HIV/AIDS

Question 1

gp120

Answer 1

on HIV

binds CD4 causing a conformational change allowing CCR-5 to bind CD4: p120 complex

Question 2

CCR-5

Answer 2

on CD4 T cell

receptor on CD4 cell that binds gp120

Question 3

gp41

Answer 3

on HIV

membrane penetration of CD4 T cell

Question 4

APOBEC3G

Answer 4

apolipoprotein B mRNA-editing, enzyme-catalytic, polypeptide-like 3G
Naive T cell enzyme
cytidine deaminase: cytosine to uracil in HIV viral DNA
prevents HIV infection of naive T cells
inactivated when T cell is activated

Question 5

Vif

Answer 5

HIV protein that promotes APOBEC3G degradation by cellular proteases

Question 6

NFkB

Answer 6

stimulates transcription of IL-2 and IL-2 receptor when T cell becomes activated

Question 7

IkkB

Answer 7

holds NFkB inactive

Question 8

Targets of HIV

Answer 8

CD4 T cell
Also
1. macrophages
2. dendritic cells

Question 9

Vpr

Answer 9

HIV protein

allows nuclear targeting of HIV preintegration complex through nuclear pore

Question 10

HIV-1

Answer 10

can infect and multiply in terminally differentiated non dividing macrophages
dependent upon vpr gene

Question 11

reservoir of HIV infection

Answer 11

vacuoles of macrophages

resistant to cytopathic effects

Question 12

vehicle for transport of HIV to various parts of body (ex: nervous system)

Answer 12

monocytes

Question 13

What does damage to brain cells in HIV infections?

Answer 13

gp41: IL-1, TNF, IL-6, NO
gp120: direct damage

Question 14

Primary HIV infection (acute phase)

Answer 14

6 weeks after infection
viral load: 10 million/ml
CD4 count: 500/cu mm
mucosal

Question 15

Clinical HIV latency (chronic phase)

Answer 15

up to 10 years after infection
viral load: 10,000/ ml
CD4 count: 50/cu mm
lymph nodes and spleen
asymptomatic
opportunistic infections: candidiasis, herpes, TB

Question 16

Final HIV crisis phase

Answer 16

11 years after infection
viral load: 10 million/ml
CD4 count: 5/cu mm
long lasting fever (> 1 month), fatigue, weight loss, diarrhea

Question 17

Pneumocystis jiroveci pneumonia

Answer 17

sym: insidious onset of dyspnea, fever, non-productive cough
signs: tachypnea
chest x-ray: bilateral hazy interstitial infiltrates, which become dense alveolar infiltrates
Test: hypoxemia

Question 18

CMV: in AIDS

Answer 18

disseminated

enteritis (diarrhea), retinitis (visual impairment), esophagities

Question 19

cryptococcus

Answer 19

fungus
yeast form in soil and pigeon poop
meningitis
virulence: capsule

Question 20

histoplasmosis

Answer 20

Memphis
small yeast in fecal-enriched soil near chicken coops
caseating granulomas or diffuse pneumonia with macrophages

Question 21

acute retroviral syndrome

Answer 21

clinical presentation of initial spread of the virus and host response
3-6 weeks after HIV infection; resolves in 2-4 weeks
nonspecific (flu-like) symptoms: sore throat, myalgias, fever, weight loss, fatigue

Question 22

AIDS

Answer 22

in absence of HIV Tx: progresses to AIDS in 7-10 years

serious opportunistic infections, secondary neoplasms, or clinical neurologic disease

Question 23

toxoplasmosis

Answer 23

protozoa

encephalitis

Question 24

JC virus

Answer 24

human papovavirus
CNS infection
progressive leukoencephalopathy (infection of oligodendogliocytes)

Question 25

Cancers with high incidence in AIDS patients

Answer 25

Kaposi sarcoma, B cell lymphoma, cervical cancer, anal cancer

Question 26

immune reconstitution inflammatory syndrome

Answer 26

paradoxical clinical deterioration when advanced HIV are given antiretroviral therapy