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Oh no- Infections > HIV & AIDS > Flashcards

HIV & AIDS Flashcards

1
Q

what are the 6 steps of the HIV (or any virus) life cycle

A

A FuckeR I AM

  1. Attachment
  2. Fusion
  3. reverse transcription
  4. integration
  5. assembly
  6. maturation
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2
Q

can you spread HIV if your viral load is low

A

no way howsay

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3
Q

where in the world is HIV most common

A

subsaharan africa

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4
Q

how many folk in UK have HIV

may be more eh

A

90,000 -> 100,000

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5
Q

is HIV a notificable disease

A

no

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6
Q

can HIV & AIDS increase your risk of getting cancer?

A

yeah

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7
Q

what are opportunistic infections

A

those that usually dont affect folk with a healthy immune system

so only affect those who are immunosuppressed

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8
Q

what is the name of HIV treatmetn

A

HAART or cART

Highly active anti-retroviral therapy or Combined antiretroviral therapy

need at least 3 drugs of 2 diveretn classes

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9
Q
A
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10
Q

how many drugs do you need in HAART

A

3 from at least 2 different classes

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11
Q

once HIV is diagnosed, when should you start treatment

A

ASAP

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12
Q

what prophlactic vaccines can be used alongisde HAART

A

Flu (yearly)

penuomoccal

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13
Q

what are like the 2 main eye shite associated with AIDS

A

CMV retinitis

HSV retinits

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14
Q

what eye associated AIDS problems are these…

  1. “pizza pie” & flame haemorrages
  2. branch-like pattern, watery, stains on fluroscein
A
  1. CMV retinits
  2. HSV retinits
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15
Q

seizures with AIDS is likely to be due to…

A

Cryptocococcal meningitis

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16
Q

cryptococooal meningitis

  1. how can it present
  2. what you see on an LP
  3. what stains it
A
  1. seizures in AIDS
  2. yeast
  3. india ink
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17
Q

if someone is on cART and they get a ‘sudden weakness’

what is this likely to be and why

A

stroke or TIA

HAART increases chance of stroke

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18
Q

if someone is being treated with HAART and then develops shite like kaposi sarcoma, what must you ask them

A

if they’re taking HAART as they should be

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19
Q

what does kaposi sarcoma look like

A

palpable pulple lesions

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20
Q

oral hairy leukoplakia can occur in HIV

what is the opportunistic infection that causes it

A

EBV

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21
Q

in somone who’s pregnant and has HIV, why must you check the viral load

A

determines if C-section is needed

>50 then C-section

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22
Q
A
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23
Q

what is the opportunisitc infetion that causes kaposi sarcoma

A

HHV-8

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24
Q

what can be offered after gay sex to reduce chance of HIV

regardless of HIV status

A

Post exposre prophylaxis

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25
Q
A
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26
Q

what opportunisitc infectiosn can occur with the following CD4 counts…

  1. 500-200
  2. 200-100
  3. 100-50
  4. >50
A

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

27
Q

what are the CD4 counts for when these brain issues can occur in HIV

  1. cerebral toxoplasmosis
  2. CNS lymphoma
  3. PML (progressive multifoal enceophalopahty)
A

1 & 3. 200-100

  1. 100-50
28
Q

what infection do you only get if CD4 count is very low (>50) and how may it present

A

mycobacterium avium

abdo pain & high ALP

29
Q

what does PML stand for regarding HIV

what virus causes it

what does it look like on MRI

A

Progressice mulifocal encephalopathy

James Cunningham virus

Mulitofocal non-enhancing Demylimationg lesions

30
Q

what type of infections usually occur when CD4 count is 100-50

A

fungal shite

aspergillosus & oesophageal candidosis

31
Q

if you get stabbed by a needle after taking blood from someone with HIV…

  1. what do you do first
  2. where do you refer yourself
  3. when do you need post-exposure prophylaxis
  4. how long you take HAART
A
  1. encourgae bleeding
  2. ED
  3. within 72hours
  4. 4 weeks
32
Q
A
33
Q

has HIV

worsening speech & behaviour

poor coordination

Mulitofocal non-enhancing demyelinating lesions on MRI

what is this

A

PML

due to JC virus

34
Q

what opporrtunisitc infection that can occur in HIV is common after renal transplants

