HIV/AIDS

Question 1

What transmembrane protein are embedded in the HIV viral envelope and allows HIV-CD4 binding?

Answer 1

Gp-120

Question 2

What makes HIV so hard to treat?

Answer 2

• Each infected CD4 produces about 100 new visions

- 1:4000 basepair error rate (very high mutation rate)

Question 3

What are 4 ways HIV kills CD4 cells?

Answer 3

1-Direct cell killing
2-Apoptosis
3-Anergy
4-Damage to precursor cells

Question 4

Healthy people have ______CD4 t cells/mL while an untreated HIV/AIDS patient can fall below________

Answer 4

800-1200

200

Question 5

_____ is the speed or rate of change and _______ numbers are the distance to immunodeficiency?

Answer 5

Viral load, CD4

Question 6

What are the three categories of CD4 cell counts?

Answer 6

1-More than 500 (normal)
2-Between 350-500 (increased risk)
3-less than 350 (high risk)

Question 7

What are the 2 types of HIV?

Answer 7

1-HIV-1
2-HIV-2 (relatively uncommon and concentrated in west africa)

*SIV in monkeys

Question 8

What drug is very reliable in preventing HIV transmission to a newborn?

Answer 8

AZT

Question 9

3 or more drugs combined (two nucleoside analogue RT inhibitors and 1 strong drug) are typical of what treatment?

Answer 9

HAART (cART) therapy

*Strong drug is a non nucleoside RT inhibitor, protease inhibitor or integrate strand transfer inhibitor

Question 10

The goal of HAART therapy is to suppress ______ and restore or preserve ________

Answer 10

Viral load, CD4 levels

Question 11

Anemia, neutropenia, xerostomia, oral ulcers, perioral paresthesia, lichenoid rxns, chapped lips, liver disease, metallic taste, dysgeusia, bone marrow suppression, and increased incidence of oral warts are all what?

Answer 11

Dental implications of HIV

Question 12

What are two of the biggest concerns of HAART therapy?

Answer 12

Hepatotoxicity, Lipodystrophy

Question 13

What are the 4 types of medications used in HAART therapy that have dental concerns?

Answer 13

1-Local anesthetics
2-Antibiotics
3-Pain killers
4-Antifungals

Question 14

What are 5 predisposing factors for oral lesions in HAART patients?

Answer 14

1-CD4 counts 3000
3-Xerostomia
4-Poor oral hygiene
5-Smoking

Question 15

What condition is characterized by a non-wipable, hairy, white lesion on the lateral borders or dorsal of the tongue?

Answer 15

Hairy leukoplakia

Question 16

What are the three major candidiasis presentations in HIV?

Answer 16

1-Psuedomembranous (thrush)
2-Erythematous (atrophic)
3-Angular chelitis

Question 17

Nystatin topicals, clotrimazole/ketoconazole or amphotericin B solutions are used to treat what?

Answer 17

Oral Candidiasis

Question 18

What are two opportunistic tumors seen in HIV?

Answer 18

1-Kaposi sarcoma (caused by HHV 8)

2-Non-hodgkins lymphoma

Question 19

What are five xerostomia management options?

Answer 19

1-Sugarless candies
2-Topical fluorides
3-Artificial saliva
4-Pilocarpine
5-Oral hygiene, decrease smoking

Question 20

What are 3 general guidelines for lab values in managings HIV patients?

Answer 20

1-CD4 level changes
2-Viral Load changes
3-Duration of infection

Question 21

What are the critical blood values for CD4 levels in HIV patients?

Answer 21

Less than 200

*normal is 800-1200

Question 22

What are the critical blood values of total white cells in HIV patients?

Answer 22

Less than 2000

*normal is 4500-10000

Question 23

What are critical blood values for absolute neutrophils in HIV patients?

Answer 23

less than 500

*normal is 2500-7500

Question 24

What are the critical blood values for platelet counts of HIV patients?

Answer 24

less than 20,000 (dental procedures contraindicated)

Question 25

What are the critical blood values of hematocrit for HIV?

Answer 25

Less than 25%

*normal is 36-50%

Question 26

What are critical blood values for hemoglobin in HIV?

Answer 26

Less than 10

*normal is 12-18