HIV/AIDS Flashcards
HIV/AIDs presents similarly as?
Leukemia
How does HIV replicate? (5)
- HIV carries genetic information as RNA
- RNA is inserted into the target CD4+ lymphocyte
- Reverse transcriptase changes RNA into DNA
- This DNA becomes part of the cell’s genetic make-up over time.
- Target cell then produces HIV cells with viral RNA
How does HIV cause AIDS? AIDS defined as?
- “Low T-Cell counts” results in immunodeficiency
- AIDS is defined as CD4 count
What is viral load? Cell count? HAART?
- Viral Load: Number of HIV cells, strength of the virus
- “Cell Count:” Number of lymphocytes per unit of blood, strength of the immune system
- HAART: Highly Active Antiretroviral Treatment
Stages of HIV and AIDS? (3)
Asymptomatic (HIV)
Early symptomatic (HIV or AIDS)
Advanced (AIDS)
How is HIV transmitted? (6)
- From mother to child
- Stuck with infected needle
- Fluid splash in mouth or eyes
- Risky sexual behavior
- IV drug users contract 10% of AIDS cases annually
- Blood transfusion
Signs: Opportunistic Disease - endocrine? (2) Skin/oral? (3) Systemic complaints? (3)
Endocrine
Adrenal gland infections
Thyroid dysfunction
Skin/oral
Herpes simplex
Zoster
Bacterial infections
Systemic complaints
Fever
Weight loss
Nausea
Signs: Opportunistic Disease - neurological - PNS? (2) CNS? (5)
PNS
Peripheral neuropathy
Myopathy
CNS Toxoplasmosis CNS lymphoma AIDS dementia Meningitis Myelopathy
Signs: Opportunistic Disease - pulmonary? (4) Musculoskeletal? GI? (3)
Pulmonary Pneumocystic pneumonia most common opportunistic infection in AIDS H influenza pneumonia Extrapulmonary TB Chronic sinusitis
Musculoskeletal
Arthritis of large joints with or without effusion
Gastrointestinal:
Candidal esophagitis
Liver disease
Malabsorption
Signs: Opportunistic Neoplasms types? (5)
Kaposi’s sarcoma Non-hodgkins lymphoma Squamous cell carcinoma Cervical cancer CNS Lymphoma
Which neoplasms are unique to HIV?
Kaposi’s sarcoma
CNS lymphoma
What is lymphodystrophy aka? Caused by? What is it? (3) Complications? (2)
- “AIDS Wasting Syndrome”
- Caused by HAART
- Fat redistribution – body weight maintained
- Significant wasting of extremities and face
- Increased girth of abdomen, upper back, thorax
- Complications: Heart disease, stroke
The Role of Exercise in Lymphodystrophy? (2) Important to monitor? (3)
- Reduce central fat gain
- Increase muscle bulk, strength and functional capacity
Important to monitor
- Postural changes
- Hip and waist circumference, bra size
- Changes in body image
Patients with Lymphodystrophy may benefit from? (4)
- Aerobic conditioning
- Nutritional support
- Strength training and PREs
- Growth hormones vs. Progressive resistive training – both seem to be equally effective
What is Myopathy? Symptoms? (5) Diagnosis? (2)
- General abnormality of disease of the muscle caused by deletion of the mitochondria
- Myalgia/chronic pain
- Increased CPK
- Type II fiber atrophy
- Denervation
- Proximal muscle weakness
EMG
Muscle biopsy
The Role of Exercise in Acute Myopathy?
Exercise is contraindicated
The Role of Exercise in Chronic Myopathy? Presents how? Difficulty with? (4)
- Can benefit from exercise
- Weakness of proximal muscle groups
- Transitioning from sit to stand
- Climbing stairs
- Arms overhead long periods
- Rising from squat
Treatment of Myopathy? (5) Discontinue? Monitor? (4)
- May be responsive to steroids
- Massage, yoga, relaxation and meditation
- Discontinue use of antiretroviral agents causing myopathy
- Monitor pain ratings: Calves, thighs, upper arms
Peripheral Neuropathy is how common? Pathogenesis? (4) Predictors of poor outcomes? (3)
- Most common complication of HIV
- Pathogenesis is largely unknown
- HAART
- HgB or albumin levels
- Poor nutrition
Predictors of poor outcomes
- Increased age
- Weight loss
- Lower CD4 count
Most common type of peripheral neuropathy? Affects sensory how? Motor? Distribution? Onset?
- Distal Symmetric Polyneuropathy (Most Common)
- Burning and parasthesia
- None
- Stocking, glove
- Late in disease progression
The Role of Rehabilitation in Peripheral Neuropathy - specific attention to? PAtient education involves? (2) Changes in? (3) Monitor? (3) Exercise is?
- Specific attention to feet
- Patient education: skin checks, proper footwear
- Changes in biomechanics
- Pronated feet
- Tendonitis
Monitor
- Severity of pain
- Distribution of sensory loss
- MMT
- Exercise may be beneficial
Exercise and intervention for patients with AIDS - Factors to Consider? (6)
Stage of disease Symptomatology Immunocompromisation Cardiac status Comorbidities Psychological factors
Exercise for asymptomatic? (2) Avoid?
- Unrestricted exercise and activity
- Competitive sports okay
- Avoid overtraining and overuse – may impact the immune system
Exercise for early symptomatic? Avoid? (2)
- Continue exercise training
- Well designed exercise program based on consistent re-evaluation
Stressful competition
Intensive exhaustive exercise