A

CMV

35
Q

has HIV

headaches & confusions

ring enhancing lesions on CT

treated with pyrimethamine + sulphadiazine for 6 weeks

what is this

A

Cerebral toxoplasmosis

36
Q

on brain imaging, what do the following look like…

PML

Cerebral toxoplamsosis

CNS lymphoma

A

PML -> non-enhancing lesions

cerebral toxoplasmosis -> enhancing lesions

CNS lumphoam -> homogenous enhancing lesions

37
Q

what can be done to treat CNS lymphoma

A

whole brain stimulation

38
Q

child with HIV

acially and cervical lymphadenopahty

big tonsils

what is this

A

Kaposi sarcoma

maybe rash more common in adults

39
Q

advanced HIV (low CD4 count)

swallowing problems

what is this

A

oesophageal candidiosis

40
Q

for pts who are asymptomatic and think they have HIV, when do you test for p24 antigen

A

4 weeks AND 12 weeks

41
Q

what is the most common opportunistic infection in HIV/AIDS

A

PJP

Pneumocystis Jivoreci Pneumonia

42
Q

how does PJP present

A

Desatutations on exertion

Dry cough

SOB

Cyanosis

Fever

Bilaterla hilar infiltrates on CXR

43
Q

what investigations would you do for PJP

A

CXR

O2 sats (exercise induced)

Broncho-alveolar levage (best)

44
Q

PJP management

  1. normal cases
  2. severe cases
  3. if hypoxic (<92%)
A
  1. co-trimoxazole
  2. pentamadine
  3. steroids
45
Q

what type of staining do you do for PJP

A

silver

46
Q

what are the SEs for co-trimoxazole

A

Agranulocytosis

SJS

47
Q

what widespread rash is this that can occur in HIV

A

toxic exanthema

48
Q

what is a normal CD4 count and when shoudl you start treatment

A

normal= >500

treatment= <350

49
Q

what can be done to try and prevent getting HIV

A

Safer sex

Circiumcission

50
Q

what can cause HIV

A

sex

vertical transmission (mother -> baby)

IV drugs

Needle sharing

Bodily fluid exposure

Blood transfusions

Organ transplants

51
Q

what 2 investigations do you do to diagnosis HIV

which one is first and why

A

p24 antigen & HIV antibody tests

antigen first cause antiboidies take time to develop

52
Q

what are the HIV-related investgiations

A

p24 antigen (first)

HIV antibiodoies

Viral load

CD4 count

HIV resistance test

53
Q
A
54
Q

what HIV investigation is used for…

  1. checkign effectiveness of HAART
  2. checkign which HAART is best to use
A
  1. HIV viral load
  2. HIV resistance test
55
Q

what genes are the 2 targets for the HIV treatments

why are they targets

(some immunology)

A

gp-120 -> HIV glycoprotein

CCR-5 -> cofactor

56
Q

what are the sort of clinical stages of HIV

A
  1. just some lymphadenopathy
  2. recurrent infections & some weight loss
  3. sevre infections, skin lesiosn, severe weight loss
  4. PJP, lymphoma…
57
Q

types of HIV drugs inhibit what different things…

A

Nucleoside & non-nucleoside reverse transcription

Fusion

Protease

Integrase

58
Q

what can HIV do to platelets

A

thrombocytopenia

59
Q

what are the different types of drugs used in HHART

A

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)

60
Q

how do the following HIV meds work:

  1. Nucleoside reverse transcriptase inhibtior
  2. Non-nuslceoside reverse transcriptase inhibtior
  3. Fusion inhibitor
  4. Protease inhibtiors
  5. Integrase inhibtiors
  6. Chemokine antagonsits
A

1 & 2. prevent transcription (RNA -> DNA)

  1. stop HIV from fusing
  2. prevents progression
  3. stop HIV integrating with CD4 chromosomes
  4. inhibits co-factor (CCR-5 gene)
61
Q

whats like the non-inhibitior HIV treatment

A

chemokine antagonist

62
Q

what is the suffix of all protease inhibitors

A

Navir

“Never tease a pro”

63
Q

what is the reason that you use 3 drugs in HAART?

A

reduce chances of drug resistance

Oh no- Infections (13 decks)

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