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Infections > HIV > Flashcards

HIV Flashcards

1
Q

How can HIV be spread?

A 
Sexual transmission
IV drug abuse
Blood products
Vertical transmission
Organ transplant
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2
Q

When can you perform an HIV test on an unconscious patient?

A

If you think it is in the patients best interest

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3
Q

What does HIV do to the immune system?

A

Destroys the cells, especially T-helper cells with CD4 receptors on their surface

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4
Q

What is the natural history of HIV infection?

A

CD4 count declines and HIV viral loads increases

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5
Q

What are patients with HIV at increased risk?

A

Infections

Tumours

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6
Q

How can severity of illness in HIV be assessed?

A

Lower CD4 counts mark more severe infections

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7
Q

When does an AIDS diagnosis occur?

A

CD4<200

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8
Q

What occurs at stage 1 HIV?

A

Asymptomatic

Persistent generalised lymphadenopathy

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9
Q

What occurs at HIV stage 2?

A

Weight loss <10% of body weight
Minor mucocutaneous infections
Herpes zoster within last 5 years
Recurrent Upper resp infections

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10
Q

What occurs at HIV stage 3?

A 
Weight loss >10% body weight
Unexplained chronic diarrhoea
Unexplained prolonged fever
Oral candidiasis
Oral hairy leukoplakia
Pulmonary TB
Severe bacterial infections
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11
Q

What occurs at HIV stage 4?

A 
HIV wasting syndrome
Pneumocystic carinii syndrome
Toxoplasmosis of the brain
Cryptosporidosis with diarrhoea
Cryptococcis extrapulmonary
Cytomegalovirus disease of organ other than liver, spleen, or lymph nodes
HSV infection mucocutaneous
Disseminated endemic mycosis
Candidiasis of oesophagus or resp tract
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12
Q

What is the difference between HIV and AIDS?

A

HIV is an immune suppressant virus

AIDS is symptoms suffered as a result of the immune system being weakened by HIV

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13
Q

What are respiratory AIDS defining conditions?

A

TB

Pneumocystitis

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14
Q

What are neurological AIDS defining conditions?

A

Cerebral toxoplasmosis
Primary cerebral lymphoma
Cryptococcal meningitis
Progressive multifocal leucoencephalopathy

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15
Q

What are neurological conditions where HIV testing should be offered?

A 
Aseptic meningitis/encephaliltis
Cerebral abscess
Space occupying lesion of unknown cause
Guillan-Barre syndrome
Transverse myelitis
Peripheral neuropathy
Dementia
Leucoencephalopathy
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16
Q

What is an AIDS defining dermatological condition?

A

Kaposi’s sarcoma

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17
Q

What is a GI AIDS defining condition?

A

Persistent cryptosporidosis

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18
Q

What oncological condition is AIDS defining?

A

Non-Hodgkin’s lymphoma

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19
Q

What Gynaecological condition is AIDS defining?

A

Cervical cancer

20
Q

What is the natural history of HIV infection?

A 
Acute infection
Asymptomatic
HIV related illness
AIDS defining illness
Death
21
Q

What is HIV seroconversion?

A

When HIV antibodies are first produced

22
Q

What are symptoms of HIV seroconversion?

A 
Flu-like illness
Fever
Malaise and lethargy
Pharyngitis
Lymphadenopathy
Toxic exanthema
23
Q

What are features of pneumocystis jiroveci pneumonia?

A

Late stage AIDS infection
Opportunistic infection
CD4 cell count usually <200
Classical history of dry cough and increasing breathlessness over several weeks

24
Q

What investigations are done for pneumocystis jiroveci pneumonia?

A

CXR

Induced sputum or broncoscopy for Polymerase Chain Reaction

25
Q

What is used to treat pneumocystis jiroveci pneumonia?

A

Cotrimoxazole

Pentamidine

26
Q

How long is treatment given for pneumocystis jiroveci pneumonia?

A

Until CD4 >200

27
Q

What is used to treat HIV?

A

Combination Antiretroviral Therapy

28
Q

What is Combination Antiretroviral Therapy?

A

Pill containing 3 drugs from at least 2 groups

29
Q

What is the required patient adherence for combination antiretroviral therapy to work?

A

90%

30
Q

How long does HIV treatment need to be taken?

A

For life

31
Q

What are different types of antiviral drugs?

A

Nucleoside reverse transcriptase inhibitors
Non-nucleoside reverse transcriptase inhibitors
Protease inhibitors
Integrase inhibitors

32
Q

What are side effects of nucleoside reverse transcriptase inhibitors?

A

Marrow toxicity
Neuropathy
Lipodystrophy

33
Q

What are side effects of non-nucleoside reverse transcriptase inhibitors?

A

Skin rashes
Hypersensitivity
Drug interactions
Neuropsychiatric effects

34
Q

What are side effects of protease inhibitors?

A

Drug interactions
Diarrhoea
Lipodystrophy
Hyperlipidaemia

35
Q

What are side effects of integrase inhibitors?

A

Rashes

Disturbed sleep

36
Q

What demographics have the most HIV prevalence?

A

Men who have sex with men

Black african population

37
Q

How can HIV be transmitted?

A 
Sexual intercourse - anal/vaginal
Vertical transmission - mother to baby via pregnancy, childbirth, or breastfeeding
Sharing needles
Needlestick injury
Blood transfusion
Organ transplant
38
Q

What is the virology of HIV?

A

HIV attaches to cells with CD4 which leads to low levels of CD4 cells

39
Q

How is HIV tested for?

A 
Antibody
Antigen
Viral load
CD4 count
Typing
40
Q

What is the diagnostic window?

A

The point of infection before it can be detected by diagnostic tests - before antibodies are made

41
Q

How is HIV infection monitored?

A

CD4 cell count
HIV viral load
Clinical features

42
Q

What body fluids can spread HIV?

A 
CSF
Pleural/peritoneal/pericardial fluid
Breast milk
Amniotic fluid
Vaginal secretions/semen
Saliva
Synovial fluid
43
Q

What should be done after exposure to HIV?

A

Wash off splashes on skin with soap and running water
Exposed mucous membranes should be irrigated with water
Encourage bleeding if skin broken
Wash out splashes in the eye

44
Q

What is HIV PEP?

A

Post exposure prophylaxis

45
Q

What drugs are given for HIV PEP?

A

Truvada

Raltegravir

46
Q

When should HIV PEP be administered?

A

Within 72 hours of exposure for 28 days

Infections (14 decks)

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