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IMM Exam 2 > HIV > Flashcards

HIV Flashcards

1
Q

genetic diversity of HIV amongst clades

A
  • 20-30%
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2
Q

innate immune response to HIV

A
  • langerhans cells in vaginal and foreskin epithelia

- macrophages, dendritic cells, NK cells in subepithelia

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3
Q

first antigen that appears

A
  • p24 antigen
  • then decreases with antibody produced against it
  • can test around 12 days
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4
Q

why you have problems maintaining antibody affecting the virus?

A
  • changes in GP120 epitopes
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5
Q

exposure to HIV after 72 hours

A
  • antivirals not really effective
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6
Q

of all places where HIV goes with viremia, which tissue is number one?

A
  • GALT
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7
Q

maximal viral load during lifetime occurs when

A
  • 3 weeks

- most infectious

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8
Q

viral set point

A
  • your body trying to manage the HIV

- different per person

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9
Q

the longest you are infected with HIV

A
  • the more chance for mutations

- more viral diversity

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10
Q

specific antibody against HIV occurs after how long?

A
  • around 10-12 days
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11
Q

which cells helps you bring down viral load

A
  • CD8
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12
Q

infants with HIV

A
  • will have more rapid progression

- cannot mount a full immune response

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13
Q

anti-HIV specific CD4+ helper cells important for

A
  • initial B and T cells responses
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14
Q

anti-HIV specific CD4+ helper cell specific target

A
  • for HIV
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15
Q

anti-HIV specific CD4+ helper cell timeline

A
  • lost early in infection in most patients
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16
Q

anti-HIV specific CD4+ helper cell in elite controllers

A
  • much higher in elite controllers
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17
Q

HIV specific CD8+ CTLs in early infection

A
  • present in high numbers in early HIV infection
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18
Q

HIV specific CD8+ CTLs control of viremia

A
  • initial control of viremia
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19
Q

HIV specific CD8+ CTLs control strongly associated with

A
  • HLA (MHC 1) genotype
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20
Q

HIV specific CD8+ CTLs decline with

A
  • progressive CD4 cell loss in most individuals
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21
Q

anti-viral effect of CTL

A
  • lysis of virus infected cell before virions are released
  • inhibition of viral replication (ifn-gamma)
  • inhibition of viral entry into surrounding cells
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22
Q
  • inhibition of viral entry into surrounding cells
A
  • produce MIP-1a, MIP-1b, RANTES

- block CCR5 usage

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23
Q

loss of CD4+ T cells chronic immune activation

A
  • apoptosis
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24
Q

level of viremia predicts

A
  • CD4 cell loss
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25
diagnostic testing
- performing an HIV test based on clinical signs or symptoms
26
targeted testing
- performing an HIV test on subpopulations of persons at higher risk
27
screening
- performing an HIV test for all persons in a defined population
28
opt-out screening
- performing an HIV test after noticing the patient that the test will be done - consent is inferred unless patient declines
29
4th generation HIV-1/2 immunoassay tests for
- HIV1/2 antibody | - p24 antigen
30
immune reconstitution with HAART
- initial rapid increase in CD4 T cells (1-6 months) | - subsequent gradual steady rise in CD4+ T cells
31
initial rapid increase in CD4 T cells (1-6 months)
- mostly memory CD4 T cells
32
subsequent gradual steady rise in CD4+ T cells
- mostly naive CD4 T cells | - derived from thymus
33
CD4 count > 200 most likely disease
- strep pneumo
34
TB CXR in HIV patients
- often do not show the classic upper lobe cavities | - atypical presentations
35
TB infection in HIV patients where?
- extra pulmonary is common
36
TB HIV patient PPD
- may be negative as immune suppression can lead to anergy
37
fungi infections at CD4 count below 200
- Pneumocystis jiroveci pneumonia - candida - esophagus - cryptococcus - meningitis
38
Pneumocystis jiroveci pneumonia importance
- most common opportunistic AIDS defining infection
39
Pneumocystis jiroveci pneumonia presents with CD4 level
- below 200
40
Pneumocystis jiroveci pneumonia symptom
- shortness of breath - nonproductive cough - fever
41
Pneumocystis jiroveci pneumonia physical exam
- minimal findings
42
Pneumocystis jiroveci pneumonia hallmark
- O2 desaturation | - hypoxemia
43
Pneumocystis jiroveci pneumonia LDH level
- frequently elevated
44
viral infections in AIDS
- CMV | - HHV-8
45
CMV virus family
- herpesvirus
46
CMV seroprevalence in HIV
- 80-100%
47
CMV disease in HIV adults due to
- reactivation
48
CMV CD4 count
- < 50 cells
49
CMV presents with
- retinitis - esophagitis - colitis - encephalitis - myelitis
50
CMV biopsy
- cytopathic effect
51
Kaposi's sarcoma causative agent
- HHV-8
52
HHV-8 spread by
- sexually | - direct contact with children in endemic countries
53
protozoa infections in AIDS
- toxoplasma gondii | - cryptosporidia
54
bacteria infection in AIDS
- mycobacterium avium complex
55
mycobacterium avium complex presentation
- diffuse infection of multiple organs - fever - night sweats - diarrhea - weight loss
56
mycobacterium avium complex lab results
- elevated alkaline phosphatase | - anemia
57
mycobacterium avium complex CD4 levels
< 100 | usually < 50
58
mycobacterium avium complex diagnosis by
- lysis centrifugation culture
59
organs mycobacterium avium complex infects
- GI tract - liver - spleen - bone marrow
60
prophylaxis of PJP
- bactrim/septra
61
prophy of MAC
- azithromycin

IMM Exam 2 (15 decks)

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