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J Repro > HIV > Flashcards

HIV Flashcards

1
Q

risk factors for HIV

A

MSM
PWID - low risk
location - sub Saharan/African/Caribbean countries

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2
Q

what type of virus is HIV

what does this cause

A

retrovirus

mistakes in RNA transcription

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3
Q

which type of HIV caused the global pandemic

A

HIV1 M

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4
Q

how can HIV be transmitted (4)

which is the most common form of transmission

A

sex - 94%
parenteral/vertical transmission - for mum to baby
infected blood products
sharing needles (PWID)

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5
Q

what are the 3 enzymes involved in replication of HIV

hence are targets for treatment

A

reverse transcriptase enzyme
integrase enzyme
protease enzyme

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6
Q

which is high and which is low in HIV between CD4+ and CD8+

A

CD4+ low - KNOW this

CD*+ high - less relevant, bc of negative feedback of low CD4+

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7
Q

why does low CD4+ cause immunosuppression

A

decreased CD4+ = decreased antibody formation = immunosuppressed = more susceptible to infection

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8
Q

which immune cell is predominantly low in HIV, and hence is the cause of the immunosuppression

A

CD4+

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9
Q

CD4+ levels in HIV late stage

what is normal levels

A

<200 cells/mm3

normal 500-1600 cells/mm3

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10
Q

how long between entry of virus and start of infection is there

clinical significance of this

A

3 days

can give PEP (post exposure prophylaxis)

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11
Q

presentation of primary HIV infection (2-4 weeks after infection) (4)

A

fever
rash
pharyngitis (sore throat)
myalgia

initially presents like another other viral infection! - not good bc can be missed

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12
Q

if young male with viral infection symptoms (fever, rash, sore throat, myalgia), what should you always check for

A

HIV!

don’t just send away to increase fluids, bc this will make them feel better but infection will go undiagnosed

reassure them its standard procedure, just checking their immunosuppression - and you just want to rule it out (better to be safe than sorry)

document if they decline

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13
Q

what happens to psoriasis in HIV

why

A

gets worse

psoriasis is CD8+ mediated, and CD8+ is high in HIV

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14
Q

what happens to rheumatoid arthritis in HIV

why

A

gets better

RA is mediated by CD4+, and CD4+ is low in HIV

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15
Q

which neuro condition can present in HIV

A

HIV dementia

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16
Q

which resp condition is common in HIV (be specific)

A

pneumocystis pneumonia

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17
Q

microbio of pneumocystis pneumonia

A

pnemocystic jirovecii

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18
Q

presentation of pneumocystis pneumonia

A

SOB

dry cough

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19
Q

management of pneumocystis pneumonia

A

high dose co-trimoxazole

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20
Q

?HIV

night sweats
fever
weight loss
cough

A

TB

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21
Q

?HIV

SOB 
dry cough (from lung consolidation)
A

pneumocystis pneumonia

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22
Q

if someone is diagnosed with HIV what other condition must you test for

A

TB (where HIV is common TB is also common)

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23
Q

treatment of TB

A

2 RIPE 4 RI

2 months of rifampicin, isoniazide, pyrazinamide and ethambutol
4 months of rifampicin and isoniazide

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24
Q

what microbio cause of cerebral abscess is common in people with HIV

A

toxoplasma gondii

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25
Q

?HIV

headache
fever
seizures papilloedema
reduced consciousness

A

cerebral toxoplasmosis

brain abscess caused by toxoplasma gondii

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26
Q

?HIV

blindness

A

CMV retinitis

27
Q

if you offer someone a HIV test and they decline, what should you do

A

document it

28
Q

what markers do you investigate for HIV infection (4)

A

viral load (viral RNA) - PCR
p24
antibody - detects IgM and IgG
CD4+ (TLC)

29
Q

what investigation is used to look at viral load (PCR) and p24 and DIAGNOSE HIV

A

serum/salivary ELISA

30
Q

what investigation is used to look at viral load (PCR) and p24 and monitor PROGRESS of HIV

how long til you get results

A

rapid HIV test (POCT) - finger prick/saliva

30 mins = good bc decreased anxiety

31
Q

is HIV treatable

A

yes!!

