Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3 REPRO > HIV > Flashcards

HIV Flashcards

1
Q

which HIV group is more virulent

A

HIV-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the target site for HIV

A

CD4+ receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is CD4

A 
glycoprotein found on the surface of a range of cells including 
T helper lymphocytes 
dendritic cells 
macrophages 
microglial cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what do CD4+ Th lymphocytes do

A

essential of induction of adaptive immune response

  • recognition of MHC2 antigen-presenting cell
  • activation of B cells
  • activation of cytotoxic T cells
  • cytokine release
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does HIV effect the immune response

A
  • sequestration of cells in lymphoid tissue (reduced circulating CD4+ cells)
  • reduced proliferation of CD4+ cells
  • reduction of CD8+ T cell activation (dysregulated expression of cytokines and increasing susceptibility to viral infections)
  • reduction in antibody class switching (reduced affinity of antibodies produced)
    chronic immune activation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

normal CD4+ Th cell levels

A

500-1600 cells/mm^3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

level of CD4+ cells with risk of opportunistic infections

A

<200 cells/mm^3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when is HIV replication fastest

A

very early and very late infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how often is a new generation of HIV produced

A

every 6-12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the average time to death without treatment

A

9-11 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pathogenesis of HIV infection

A

infection of mucosal CD4 cell (langerhans and dendritic cells)
transport to regional lymph nodes
infection established within 3 days of entry
dissemination of virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

average onset of HIV symptoms

A

2-4 weeks post infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

primary HIV infection presentation

A 
fever
maculopapular rash
myalgia 
pharyngitis 
headache 
aseptic meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what occurs during asymptomatic HIV infection (after initial presentation)

A

ongoing viral replication
ongoing CD4 count depletion
ongoing immune activation
risk of onward transmission if remains undiagnosed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is an opportunistic infection

A

an infection caused by a pathogen the does not normally produce disease in a health individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

opportunistic pneumonia

A

pneumocystis jiroveci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

signs/symptoms of pneumocystis pneumonia

A

insidious one
SOB dry cough
exercise desaturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

treatment of pneumocystis pneumonia

A

high dose cotrimoxazole (+/- steroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

types of TB more common in HIV+ individuals

A 
symptomatic primary infection 
reactivation of latent TB
lymphadenopathies 
miliary TB
extrapulmonary TB
multi-drug resistant TB
immune reconstitution syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

presentation of cerebral toxoplasmosis

A 
headache 
fever 
focal neurology 
seizures 
reduced consciousness
raised ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

presentation of CMV

A

reduced VA
floaters
abdo pain/diarrhoea/PR bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

skin infections associated with HIV

A 
HZV
HSV
HPV
penicilliosis 
histoplasmosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

presentation of HIV-associated neurocognitive impairment

A

reduced short-term memory

+/- motor dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

presentation of progressive multifocal leukoencephalopathy

A

rapidly progressing
focal neurology
confusion
personality change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is ‘slim’s disease’

A

HIV-associated wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

AIDS related cancers

A

kaposi’s sarcoma (vascular tumour)
non-hodgkins lymphoma
cervical cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

factors increasing sexual transmission risk

A

unreceptive sex
trauma
genital ulceration
concurrent STI

28
Q

forms of parenteral transmission

A

infection drug use (sharing needles etc)
infected blood products
iatrogenic

29
Q

how can HIV be transmitted from mother to child

A

in utero/trans-placental
delivery
breast-feeding

30
Q

likelihood of an at-risk baby becoming infected

A

1/4

31
Q

group most at risk of HIV (UK)

A

MSM

32
Q

what percentage of people with HIV are undiagnosed

A

17%

33
Q

which group is most likely to be undiagnosed

A

heterosexual men

34
Q

who should be tested for HIV

A

universal testing in high prevalence areas
opt-out in certain clinical settings
screening of high risk groups
testing in the presence of ‘clinical indicators’

