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Infection AM > HIV > Flashcards

HIV Flashcards

1
Q

What type of virus is HIV?

A

RNA retrovirus

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2
Q

What is the mechanism of HIV?

A

Enters and destroys CD4 T helper cells

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3
Q

How is HIV transmitted?

A

Unprotected oral, vaginal or anal sex
Vertical transmission
Open wounds, mucous membrane or blood exposure to infected blood/bodily fluids e.g. needle stick, blood in eye

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4
Q

What is the progression of HIV?

A

Initial seroconversion illness
Becomes asymptomatic until progression
HIV suggesting conditions
AIDS defining conditions

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5
Q

What is the presentation of the initial seroconversion in HIV?

A

Flu/glandular fever like illness for several weeks

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6
Q

What are some conditions suggestive of HIV?

A 
Oral hairy leukoplakia 
Extensive seborrheic dermatitis or psoriasis 
Very early onset dementia 
Shingles, esp recurrent 
Hep B/C 
Invasive cervical cancer 
Unusual meningitis/encephalitis 
Cerebral abscess
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7
Q

What are sone AIDS definition conditions?

A 
PJP 
Cerebral toxoplasmosis, cryptococcal meningitis, progressive multifocal leukoencephalopathy 
TB 
Kaposi's sarcoma 
CMV 
Lymphoma 
Oesophageal/bronchial candidiasis 
Aspergillosis
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8
Q

What is the Diagnostic test for HIV?

A

HIV antibody test- ELISA and Western Blot assay

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9
Q

What investigations are done if HV test comes back +?

A

PCR for viral load
CD4 count
Resistance assay
FBC, LFTs, U&Es, lipid profile for underlying health and complications

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10
Q

What investigations are done to screen for opportunistic infections at the time of diagnosis?

A

CXR for TB
Hep B and C
STI screen
Toxoplasmosis

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11
Q

What is the principle of management of HIV?

A

Combination antiretroviral therapy- At east 3 drugs from at least 2 classes

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12
Q

What are the antiretroviral options?

A

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

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13
Q

What is the standard combination antiretroviral therapy?

A

Normally 2 NRTAs as “backbone” and 1 other “active”

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14
Q

How is HIV monitored?

A

Viral load
CD4
CV health
Cervical smear

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15
Q

What is the vaccination protocol with HIV?

A

Up to date vaccines
Flu, pneumococcal, hepatitis
Avoid live vaccines if very immunosuppressed

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16
Q

What is the management of HIV in pregnancy?

A

Start antiretroviral therapy before 3rd trimester
Deliver via C section unless viral load undetectable
Treat baby with antiretrovirals for 4 weeks
Do not breastfeed

17
Q

How is PJP treated?

A

Cotrimoxazole +/- prednisolone

18
Q

What is the post exposure prophylaxis for HIV?

A

Combination antiretroviral for 28 days

Test at 3 months

19
Q

Why is diarrhoea common in HIV?

A

Due to virus itself and opportunistic infections

20
Q

What is the most common cause of cerebral lesions in HIV patients?

A

Toxoplasmosis

21
Q

What is the appearance of cerebral toxoplasmosis?

A

Multiple lesions with ring enhancement

22
Q

What are some common neuro complications with HIV?

A 
Toxoplasmosis 
Primary CNS lymphoma 
Encephalitis
Cryptococcal meningitis 
AIDS dementia complex 
Progressive multifocal leukoencephalopathy
23
Q

What is progressive multifocal leukencephalopathy?

A

Widespread demyelination due to JC virus

Causes behavioural changes, and speech, motor and visual impairment

24
Q

What causes Kaposi’s sarcoma?

A

HPV 8

25
Q

What is the presentation of Kaposi’s sarcoma?

A

Purple papules/plaques on skin and mucosa
May ulcerate
Resp involvement can cause massive haemoptysis

26
Q

What is PJP pneumocystis jirovecii pneumonia?

A

Fungal infection

Most common opportunistic infection in AIDS

27
Q

What is the presentation of PJP?

A 
Dyspnoea
Dry cough 
Fever
Few chest signs
Rare= lymphadenopathy, hepatosplenomegaly
28
Q

What investigations are done for PJP?

A

CXR= bilateral interstitial pulmonary infiltrates, not a classic pneumonia XR
Exercise induced desaturation
Sputum/bronchoalveolar lavage PCR

29
Q

What is the management of PJP?

A

Co-trimozaxole

Severe= + prednisone

30
Q

What is the presentation of oesophageal candidiasis?

A

Dysphagia

Odynophagia

31
Q

What is the management of oesophageal candidiasis?

A

Fluconazole

Itraconazole

Infection AM (6 decks)

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