immune Reconstitution Inflammatory Syndrome (IRIS)

commonly seen in MTB and cryptococcosis

Question 15

Cytokines indcers of HIV

Answer 15

TNF a
IL 1B
IL 6

Question 16

Cytokines that suppress HIV

Answer 16

IFN a and B

Question 17

Standard blood SCREENING test

Answer 17

ELISA

Question 18

CONFIRMATORY test

Answer 18

Western blot

Question 19

Positive Western Blot

Answer 19

(+) antibodies to 2 of 3: p24, gp41, gp 120/160

Question 20

MC patterns of cross-reactivity

Answer 20

Antibodies that react with p24 and/or p55

Question 21

If indeterminate for western blot

Answer 21

Repeat 4-6 weeks and do

p24 antigen capture assay
or HIV1 RNA
or HIV1 DNA PCR + serologic HIV2

Question 22

Gold standard for diagnosis of HIV

Answer 22

positive EIA + confirmatory Western blot

Question 23

Best indicator of the immediate state of immunologic competence of the patient and ith HIV infection

Answer 23

CD4 T cell counts

Question 24

CD4 count for initiation of ARV

Answer 24

<350

Question 25

Guideline for initiating therapy based on HIV RNA

Answer 25

> 100,000 copies

Goal <50 copies

Question 26

First CCR5 antagonist

Answer 26

Maraviroc

Question 27

MC manifestation of pulmonary disease in HIV

Answer 27

Pneumonia

Question 28

MC clinically significant cardiac finding in HIV

Answer 28

Dilated CMP with CHF

Question 29

Hallmark of HIVAN

Answer 29

proteinuria

Question 30

Renal biopsy finding in HIVAN

Answer 30

FSGS

Question 31

MC hematologic abnormality in HIV

Answer 31

Anemia

Question 32

Persistent generalized lymphadenopathy (PGL)

Answer 32

LN >1cm >2 extrainguinal sites >3mos

Question 33

Leading infectious cause if meningitis with AIDS

Answer 33

C.neoformans

CD4 <100

Question 34

MC peripheral neuropathy

Answer 34

Distal sensory polyneuropathy

Question 35

MC abnormal finding on fundoscopy

Answer 35

Cotton-wool spots