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Clin Med hematology > HIV / AIDS > Flashcards

HIV / AIDS Flashcards

1
Q

Which gender is more commonly effected by HIV

A

Men

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2
Q

Which ethnicity is more commonly effected by HIV

A

African American

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3
Q

What is the etiology of new HIV dx

A

Mostly male to male sexual contact

23% heterosexual contact

minimal IVDU

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4
Q

What mode of intercourse puts someone at highest risk for HIV

A

Receptive anal intercourse

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5
Q

Which forms of HIV are human pathogens

A

HIV 1
HIV 2

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6
Q

What are the symptoms of HIV

A

Often asymptomatic

*Can have acute retroviral syndrome

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7
Q

When will an acute retroviral syndrome present

A

3-6 weeks post infection and will last 1-2 weeks

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8
Q

What is occurring in the body during an acute retroviral syndrome

A

Rapid surge in viral load and a drop in CD4

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9
Q

What symptoms will someone with mild retroviral syndrome show

A

Vague
flu like

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10
Q

What symptoms will someone with severe retroviral syndrome show

A

Meningitis
encephalitis
thrombocytopenia

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11
Q

When are HIV screenings done

A

CDC recommends 1x screening for all patients 13-64

1x/year for high risk patients

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12
Q

What diagnostic tests are available for HIV testing

A

Nucleic acid tests
Antigen/antibody testing
Antibody only testing

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13
Q

What does the nucleic acid test show

A

HIV RNA

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14
Q

What does the antigen/ antibody HIV test show

A

Detects HIV p24 antigen and HIV IgM and IgG

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15
Q

What does the antibody only testing show for HIV

A

HIV IgM & IgG

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16
Q

When is nucleic acid most beneficial

A

Acute HIV or indeterminate test
*No HIV antibodies yet

Detectable 10 days post exposure

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17
Q

Which HIV test is considered a rapid test

A

HIV 1/2 antigen/antibody immunoassay

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18
Q

What can you start to receive HIV treatment if positive

A

> 18y/o
*regardless of CD4 count

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19
Q

Can pregnant women receive HIV treatment

A

Yes (Avoid TDF)

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20
Q

How soon do you initiate HIV treatment after infection

A

As immediately as possible

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21
Q

What baseline labs should be done before first HIV treatment

A

Viral load
HUV genotyping
CD4 count
BMP/CMP
Lipids
CBC
Glucose
Urinalysis
Pregnancy testing

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22
Q

What is the first line treatment for HIV

A

ART
(Anti-retroviral therapy)
*3 drug combo

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23
Q

What does the 3 drug combo include with ART

A

1InSTI + 2NRTIs

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24
Q

What is the second line treatment for HIV

A

2 NRTIs and 1 from a different class (PI/II/NNRTI)

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25
Q

What are the main goals of HIV treatment

A

Virology suppression
*CD4 should rise with the viral suppression

26
Q

What is IRIS HIV treatment

A

Immune reconstitution inflammatory syndrome

27
Q

When is IRIS treatment given for HIV

A

After the initiation of ART

*Secondary to rapid increase in CD4

28
Q

What must be ruled out before IRIS can be initiated

A

Worsening opportunistic infection… can make additive treatment higher risk

29
Q

What are some reasons ART treatment can be adjusted

A

side effects
toxicity
simplify for regimen compliance
virologic failure

30
Q

How can HIV be prevented

A

cessation of IV drug use / needle sharing

Safe sex practices

Sex education

ART as prevention

31
Q

What are some harm reduction approaches for HIV prevention

A

Needle exchange programs
appropriate cleansing of needles
PrEP
PEP

32
Q

what is PrEP

A

Pre-exposure prophylaxis

*prevention of HIV infection in HIV negative patients

33
Q

Who can be given PrEP

A

Indicated for any high risk patient who requests it

34
Q

What tests need to be done before administering PrEP

A

Negative HIV antibody
creatinine
Hep B/C
STD test
Pregnancy testing

35
Q

How can PrEP be taken

A

Oral (Daily)
IM (every 2 months)

36
Q

How often does one need to be monitored with PrEP

A

every 3 months

37
Q

what is PEP

A

post exposure prophylaxis

*Prevention of HIV in negative patients after exposure to HIV (Includes potential exposure)

38
Q

How soon must PEP be administered after exposure

A

within 72 hours

39
Q

How long is PEP treatment

A

Orally for 28 days

40
Q

What screening needs to be done before starting PEP

A

HIV rapid test
Pregnancy test
LFTs
BUN /creatinine
STI screen
Hep B/C screen

41
Q

After PEP how frequently does HIV need to be screened for and why

A

at 30 / 90 days to rule out seroconversion

42
Q

What are some complications of HIV

A

CAD
RA
osteoporosis
AIDS

43
Q

What is the time period from the initial HIV infection and AIDS

A

roughly 10 years (without ARV treatment)

44
Q

What properties must one have to be considered as having AIDS

A

CD4 count <200 cells
OR
AIDS defining infection / malignancy
(Opportunistic infection)

45
Q

What is (was) the most common opportunistic infection in AIDS patients

A

PCP
Pneumocystitis jirovecii

46
Q

What will be seen in someone with PCP

A

Diffuse or perihilar infiltrates on CXR

*DX with sputum testing
*TX: Bactrim x 21 days

47
Q

How does Toxoplasmosis show up in AIDS patients

A

CNS infection
-seizures / AMS
- Ring enhancing lesion on CT
-CD<100

48
Q

How do you treat toxoplasmosis with AIDS patients

A

Pyrimethamine + Sulfadiazine

49
Q

If an AIDS patient has a CD4 count of <50 what are you looking for

A

MAC
Mycobacterium Avium Complex

50
Q

How do you diagnose MAC in AIDS patients

A

Sputum culture

51
Q

How do you treat MAC in AIDS patients

A

Clarithromycin (Azithromycin)
+ Ethambutol
+Rifampin

52
Q

If someone with AIDS have cryptococcal meningitis, what sx will they have

A

headache
Fever

53
Q

How do you diagnose cryptococcal meningitis in AIDS patients

A

CRAG (Serum cryptococcal antigen)

+India ink strain CSF

54
Q

How do you treat cryptococcal meningitis

A

IV lysosome Amp B + Flucytosine x2 weeks
THEN
Fluconazole 400mg x 8weeks
THEN
Fluconazole 200mg x 1 year

55
Q

What is CMV retinitis in AIDS patients

A

Infection of the retina with cytomegalovirus

Preivascular hemorrhages and white fluffy exudates
**NOT cotton wool spots

56
Q

What are AIDS opportunistic diseases

A

HIV related encephalopathy
Invasive cervical cancer
Kaposis Sarcoma
Lymphomas
PML
Wasting syndrome

57
Q

What is karposis sarcoma

A

Infection with kaposis sarcoma herpes virus (KSHV)

58
Q

How does kaposis sarcoma look

A

Purplish macule / papule / nodules (CD4 <200)

59
Q

How do you diagnose kaposis sarcoma

A

Biopsy

60
Q

What is the tx for kaposis sarcoma

A

ART if not widespread

*Add chemo if widespread

Clin Med hematology (6 decks)

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