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REPRO > HIV > Flashcards

HIV Flashcards

1
Q

WHat does it mean to be a retrovirus?

A
  • use of reverse transcriptase to replicate its RNA strand (for a second RNA strand)
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2
Q

WHere is HIV-2 commonly seen?

A
  • in west Africa

- less frequent thus not often seen

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3
Q

What is the target site for HIV ? What is their role?

A
  • CD4+ receptors
  • —-a glycoprotein found on the surface of a range of cells
  • —import. for inducing adaptive immune response
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4
Q

How does HIV infections affect immune responses?

A
  • reduced prolif. and circulation of CD4+ CELLS
  • reduced C8+ activation
  • reduced antibody class switching —reduced Ab affinity
    • chronic immune activation in the GUT
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5
Q

What is the CD4 count that puts an individual at risk of opportunistic infections?

A
  • CD4 count below 200 cells/mm3
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6
Q

How rapid is HIV replication ?

A
  • RAPID in EARLY and VERY late infection

- new gen every 6-12 hrs

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7
Q

What is the time to death w.o HIV rx?

A
  • 9-11 years
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8
Q

How long does it take for HIV to establish infection?

A

within 3 days of entry

therefore ….72 hrs to intervene with prophylaxis

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9
Q

WHat are the symptoms of Primary HIV infection?

A
  • rash; maculopapular
  • fever
  • swollen glands
  • pharyngitis
  • Myalgia
  • headache/ aseptic meningitis
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10
Q

When does primary HIV infections set in?

What is the risk of person experiencing Primary HIV infection?

A
  • ~2-4 weeks after infection

- VERY high risk of TRANSMISSION

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11
Q

If the glandular test comes out as negative…

A
  • do HIV testing
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12
Q

Define opportunistic infections.

A

infection caused by a pathogen that does not normally produce disease in a healthy individual—-seeks the Opportunity with a weakened immune system

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13
Q

Most COMMON opportunistic infection in HIV pt?

Wht is the CD4 count like?

A

pneumocystis pneumonia by pneumocystis jiroveci

  • <200
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14
Q

What are the symptoms of p.pneumonia?

A

insidious onset

  • SOB
  • Dry cough
  • —signs: EXERCISE desaturation (make them walk a flight of stairs 5 times)
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15
Q

How to dx PP?

A
  • PCR
  • bronchoalveolarlavage
  • immunofluorescence
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16
Q

How to treat pneumocystic pneumonia?

A
  • high dose Co-trimoxazole (w/ or w/o steroid)

–low-dose for Prophylaxis

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17
Q

Symptoms of Cerebral toxoplasmosis?

A 
Headache
Fever
Focal neurology
Seizures
Reduced consciousness
Raised intracranial pressure

—–very specifc neuro symptoms d/t cerebral abscess

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18
Q

What are symptoms of CMV infection present as?

A

Reduced visual acuity
Floaters
Abdo pain, diarrhoea, PR bleeding
—-colitis (tender abdomen)

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19
Q

How does HIV- associated neurocognitive impairm/ present as?

A

Reduced short term memory
+/- motor dysfunction
—-age-related dementia

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20
Q

How may PML appear on CT scan?

A
  • like multiple sclerosis
  • —-white matter pathology
  • —FRONTAL lobe changes (personality change/ confusion/ focal neurology)
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21
Q

How does HIV- associated wasting present as?

A
  • Slim’s disease (extremely cachexic)

- —-multifactorial (anorexia/metabolic- chronic metabolic activ./ malabsorption/ hypogonadism)

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22
Q

Name an AIDS related cancer. and the causal virus?

A

Kaposi’s Sarcoma

- Herpes virus 8

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23
Q

EBV causing, AID-related cancer? Presentation?

A
  • non-Hodgkin’s Lymphoma
  • More advanced
    B symptoms
    Bone marrow involvement
    Extranodal disease
    ↑ CNS involvement
24
Q

Main hematological manifestation of HIV?

A

Anemia
—-affects up to 90%
Thrombocyotpenia

25
Q

Factors increasing transmission risk of HIV

A

Anoreceptive sex
Trauma
Genital ulceration
Concurrent STI

  • injection drug use and SHARING
  • iatrogenic
  • infected blood products

In utero/trans-placental
Delivery
Breast-feeding

26
Q

Which groups should be tested for HIV?

A
  • universal testing in HIGH prevalence areas (cost-effective)
  • opt-out HIV testing in clinical settings (enter a sexual health clinic, drug users)
  • screening of HIGH risk groups (MSM/ female partners of BISEXUAL men/ drug injectors/ hiv partner)
  • testing on clinical grounds (those with SYMPTOMS
27
Q

HIV markers for testing?

A
  • HIV antigen develops faster

- — better to test for this than antibodies (appears in 3 months)

28
Q

What is occurring during asymptomatic HIV infection?