35
Q

high risk groups that should be screened regularly

A

MSM
females with bisexual male partners
PWIDs
partners of people with HIV

36
Q

endemic areas

A

sub-saharan africa
caribbean
thailand

37
Q

what is needed for a HIV test

A

venous blood sample for serology

38
Q

which markers are highest in the first 3 months of infection

A

viral load

p24 (antigen)

39
Q

which markers are highest in chronic infection

A

antibody

40
Q

which markers are highest in late disease

A

antibody and viral load

41
Q

what do HIV antibody tests detect

A

HIV-1 and HIV-2 antibody

IgM and IgG

42
Q

which test has a shorter window period

A

4th generation HIV test

43
Q

what is the difference between 3rd and 4th generation HIV test

A 
3rd generation
- antibody only 
- window period 20-25 days 
4th generation 
- antibody and antigen 
- shorter window period (14-28 days)
44
Q

a negative 4th generation test performed at ___ weeks after exposure is highly likely to exclude HIV infection

A

4 weeks

45
Q

what is a rapid HIV test

A

fingerprick specimen or saliva
results within 20-30 minutes
3rd/4th generation
wide variation in performance

46
Q

advantages of rapid HIV test

A 
simple to use 
no lab required 
no venipuncture required 
no anxious wait 
reduce follow up
good sensitivity
47
Q

disadvantages of rapid HIV test

A 
expensive 
quality control 
poor positive predictive value in low prevalence settings 
not suitable for high volume 
can't be relied on in early infection
48
Q

which enzyme is used in HIV viral RNA replication

A

reverse transcriptase

49
Q

what is the function of integrase

A

integrates the new viral double stranded DNA into the host DNA

50
Q

what is the function of protease

A

cleaves the viral proteins into smaller proteins to form mature HIV particles

51
Q

what are targets for anti-retroviral drugs

A 
reverse transcriptase 
integrase
protease 
entry (fusion or CCR5 receptor)
maturation
52
Q

when are protease inhibitors used in HIV treatment

A

for non-responsive HIV

53
Q

how do CCR5 receptors work

A

block the correceptor to prevent virus entering the cell

54
Q

what is highly active anti-retroviral therapy

A

a combination of 3 drugs from at least 2 drug classes to which the virus is susceptible

55
Q

what is the purpose of HAART

A

reduce viral load to undetectable
restore immunocompetence
reduce morbidity and mortality
minimise toxicity

56
Q

why is there a higher rte of ‘mistakes’ during viral replication than human DNA replication

A

reverse transcriptase doesn’t have a ‘proof-reading’ ability so can’t tell if it has made a mistake
transcriptase does have this function so can detect mutations

57
Q

how to prevent drug resistance

A

adherence/compliance

  • lifestyle
  • tolerability
  • pharmacokinetics
  • drug-drug interactions
  • treatment interruptions
58
Q

what is functional mono therapy

A

if taking combination therapy that is suddenly stopped, the drug with the longest half-life will continue to be present in the blood which therefore puts it at risk of becoming resistant

59
Q

skin side effects of HAART

A

rash

hypersensitivity

60
Q

CNS side effects of HAART

A

mood

psychosis

61
Q

renal side effects of HAART

A

proximal renal tubulopathies

62
Q

bone side effects of HAART

A

osteomalacia

63
Q

CVS side effects of HAART

A

increased MI risk

64
Q

haematological side effects of HAART

A

anaemia

65
Q

GI side effects of HAART

A

transaminitis

fulminant hepatitis

66
Q

how to prevent transmission of HIV from mother to child

A 
HAART during pregnancy 
vaginal delivery if undetected viral load (at 36 weeks)
c-section if detected viral load 
4/52 PEP for neonate 
exclusive formula feeding
67
Q

eligibility criteria for prep

A

high risk for HIV (HIV+ partner with detectable viral load or MSM or transwoman)
age >16
HIV negative
willing to stop if criteria no longer apply
resident in scotland

3 REPRO (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions