Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ID Exam 4 > HIV/AIDS > Flashcards

HIV/AIDS Flashcards

1
Q

Human Immunodeficiency Virus

A

single stranded RNA retrovirus
Targets a key part of our immune system; the CD4 helper T-cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acquired Immune Deficiency Syndrome (AIDS)

A

acquired syndrome caused by HIV as the virus depletes the immune system
The person becomes immunodeficient
For most, death occurs from an opportunistic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment for HIV consists of _____

A

lifetime antiretrovirals which suppress viral activity
No cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does AIDS virus come from?

A

Derived from primate lentivirus
a subgroup of retroviruses (RNA integrates into host DNA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When wat HIV-1 isolated?

A

1985

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two types of HIV, both cause AIDS

A

HIV 1- more common worldwide
HIV 2- predominantly west africa, less transmissible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Transmission of HIV

A

Blood exposure or sexually transmitted

Mother to neonate
Vertical transmission
Via placenta, birth or breast milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Exposure Risks for HIV

A

Heterosexual contact
Male to male sexual contact
IV drug use
Transactional sex
Prior skin lesions from other sexually transmitted infections
Hemophilia and the use of unscreened blood for transfusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a cancer that HIV patients are more susceptible to getting?

A

Kaposi’s sarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

gp120’s role in fusion/entry

A

gp120 which protrudes from viral surface attaches to CD4 receptors on cell surface
gp120 then interacts with CCR5 and CXCR4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does gp41 do?

A

gp41 mediates fusion to the viral membrane to the cell membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How Viral replication begins

A

Host DNA mechanism is then used to make viral copies
Viral mRNA is transcribed from the integrated DNA via RNA polymerase
Then made into large proteins via host ribosomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clinical features of HIV stage 1

A

Stage 1 - Early acute
Onset after 2-3 wks of exposure, fever, lethargy, sore throat, diarrhea, lymphadenopathy, maculopapular rash trunk and arms, high viral count.
Virus is transmissible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical features of Stage 2 HIV - Middle latent stage

A

Early symptoms resolve around 2 months, the viral load drops and levels off for about 7-11 years. Patient is asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical features of Stage 3 HIV - Late immunodeficient stage

A

CD4 drops → onset of AIDS, and death in about 2 yrs if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

False-negative “window” of HIV infection occurs _____

A

until the antibodies become present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Old School HIV testing

A

ELISA with a western blot for confirmation (ELISA still used as a rapid HIV test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Current HIV Testing guidelines

A

p24 antigen- detection earlier in the “window” period
HIV1 / HIV2 antibodies- wks 2-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Seroconversion occurs when _____

A

when the antibodies form (weeks 2-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CD4 count for an increase in opportunistic infections

A

<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Additional testing for HIV

A

CD4 count- increase in opportunistic infections < 500
CD4 lymphocyte percentage- compared to all WBCs
Viral Load (via PCR)
HIV subtyping and order a resistance profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

______, occurring as a patient becomes immunodeficient, indicates they have progressed into AIDS

A

Detection of an AIDS defining illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Neurologic symptoms with AIDS

A

Dementia, Subacute encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Opportunistic infections with AIDS

A

Pneumonia- Pneumocystis jirovec
CMV
Kaposi Sarcoma- Herpesvirus 8
Non-Hodgkin’s B cell lymphoma- EBV
Meningitis- Cryptococcus neoformans
Brain abscess- Toxoplasma gondii
Shingles-zoster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
As CD4 count drops, triggers prophylaxis, including
Pneumocystis pneumonia and Toxoplasmosis - TMP-SMX Cryptococcal meningitis- Fluconazole CMV retinitis- Ganciclovir Oral candidiasis- Clotrimazole Azithromycin- MAC complex
26
Cancers caused by ____ are common in AIDS patients
HPV
27
____% of patients with AIDS will get TB
4
28
Herpes in HIV
HSV 1 and 2 In AIDS, more severe and more likely disseminated Can also cause ocular herpes infections
29
You should treat all Herpes outbreaks in HIV patients with
Oral acyclovir HSV Prophylaxis with daily oral acyclovir, etc. Zoster is treated with famciclovir or valacyclovir Vaccine-Shingrix
30
Candidiasis in HIV
Oral candidiasis Unpleasant taste, dryness Can be scraped off, unlike hairy leukoplakia Esophageal candidiasis Common AIDS complication, suggest AIDS onset KOH prep
31
Treatment of candidiasis in HIV
Clotrimazole troches Oral fluconazole for oral or esophageal Ketoconazole for angular cheilitis
32
Kaposi Sarcoma Clinical features in HIV patients
HHV-8 Vascular tumor Rare cancer, but ↑↑in HIV and AIDS - Not just AIDS patients Skin, GI tract, mucosal surfaces, pulmonary
33
Treatment of Karposi sarcoma in HIV patients
Localized chemotherapy or radiation Cryotherapy or laser therapy Intralesional injections
34
Clinical features of hairy leukoplakia in HIV
Epstein-Barr Virus (EBV) Lateral border of the tongue Leukoplakic area with a corrugated or what sometimes appears “hairy”
35
Pneumocystis Pneumonia clinical featrures in HIV
P.jirovecii A common opportunistic fungal infection Cough, fever, shortness of breath CT scan or Chest X-ray PCR sputum or bronchial lavage
36
Treatment of Pneumocystis Pneumonia in HIV
TMP-SMX Prednisone- decrease alveolar inflammation
37
Mycobacterium Avium Complex (MAC) in HIV
Sputum sample renders acid-fast bacilli Sputum culture used distinguish between TB
38
Prophylaxis of _____ is no longer recommended in most patients initiating ART (HIV) due to low incidence among those on ART
Mycobacterium Avium Complex (MAC)
39
Toxoplasmosis clinical features in HIV
Common space occupying lesion Headache, neurologic Sx, seizures and AMS Ring-enhancing lesions on brain CT w/ positive toxoplasma IgG
40
Prophylactic treatment of Toxoplasmosis in HIV?
With CD4 count < 100 cells/µL Cross cover PJP with Trimethoprim-sulfamethoxazole (TMP-SMX) DC prophylaxis if > 200 cells/µL for 3 months Treatment with pyrimethamine and sulfadiazine
41
Cytomegalovirus (CMV) Retinitis clinical features in HIV
Visual changes must be worked up for HIV patients Blind spots, blurred vision and floaters Immediate consultation with ophthalmology Perivascular changes with white fluffy exudate Common retinal infection w/ CD4 count < 50 cells/µL Watch for herpes or other retinal infections
42
Cytomegalovirus (CMV) Retinitis Treatment in HIV
Intravitreal Ganciclovir IV Foscarnet + Valganciclovir Prophylaxis- Valganciclovir, and DC when > 100 cells/µL for at least 6 months
43
HIV Associated CNS Lymphoma Clinical features
Common CNS lesion in people with HIV Symptoms similar to toxoplasmosis, Order toxoplasma titers Rule out abscess, toxoplasmosis, crtyptocomma May require a brain biopsy PCR of EBV DNA in CSF Associated with Epstein-Barr virus
44
Cryptococcal Meningitis clinical features in HIV
As you imagine a headache in an HIV patient should never be taken lightly Common opportunistic infection in new HIV diagnosis With meningitis- fever, headache, yet with HIV, less meningismus Cryptococcal antigen serology or positive CSF culture for cryptococcal
45
T/F a headache in an HIV patient should never be taken lightly
T
46
Cryptococcal Meningitis Treatment in HIV
Manage elevated CSF pressure- Therapeutic LP Amphotericin with flucytosine, followed by fluconazole Secondary prophylaxis fluconazole- DC when ART effective for 3 mons
47
Goals in HIV treatment
Reduce viral load, thus preventing advancement to AIDS Reducing viral load also reduces transmissibility Monitor patients response to therapy- CD4 count and Viral load Prophylaxis and treatment of opportunistic infections and cancer With effective treatment, life expectancy is near same to those without HIV
48
_____ is key to avoiding resistance in HIV Patients
Adherence (to treatment)
49
HAART
Highly Active Antiretroviral Therapy
50
IRIS
Immune Reconstitution Inflammatory Syndrome
51
IRIS in HIV
The patient will have an inflammatory response to current infections Simply stated, your body restores its inflammatory response Thus, symptoms can flare when starting antiretrovirals
52
Nucleoside/ Nucleotide Reverse Transcriptase Inhibitors (NRTIs) MOA
Inhibits DNA synthesis via the viral reverse transcriptase
53
Examples of NRTIs
Abacavir (Ziagen)- only HLA-B5701 allele negative patients, possible hypersensitivity reaction Lamivudine (Epivir) Emtricitabine (Emtriva) Zidovudine (AZT, or ZDV)- First drug ever approved Tenofovir (TAF or TDF) (TAF) alafenamide or (TDF) disoproxil fumarate Emtricitabine/Tenofovir disoproxil fumarate (Truvada)
54
Non-nucleoside reverse transcriptase inhibitors (NNRTIs) MOA
Inhibit reverse transcriptase at a different site then NRTIs
55
Examples of NNRTIs
Efavirenz (Sustiva) Nevirapine (Viramune) Rilpivirine (Edurant) Doravirine (Pifeltro) Etravirine (Intelence)
56
Integrase Inhibitors MOA
Blocks replicated viral DNA from “integrating” into host DNA Used in preferred regimes- efficacious and well tolerated
57
Examples of Integrase Inhibitors
Raltegravir (Isentress) Dolutegravir (Tivicay) Elvitegravir- only available as a combination (Stribild or Genvoya) Cabotegravir (Vocabria)- oral and injectable; given with rilpivirine
58
Protease Inhibitors Examples
Darunavir (Prezista) Atazanavir (Reyataz) Ritonavir (Novir)
59
BBW for Protease Inhibitors
Common DDI due to metabolism via P450 system-
60
Entry Inhibitors examples
Enfuvirtide (Fuzeon) Maraviroc (Selzentry) Fostemsavir (Rukobia) Ibalizumab (Trogarzo)
61
Prevention and Education: Post HIV exposure
Tenofovir/ Emtricitabine (Truvada) and Dolutegravir- ASAP (< 72 hrs) for 28 days
62
Pre exposure prophalaxis in HIV (PrEP)
Tenofovir and Emtricitabine (Truvada) for high risk of exposure Cabotegravir q2 months- New FDA approval
63
HIV Screening Recommendations
- Screening asymptomatic and high risk individuals for HIV - USPSTF 2019 Recommends screening all pregnant persons

ID Exam 4 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions