HIV & AIDS Flashcards
what are the 6 steps of the HIV (or any virus) life cycle
A FuckeR I AM
- Attachment
- Fusion
- reverse transcription
- integration
- assembly
- maturation
can you spread HIV if your viral load is low
no way howsay
where in the world is HIV most common
subsaharan africa
how many folk in UK have HIV
may be more eh
90,000 -> 100,000
is HIV a notificable disease
no
can HIV & AIDS increase your risk of getting cancer?
yeah
what are opportunistic infections
those that usually dont affect folk with a healthy immune system
so only affect those who are immunosuppressed
what is the name of HIV treatmetn
HAART or cART
Highly active anti-retroviral therapy or Combined antiretroviral therapy
need at least 3 drugs of 2 diveretn classes
how many drugs do you need in HAART
3 from at least 2 different classes
once HIV is diagnosed, when should you start treatment
ASAP
what prophlactic vaccines can be used alongisde HAART
Flu (yearly)
penuomoccal
what are like the 2 main eye shite associated with AIDS
CMV retinitis
HSV retinits
what eye associated AIDS problems are these…
- “pizza pie” & flame haemorrages
- branch-like pattern, watery, stains on fluroscein
- CMV retinits
- HSV retinits
seizures with AIDS is likely to be due to…
Cryptocococcal meningitis
cryptococooal meningitis
- how can it present
- what you see on an LP
- what stains it
- seizures in AIDS
- yeast
- india ink
if someone is on cART and they get a ‘sudden weakness’
what is this likely to be and why
stroke or TIA
HAART increases chance of stroke
if someone is being treated with HAART and then develops shite like kaposi sarcoma, what must you ask them
if they’re taking HAART as they should be
what does kaposi sarcoma look like
palpable pulple lesions
oral hairy leukoplakia can occur in HIV
what is the opportunistic infection that causes it
EBV
in somone who’s pregnant and has HIV, why must you check the viral load
determines if C-section is needed
>50 then C-section
what is the opportunisitc infetion that causes kaposi sarcoma
HHV-8
what can be offered after gay sex to reduce chance of HIV
regardless of HIV status
Post exposre prophylaxis
what opportunisitc infectiosn can occur with the following CD4 counts…
- 500-200
- 200-100
- 100-50
- >50
1.
Oral thrush
shingles (HSV)
Oral hairy leukoplakia (EBV)
Kaposi sacroma (HHV-8)
2.
cryptospirosis (dirrhoea)
Cerebral toxoplasmosis
PML
PJP
3.
Oesophageal candiasis
Aspergillous
CNS lymphoma
4.
CMV retinits
Mycobacterim acium
what are the CD4 counts for when these brain issues can occur in HIV
- cerebral toxoplasmosis
- CNS lymphoma
- PML (progressive multifoal enceophalopahty)
1 & 3. 200-100
- 100-50
what infection do you only get if CD4 count is very low (>50) and how may it present
mycobacterium avium
abdo pain & high ALP
what does PML stand for regarding HIV
what virus causes it
what does it look like on MRI
Progressice mulifocal encephalopathy
James Cunningham virus
Mulitofocal non-enhancing Demylimationg lesions
what type of infections usually occur when CD4 count is 100-50
fungal shite
aspergillosus & oesophageal candidosis
if you get stabbed by a needle after taking blood from someone with HIV…
- what do you do first
- where do you refer yourself
- when do you need post-exposure prophylaxis
- how long you take HAART
- encourgae bleeding
- ED
- within 72hours
- 4 weeks
has HIV
worsening speech & behaviour
poor coordination
Mulitofocal non-enhancing demyelinating lesions on MRI
what is this
PML
due to JC virus
what opporrtunisitc infection that can occur in HIV is common after renal transplants
CMV
has HIV
headaches & confusions
ring enhancing lesions on CT
treated with pyrimethamine + sulphadiazine for 6 weeks
what is this
Cerebral toxoplasmosis
on brain imaging, what do the following look like…
PML
Cerebral toxoplamsosis
CNS lymphoma
PML -> non-enhancing lesions
cerebral toxoplasmosis -> enhancing lesions
CNS lumphoam -> homogenous enhancing lesions
what can be done to treat CNS lymphoma
whole brain stimulation
child with HIV
acially and cervical lymphadenopahty
big tonsils
what is this
Kaposi sarcoma
maybe rash more common in adults
advanced HIV (low CD4 count)
swallowing problems
what is this
oesophageal candidiosis
for pts who are asymptomatic and think they have HIV, when do you test for p24 antigen
4 weeks AND 12 weeks
what is the most common opportunistic infection in HIV/AIDS
PJP
Pneumocystis Jivoreci Pneumonia
how does PJP present
Desatutations on exertion
Dry cough
SOB
Cyanosis
Fever
Bilaterla hilar infiltrates on CXR
what investigations would you do for PJP
CXR
O2 sats (exercise induced)
Broncho-alveolar levage (best)
PJP management
- normal cases
- severe cases
- if hypoxic (<92%)
- co-trimoxazole
- pentamadine
- steroids
what type of staining do you do for PJP
silver
what are the SEs for co-trimoxazole
Agranulocytosis
SJS
what widespread rash is this that can occur in HIV
toxic exanthema
what is a normal CD4 count and when shoudl you start treatment
normal= >500
treatment= <350
what can be done to try and prevent getting HIV
Safer sex
Circiumcission
what can cause HIV
sex
vertical transmission (mother -> baby)
IV drugs
Needle sharing
Bodily fluid exposure
Blood transfusions
Organ transplants
what 2 investigations do you do to diagnosis HIV
which one is first and why
p24 antigen & HIV antibody tests
antigen first cause antiboidies take time to develop
what are the HIV-related investgiations
p24 antigen (first)
HIV antibiodoies
Viral load
CD4 count
HIV resistance test
what HIV investigation is used for…
- checkign effectiveness of HAART
- checkign which HAART is best to use
- HIV viral load
- HIV resistance test
what genes are the 2 targets for the HIV treatments
why are they targets
(some immunology)
gp-120 -> HIV glycoprotein
CCR-5 -> cofactor
what are the sort of clinical stages of HIV
- just some lymphadenopathy
- recurrent infections & some weight loss
- sevre infections, skin lesiosn, severe weight loss
- PJP, lymphoma…
types of HIV drugs inhibit what different things…
Nucleoside & non-nucleoside reverse transcription
Fusion
Protease
Integrase
what can HIV do to platelets
thrombocytopenia
what are the different types of drugs used in HHART
Nucleoside reverse transcriptase inhibtior
Non-nuslceoside reverse transcriptase inhibtior
Fusion inhibitor
Protease inhibtiors
Integrase inhibtiors
Chemokine antagonsits
(rememeber need 3 drugs of at least 2 different classes)
how do the following HIV meds work:
- Nucleoside reverse transcriptase inhibtior
- Non-nuslceoside reverse transcriptase inhibtior
- Fusion inhibitor
- Protease inhibtiors
- Integrase inhibtiors
- Chemokine antagonsits
1 & 2. prevent transcription (RNA -> DNA)
- stop HIV from fusing
- prevents progression
- stop HIV integrating with CD4 chromosomes
- inhibits co-factor (CCR-5 gene)
whats like the non-inhibitior HIV treatment
chemokine antagonist
what is the suffix of all protease inhibitors
Navir
“Never tease a pro”
what is the reason that you use 3 drugs in HAART?
reduce chances of drug resistance