32
Q

treatment for HIV

A

HAART (highly active anti-retroviral therapy)

3 drugs from 2 diff classes - NtRTI, NRTI, NNTRI

33
Q

what is a NRTI

example

A

nucleoside reverse transcriptase inhibitor

eg emtricitabine

34
Q

what is a NNRTI

example

A

non nucleoside reverse transcriptase inhibitor

eg efvirenz

35
Q

NtRTI example

A

eg tenofovir

36
Q

what is the aim of HARRT treatment for HIV

A

to gain an undetectable viral load

37
Q

when is PEP (Post Exposure Prophylaxis) used in HIV

A

if condom breaks

infected person doesn’t tell partner til after

38
Q

within what time frame of having sex and being infected is PEP effective

A

<3 days

39
Q

when is PrEP (PRe Exposure Prophylaxis) used in HIV

A

regular partner infected

MSM unprotected sex >2 per year with partners

40
Q

PrEP example

A

eg tenofovir

41
Q

what contraceptive measure is PrEP similar to (in principle)

A

COCP

42
Q

what contraceptive measure is PEP similar to (in principle)

A

morning after pill

43
Q

diagnosis of HIV requires what type of screening

A

STI screening

44
Q

if someone is diagnosed with HIV what do you want to do to partner

A

get partner tested too

45
Q

what is it called when you give the patient 1 month to tell their partner and if they don’t get tested you can contact them

A

conditional testing

46
Q

what obligations does a HIV clinician have to the partner of someone infected with HIV

A

none if theyre not your patient
cant break confidentiality
your care is to your patient - you need to get them to trust you

47
Q

what obligations does a GP have to the partner of someone infected with HIV if they are also your patient

A

obligation to both

encourage HIV patient to tell partner
if not; could try test them sneakily eg if they come in with a cough, would test for ‘immunosuppression’
if not; give them the chance again to tell them and warn them if not youll have to break confidentiality

PHONE DEFENCE UNION foe help lol

48
Q

can someone with HIV still have sex

what about if untreated or treated but viral load still detectable
what about if treated and viral load not detectable

A

yes

if untreated/viral load still detectable; need to use condom/partner on PrEP/PEP
if treated and viral load undetectable; no risk of transmission!

49
Q

is there a risk of HIV transmission if you share the same cup

A

no

50
Q

is there a risk of HIV transmission if you share the same razor

A

yes - bc risk of bleeding

51
Q

legal consequence in Scotland if you have HIV and have unprotected sex and don’t tell partner

A

charged for reckless behavior

52
Q

main complication of HIV

A

psychosocial wellbeing (exclusion, stigma etc)

NOT AIDS! actually rare

53
Q

rare complication of HIV

A

AIDS

54
Q

how can HIV cause AIDS

A

if untreated

55
Q

do all people with HIV get AIDS

A

no - not if treated

in the past yes bc of lack of treatment

56
Q

what does AIDS stand for

A

acquired immunodeficiency syndrome

57
Q

which vascular tumour can occur in AIDS

A

Kaposi sarcoma

58
Q

how does Kaposi sarcoma present

A

papules on skin (vascular tumour)

59
Q

which type of lymphoma can occur with AIDS

A

non hodgekins lymphoma

60
Q

what type of cancer are women with HIV screened for more regularly than normal

A

cervical cancer

61
Q

if untreated HIV, how long til death

A

10 years

62
Q

why are MSM higher risk for HIV

A

anoreceptive sex = anal mucosa is only 1 cell thick (vagina is 30)

63
Q

what is viral load measuring

A

viral RNA

J Repro (28 decks)

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