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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
Q

diagnostic testing

A
  • performing an HIV test based on clinical signs or symptoms
26
Q

targeted testing

A
  • performing an HIV test on subpopulations of persons at higher risk
27
Q

screening

A
  • performing an HIV test for all persons in a defined population
28
Q

opt-out screening

A
  • performing an HIV test after noticing the patient that the test will be done
  • consent is inferred unless patient declines
29
Q

4th generation HIV-1/2 immunoassay tests for

A
  • HIV1/2 antibody

- p24 antigen

30
Q

immune reconstitution with HAART

A
  • initial rapid increase in CD4 T cells (1-6 months)

- subsequent gradual steady rise in CD4+ T cells

31
Q

initial rapid increase in CD4 T cells (1-6 months)

A
  • mostly memory CD4 T cells
32
Q

subsequent gradual steady rise in CD4+ T cells

A
  • mostly naive CD4 T cells

- derived from thymus

33
Q

CD4 count > 200 most likely disease

A
  • strep pneumo
34
Q

TB CXR in HIV patients

A
  • often do not show the classic upper lobe cavities

- atypical presentations

35
Q

TB infection in HIV patients where?

A
  • extra pulmonary is common
36
Q

TB HIV patient PPD

A
  • may be negative as immune suppression can lead to anergy
37
Q

fungi infections at CD4 count below 200

A
  • Pneumocystis jiroveci pneumonia
  • candida - esophagus
  • cryptococcus - meningitis
38
Q

Pneumocystis jiroveci pneumonia importance

A
  • most common opportunistic AIDS defining infection
39
Q

Pneumocystis jiroveci pneumonia presents with CD4 level

A
  • below 200
40
Q

Pneumocystis jiroveci pneumonia symptom

A
  • shortness of breath
  • nonproductive cough
  • fever
41
Q

Pneumocystis jiroveci pneumonia physical exam

A
  • minimal findings
42
Q

Pneumocystis jiroveci pneumonia hallmark

A
  • O2 desaturation

- hypoxemia

43
Q

Pneumocystis jiroveci pneumonia LDH level

A
  • frequently elevated
44
Q

viral infections in AIDS

A
  • CMV

- HHV-8

45
Q

CMV virus family

A
  • herpesvirus
46
Q

CMV seroprevalence in HIV

A
  • 80-100%
47
Q

CMV disease in HIV adults due to

A
  • reactivation
48
Q

CMV CD4 count

A
  • < 50 cells
49
Q

CMV presents with

A
  • retinitis
  • esophagitis
  • colitis
  • encephalitis
  • myelitis
50
Q

CMV biopsy

A
  • cytopathic effect
51
Q

Kaposi’s sarcoma causative agent

A
  • HHV-8
52
Q

HHV-8 spread by

A
  • sexually

- direct contact with children in endemic countries

53
Q

protozoa infections in AIDS

A
  • toxoplasma gondii

- cryptosporidia

54
Q

bacteria infection in AIDS

A
  • mycobacterium avium complex
55
Q

mycobacterium avium complex presentation

A
  • diffuse infection of multiple organs
  • fever
  • night sweats
  • diarrhea
  • weight loss
56
Q

mycobacterium avium complex lab results

A
  • elevated alkaline phosphatase

- anemia

57
Q

mycobacterium avium complex CD4 levels

A

< 100

usually < 50

58
Q

mycobacterium avium complex diagnosis by

A
  • lysis centrifugation culture
59
Q

organs mycobacterium avium complex infects

A
  • GI tract
  • liver
  • spleen
  • bone marrow
60
Q

prophylaxis of PJP

A
  • bactrim/septra
61
Q

prophy of MAC

A
  • azithromycin

IMM Exam 2 (15 decks)

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