HIV Flashcards
clinical presentation of acute symptomatic HIV infection include
fever, lymphadenopathy, sore throat, myalgia/arthralgia, headache, diarrhoea, maculopapular rash but commonly asymptomatic
physical examination of asymptomatic chronic infection with HIV will reliably reveal
generalized lymphadenopathy, (mobile, rubbery, painless, symmetrical, cervical/submandibular/occipital/axillary, don’t consider inguinal)
skin conditions seen in HIV infection without significant immunosuppression commonly include
persistent oropharyngeal/vulvovaginal candidiasis seborrheic dermatitis oral hairy leukoplakia (EBV) HSV, Shingles (VZV) bacterial folliculitis (staph aureus)
What other infections frequently co-occur in HIV infection?
Hep B and C
Syphillus
what CD4 count defines AIDS?
<200
What are some common AIDS-defining illnesses?
PJP pneumonia Kaposi's Sarcoma Oesophageal candidiasis Mycobacterium complex infections wasting syndrome PML fungal infections CMV
gradual development of a fever, non-productive cough, dyspnoea and fatigue with usual activities in an HIV-infected patient is suspicious for
PJP pneumonia
PJP pneumonia appearance on CXR
diffuse, bilateral, interstitial/alveolar infiltrates +/- cysts/nodules/pleural effusions
definitive diagnosis (usually just mad eon clinical grounds) of PJP is made using
microscopy and PCR of sputum, bronchoalveolar lavage or transbronchial biospy
treatment of PJP is
trimethoprim + sulfamethoxazole
acute onset altered consciousness, headache, fever, focal neurological symptoms in an HIV infected patient is suspicious for
Toxoplasmosis (toxplasma gondii reactivation in CNS)
investigations for suspected toxoplasmosis in an HIV-infected patient include
MRI head
positive anti-toxoplasma IgG antibody (titre does not matter)
treatment of toxoplasmosis is
sulfadiazine and pyrimethamine PO
what must be given with pyrimethamine and why
folinic acid to prevent haematological toxicity
