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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
Category C- AIDS defining Illnesses
cervical cancer (invasive), Candidiasis esophagus, bronchi, trachea, lungs; cryptococcosis, extrapulmonary;
26
pneumocystis pneumonia (PCP)
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
how is PCP identified
tracheobronchial washings: by the organism in the lung tissue/ bronchial secretions
28
TPM-SMZ
bactrim, cotrim, septra, antibiotics used to treat PCP
29
Mycobacertium Avium Complex (MAC)
common bacteria found in water, soil, dust and food. | Localized or disseminated in the lungs, intestines, bone marrow, liver or spleen
30
what are the s/s of MAC
fever, night sweats, weight loss, abdominal pain, diarrhea
31
what is the treatment for MAC
clarithromycin or azithromycin | second choice: ethambutol, rifampin, aminoglycosides
32
Mycobacterium Tuberculosis--Latent
-no symptoms, can't spread, can advance to TB disease
33
TB-disease
can make person feel sick and have symptoms, infectious
34
TB
isoniazide and pyridoxine
35
MDR-TB
resistant to isoniazid and rifampicin
36
IRIS
condition in which immune system begins to recover, fevers, respiratory and abdominal symptomes, treat with steroids
37
candidasis
creamy white patches in the oral cavity--can spread to the esophagus and stomach * retrosternal pain, dysphagia, weightloss tx: fluconazole
38
chronic diarrhea
anorexia, N/V, weight loss, poor ADL's, perianal exccoriation, dehydration, electrolyte imbalances, Tx: octreotide (sandostatin)
39
HIV wasting syndrome
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
appetite stimulants
megestrol (megace) dronabinol (Marinol) Synthetic THC (tetrahydrocannabinol)
41
Strategies to treat wasting syndrome
high-protein, high-calorie meals with diary Treat deression enteral feeding or TPN Appetite stimulants
42
kaposi's sarcoma
brownish pink-deep purple lesions. Increased risk of other infections Tx: alpha-interferon for cutaneous KS (tumor regression improved immune function)
43
Toxoplasmosis
Altered mental status, fever, weakness, speech disturbances, seizures, psychiatric
44
Treatment for acute toxoplasmosis
pyrimethamine & sulfadiazine with folinic acid (leucovorin)
45
cryptococcal meningitis
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
what are the side effects of amphotericin B
anemia, kidney/;iver insufficiency, hypokalemia, hypomagnesemia, phlebitis
47
progressive multifiocal leukoencephalopathy (PML)
virus causes demyleinating disorder of CNS | Confusion, blindness, aphasia, paresis
48
HIV encephalopathy (dementia)
memory impairment, difficulty concentrating, ataxia, hallucinations, seizures, death Tx: zidovudine (retrovir) crosses the blood brain barrier
49
Cytomegalovirus (CMV)
decreased visual acuity, floaters, fundus exudates, hemorrhages, blindness Tx: ganciclovir (Side effect: neutropenia)
50
depression
imipramine (tofranil) Desipromine (norpramin) fluoxetine (Prozac)
51
Attachment/binding
HIV sies attach to CD4 receptor
52
uncoating
HIV contents two single strands of RNA, reverse transcriptase, integrase, protease empty into the CD4 cell
53
Dna synthesis
HIVs RNA is transcribed into HIV's DNA
54
Integration
insertion of HIV DNA into CD4 DNA, now patient is permenantely infected
55
Transcription
when CD4 cell is activated double stranded DNA forms single stranded messenger RNA which builds new viruses
56
Translation
the mRNA creates chains of new protein and enzymes that contain the componeents needed in the construction of new viruses.
57
cleavage
hiv enzyme breaks poply protein chain into individual proteins that make up new virons
58
Budding
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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