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HIV > HIV > Flashcards

HIV Flashcards

1
Q

Elisa/EIA

A

screens for Antibodies against HIV

3-12 weeks

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2
Q

HIV differentiation Assay

A

disinguishes HIV from ABS

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3
Q

Nucleic Acid Test (NAT)

A

shows actual virus in blood, used for high-risk exposure

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4
Q

Viral load (NAT)

A

REverse transcriptase-polymerase chain reaction (RT-PCR)
Tracks response to ART therapy
Shows # of HIV circulating in blood

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5
Q

P24 Assay

A

Detects HIV 10-14 days post exposure

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6
Q

Goals of ART Therapy

A
  1. ) Reduce HIV associated morbitidy
  2. ) Restore and preserve immune function
  3. ) Maximally and durably suppress plasma HIV viral load
  4. ) Prevent transmission
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7
Q

what are some signs that art therapy is working

A

cd4+t cell cound will increase (50-150cells/mm/yr)

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8
Q

signs of non-adherence

A

active substance abuse, depression, lack of social support

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9
Q

Nucleoside Reverse Transcriptase Inhibitors (NRTI’s)

A 
(ART) 
axidothymidine (zidovudine) 
Bone marrow suppression 
N/V/D
LActic Acidosis
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10
Q

Non-Nucleoside REverse Transcriptase Inhibitors (NNRTI’s)

A 
(ART) 
Efavirenz (sustiva) 
Teratogenic (birth defects)
CNS Disturbances, dreams, confusion 
caution with underlying mental illness
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11
Q

Protease inhibiors (PI)

A

Darunavir (Prezista)
Often prescribed with another PI (ritonavir or cobicistat)
Blocks HIV’s ability to break polypeptide chains into individual proteins for new virons
Class ussed for Hep C

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12
Q

Fusion Inhibitors (FI)

A

enfuviritide (Fuzeon)
Local injection site reaction ( pain, erythema, induration, nodules, cysts, pruritus, ecchymosis)
Increased rate of bacterial pneumonia; hypersensitivity reaction–symptoms may include rash, fever, nausea, vomiting, chills, rigors, hypotension

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13
Q

Ritonavir

A

Protease inhibitor

used in HAART, keeps plasma levels of main PI high

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14
Q

Inegrase Strand Transfer inhibitor (INSTI)

A

Raltegravir (isentress)

blocks insertion of HIV’s DNA into CD4T’s DNA (prevents HIV replication)

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15
Q

CCR5

A

maraviroc (Selzentry)

blocks receptor sites on CD4 cell

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16
Q

Common side effects to ART regimes

A

Hepatotoxicity, nephrotoxicity, osteopenia, lipodystorphy, rashes,

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17
Q

HAART Therapy

A

Two NRTI’s in combination with one of the other 3 drug classes; NNRTI, PI booseted with ritonavir, INSTI

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18
Q

salvage therapy

A

persistently detectable viral loads while taking ART

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19
Q

Mega HAART

A

6 or more drugs

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20
Q

Optimal Regimen

A

at least three drugs

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21
Q

persistent genralized lymphadenopathy (PGL)

A

in more then 2 areas for more than 3 months
(Jaw, neck, axillla, elbow crease, groin, behind the knee)
Happens in early stages of HIV & Lymph nodes where virus invades CD4

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22
Q

lipoatrophy

A

subq fat loss in face arms legs butocks

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23
Q

lipohypertrophy

A

fat acumulation in abdomen, breasts, dorsocervical, liver

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24
Q

Category B conditions

A

Oral thrush, Pelvic inflam disease, herpes zoster (shingles), peripheral neuropathy
Constitutional symptoms: fever greater than 38.5 or diarrhea for more than 1 month.

25
Q

Category C- AIDS defining Illnesses

A

cervical cancer (invasive), Candidiasis esophagus, bronchi, trachea, lungs; cryptococcosis, extrapulmonary;

26
Q

pneumocystis pneumonia (PCP)

A

p. jiroveci/ p. carnii
dry cough, fever, chills, SOB, dyspnea, Chest pain, severe hpoxemia, cyanosis, tachypnea, Altered mental status
Start treatment and adjunctibe corticosteroids within 72 hours

27
Q

how is PCP identified

A

tracheobronchial washings: by the organism in the lung tissue/ bronchial secretions

28
Q

TPM-SMZ

A

bactrim, cotrim, septra, antibiotics used to treat PCP

29
Q

Mycobacertium Avium Complex (MAC)

A

common bacteria found in water, soil, dust and food.

Localized or disseminated in the lungs, intestines, bone marrow, liver or spleen

30
Q

what are the s/s of MAC

A

fever, night sweats, weight loss, abdominal pain, diarrhea

31
Q

what is the treatment for MAC

A

clarithromycin or azithromycin

second choice: ethambutol, rifampin, aminoglycosides

32
Q

Mycobacterium Tuberculosis–Latent

A

-no symptoms, can’t spread, can advance to TB disease

33
Q

TB-disease

A

can make person feel sick and have symptoms, infectious

34
Q

TB

A

isoniazide and pyridoxine

35
Q

MDR-TB

A

resistant to isoniazid and rifampicin

36
Q

IRIS

A

condition in which immune system begins to recover, fevers, respiratory and abdominal symptomes, treat with steroids

37
Q

candidasis

A

creamy white patches in the oral cavity–can spread to the esophagus and stomach

  • retrosternal pain, dysphagia, weightloss
    tx: fluconazole
38
Q

chronic diarrhea

A

anorexia, N/V, weight loss, poor ADL’s, perianal exccoriation, dehydration, electrolyte imbalances,
Tx: octreotide (sandostatin)

39
Q

HIV wasting syndrome

A

weightloss greater than 10%, fever, chronic diarrhea
Tumore necrosis factor and interleukin 1 are cytokines that act on hypothalamus and that controls apetite and cause anorexia.

40
Q

appetite stimulants

A

megestrol (megace)
dronabinol (Marinol)
Synthetic THC (tetrahydrocannabinol)

41
Q

Strategies to treat wasting syndrome

A

high-protein, high-calorie meals with diary
Treat deression
enteral feeding or TPN
Appetite stimulants

42
Q

kaposi’s sarcoma

A

brownish pink-deep purple lesions.
Increased risk of other infections
Tx: alpha-interferon for cutaneous KS (tumor regression improved immune function)

43
Q

Toxoplasmosis

A

Altered mental status, fever, weakness, speech disturbances, seizures, psychiatric

44
Q

Treatment for acute toxoplasmosis

A

pyrimethamine & sulfadiazine with folinic acid (leucovorin)

45
Q

cryptococcal meningitis

A

S/S: fever, headache, stiff neck, N/V, altered mental status, seizures
Dx: cerebral spinal fluid
Tx: amphotericin B & (flucytosine or c) IV for 2 weeks
Fluconazole 400-800mg/day 8 weeks

46
Q

what are the side effects of amphotericin B

A

anemia, kidney/;iver insufficiency, hypokalemia, hypomagnesemia, phlebitis

47
Q

progressive multifiocal leukoencephalopathy (PML)

A

virus causes demyleinating disorder of CNS

Confusion, blindness, aphasia, paresis

48
Q

HIV encephalopathy (dementia)

A

memory impairment, difficulty concentrating, ataxia, hallucinations, seizures, death
Tx: zidovudine (retrovir) crosses the blood brain barrier

49
Q

Cytomegalovirus (CMV)

A

decreased visual acuity, floaters, fundus exudates, hemorrhages, blindness
Tx: ganciclovir (Side effect: neutropenia)

50
Q

depression

A

imipramine (tofranil)
Desipromine (norpramin)
fluoxetine (Prozac)

51
Q

Attachment/binding

A

HIV sies attach to CD4 receptor

52
Q

uncoating

A

HIV contents two single strands of RNA, reverse transcriptase, integrase, protease empty into the CD4 cell

53
Q

Dna synthesis

A

HIVs RNA is transcribed into HIV’s DNA

54
Q

Integration

A

insertion of HIV DNA into CD4 DNA, now patient is permenantely infected

55
Q

Transcription

A

when CD4 cell is activated double stranded DNA forms single stranded messenger RNA which builds new viruses

56
Q

Translation

A

the mRNA creates chains of new protein and enzymes that contain the componeents needed in the construction of new viruses.

57
Q

cleavage

A

hiv enzyme breaks poply protein chain into individual proteins that make up new virons

58
Q

Budding

A

New HIV proteins & RNA migrate to membrane of CD4 cell, exit and from new HIV virons and then infect more CD4 cells

HIV (1 decks)

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