A
  • ongoing VIRAL infection
  • ongoing CD4 count depletion
  • ongoing IMMUNE activation
  • —-onward transmission if UNDIAGNOSED
29
Q

What is seen on CXR of pneumocystic pneumonia?

A
  • normal
    OR
  • reticulonodular markings
  • interstitial infiltrates
30
Q

What does HIV cause?

A
  • AIDS

(Acquired Immunodeficiency Syndrome) —-> opprotunistic infections or AIDS-related cancers

31
Q

Is AIDS preventable?

A

YES
- by early HIV dx and rx

HIV infection is ALSO preventable

32
Q

Where does Hiv-1 originate from?

A
  • CENTRAL and WEST African chimpanzees
33
Q

What does CD4 activate?

A
  • Bcells
  • cytotoxic T-cells (CD8+)
  • cytokine release
  • recog. of MHC2 Ag-presenting cell
34
Q

With HIV’s impact on the immune response, what does this ultimately make one susceptible tO?

A

VIRAL infections
FUNGAL infections
Mycobacterial infections
Infection-induced cancers

35
Q

What forms of TB may be seen with HIV infections?

A
  • ones NOT commonly seen in those who are HIV-
  • miliary TB
  • Lymphadenopathies
  • extrapulmonary TB
  • Multi-drug resistant TB
  • Immune reconstitution Syndrome
36
Q

What cuases Cerebral Toxoplasmosis?

What is the CD4 count at,?

A
  • causes by Toxoplasma Gondii

- CD4 <150

37
Q

What occurs is Cerebral toxoplasmosis?

A
  • reactivation of a LATENT infection

- –> MULTIPLE cerebral abscess !

38
Q

Reactivation of of LATENT CMV infection, results in what?

A
  • retinitis
  • colitis
  • esophagitis

-CD4 < 50

39
Q

WHta skin infection may arise IIary to HIV infection?

A
  1. Herpes Zoster
  2. Herpes Simplex
  3. Human Papilloma virus
  4. Weird/ Wonderful
40
Q

WHich skin infection is multidermatomal and RECURRENT ?

A
  • Herpes Zoster !
41
Q

Which skin infection is extensive and ACLIOCVIR -resistant?

A

Herpes Simplex

42
Q

What does HIV-1 cause?

WHen may it occur?

A

HIV-associated Neurocognitive Impairment

  • incr. incidence with Incr. short term immunosuppression
43
Q

How does HIV-associated Neurocognitive Impairment present as?

A
  • reduced short term memory

+/- MOTOR dysfxn

44
Q

What does JC virus cause?

A

at CD4 <100

> progressive multifocal leukoencephalopathy

45
Q

How does progressive multifocal leukoencephalopathy present as?

A
  • focal neurology
  • rapidly progressive
  • CONFUSION
  • personality change
46
Q

What are other neurological pres. of HIV>

A 
Distal sensory polyneuropathy
Mononeuritis multiplex
Vacuolar myelopathy
Aseptic meningitis
Guillan-Barre syndrome
Viral meningitis (CMV, HSV)
Cryptococcal meningitis
Neurosyphilis
47
Q

How may HIV affect weight?

A
  • Slim’s Disease
    (HIV-associated Wsting)
- could be d.t:
> metabolic cause 
> anorexia
> diarrhoea
>hypogonadism
48
Q

Name the 3 cancers HIV may cause?

A
  1. Kaposi’s CA
  2. NON-Hodgkins Lymphoma
  3. Cervical Cancer
49
Q

What causes Kaposi’s sarcoma caused by?

A

Herpes Virus 8 (HHV8)

—-used to affect 40% before antiretroviral drugs era

50
Q

What is kaposi’s Sarcoma? How is it treated?

A
  1. Vascular tumor

2. HAART; Local therapies; systemic chemotherapy

51
Q

WHat virus causes Non-hodgkin’s lymphoma?

How does it present as?

A
  • EBV

- > bone marrow involvement; extranodal disease; ^ CNS involvement

52
Q

How does cervical cancer occur ?

A
  • persistence of HPV infection

rapid progression of SEVERE dysplasias and INVASIVE disease

53
Q

What specific testing should be offered to ALL complicated HPV disease?

A
  • HIV testing

- those with high grade CIN/ VIN/ AIN/ PIN

54
Q

Name some NON-opportunistic infections for symptomatic HIV.

A
  1. mucosal candidiasis
  2. seborrhoeic dermatitis
  3. diarrhoea
  4. fatigue
  5. worsening of PSORIASIS
  6. parotitis
  7. lymphadenopathy
  8. (STIs/ Hep B/ Hep C)
55
Q

Name Hematological manifestations in HIV pts. Why may it occur?

A

Anaemia (90%)
Thrombocyotpenia (ITP)

d.t HIV, Opportunistic inf./ AIDs-Malignancies

REPRO (55 decks)

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