HIV/AIDS

Question 1

HIV transmission

Answer 1

• blood
• semen
• vaginal secretions: during pregnancy or thru delivery
• breast milk

Question 2

most common mode of HIV transmission

Answer 2

• sex
• risk is higher to person receiving fluids
• but still possible if not receiving
• easier to infect women than men in heterosexual sex

Question 3

transmission vs exposure

Answer 3

to be transmitted:

• large acts of virus must enter
• duration and frequency of contact
• volume of fluid
• virulence and concentration of organism
• host immune status

Question 4

Acute infectious phase

Answer 4

• a flu that won’t go away
• lasts for 1-3 weeks
• high viral load, CD4 falls temporarily, but quickly returns to baseline

Question 5

early chronic infection

Answer 5

• asymptomatic phase or acute retroviral syndrome
• viral load low, CD4 normal
• fatigue, low grade fever, HA, generalized lymph adenopathy

Question 6

symptomatic chronic infection

Answer 6

• CD4 t cell count drops below 200-500
• viral load increases
• persistent fever, night sweats, recurrent HA, fatigue
• oral thrush, shingles, gential herpes

Question 7

late chronic infection/AIDS

Answer 7

diagnostic criteria:

• CD4 count drops below 200 or
• development of opportunistic dz
• wasting syndrome
• AIDS dementia complex
• immune system is severely compromised

Question 8

prevention of opportunistic infections

Answer 8

• antiretroviral tx: HART
• bactrim
• acyclovir
• start ppx @ CD4 count 500-1200
• consider tx @ 350 or less

Question 9

prevent HIV sexual route

Answer 9

• safe sex, condoms, barriers

- risk reducing activities

Question 10

prevent HIV drug route

Answer 10

-don’t inject, snort it

Question 11

prevent HIV blood route

Answer 11

• work exposure: needle sticks/splash
• contaminated blood
• seroconversion: if babies don’t seroconvert @ 12 mo, they can get AIDS

Question 12

prevent HIV perinatal route

Answer 12

-using ART to decrease the risk of transmission

Question 13

laboratory studies

Answer 13

• CD4/T-cell counts: start tx below 350
• viral load: the lower, the less active the dz
• WBC: for neutropenia, anemia, altered LFTs

Question 14

polymerase chain reaction test

Answer 14

• used to test babies
• to test blood supplies
• to measure Viral Loads

Question 15

goal of pharmacological tx

Answer 15

• decrease viral load

- increased CD4 to 500+

Question 16

comorbidities of HIV

Answer 16

• hyperlipidemia
• hyperglycemia
• CAD
• lactic acidosis
• fat distribution
• lipodystrophy

Question 17

pneumocystic carinii pneumonia

Answer 17

• 2/3 children have it by 2-4 years
• airborne
• non productive cough
• hypoxemia
• progressive SOB
• fever, night sweats, fatigue

Question 18

cytomegalovirus

Answer 18

• transmitted from human urine
• untreated: blindness, goal is to reduce visual loss
• retinities: blurred vision, loss of vision
• esophagitis, stomatitis: dysphagia, colitis, blood diarrhea, pain, wt loss

Question 19

mycobacterium avium complex

Answer 19

• in dust particles and birds
• transmission via many routes
• gastroenteritis
• watery diarrhea
• weight loss

Question 20

Kaposi’s Sarcoma

Answer 20

• neoplasm caused by HHV8
• type of cancer, overgrowth of blood vessel
• transmitted via sex
• flat, raised lesions
• can be in the GI, lungs
• increased ART tx

Question 21

mycobacterium TB

Answer 21

-high risk: homeless, prisons
-wt loss, night sweats, hemoptysis, SOB
-

Question 22

toxoplasmosis of the brain

Answer 22

• from cats, birds, cat feces, uncooked pork
• can go into nay organ
• HA, confusion, motor weakness, sz, coma
• dexamethasone,
• anti sz
• azithromycin, clindamycin