Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > HIV/AIDS > Flashcards

HIV/AIDS Flashcards

1
Q

What organism causes AIDS?

A

HIV

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

How many strains of HIV are there?

A

2:
HIV 1
HIV 2

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

Which HIV strain is most virulent?

A

HIV 1

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

Which HIV strain is spread world wide?

A

HIV 1

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

Where is HIV 2 largely restricted to?

A

Sub-Saharan Africa

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

Describe the pathogenesis of HIV

A

Infect mucosal Cd4+ cells -> Transport to regional lymph nodes -> Day 3 infection established -> Infection spreads

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

What is the life expectancy of those with treated HIV like?

A

Nearly normal

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

How can HIV be treated?

A

Sexually- damaged epithelium risk factor
Parenteral- IVDU, Blood transfusion, iatrogenic
Mother-to-child- Transplacental, delivery, breastmilk

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

What are the three stages of HIV infection?

A

Primary infection
Latency/chronic phase
AIDS/late phase

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

What kind of cells does HIV infect?

A

CD4+

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

What kind of virus is HIV?

A

Retrovirus

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

What does HIV do to CD4+ cells?

A

Infects Cd4+ cells thus reducing their number.

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

What does HIV do to CD4+?

A

Leads in decreased Cd8 activation

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

What are CD4+ parameters?

A

Normal- 500-1600 cells/mm3

Risk of opportunistic infection- <300 cells/mm3

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

Describe how CD4+ levels vary during HIV infection?

A

Primary infection- Sharp decrease
Chronic infection- Slight increase then gradual decrease
Late stage- Continue gradual decrease until 0

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

How does HIV RNA levels vary during HIV infection?

A

Primary infection- Rapid increase
Chronic infection- Sharp decrease then gradual increase
Late stage- Rapid increase

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

How long does the primary infection of HIV last?

A

A month or two.

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

When do constitutional symptoms first appear in HIV?

A

At the end of the chronic phase

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

When do opportunistic infections occur in HIV?

A

During the late stage

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

What does HIV cause?

A

AIDS

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

What are the symptoms of primary HIV infection?

A 
Fever 
Rash (maculopapular)
Myalgia
Pharyngitis 
Headache/aseptic meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long does primary HIV infection take to occur after actual infection?

A

2-4w

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

During a primary HIV infection how infectious are you?

A

Very

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

What things does HIV increase your susceptibility to?

A

Viral infections
Fungal infections
Mycobacterial infections
Infection induced cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some opportunistic infections common in HIV?

A

Pneumocystis pneumonia (pneumocystis jiroveci)
TB
Cerebral toxoplasmosis (toxoplasma gondii)
Cytomegalovirus (CMV)
Skin infections- Herpes zoster, Herpes simplex, HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some symptoms of Pneumocystic pneumonia (pneumocystis jiroveci)?

A

SOB
Dry cough
Exercise desaturation
High dose co-trimoxazole (+/- steroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are some symptoms of Cerebral toxoplasmosis (toxoplasma gondii)?

A 
Headache
  Fever
  Focal neurology
  Seizures
  Raised ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some symptoms of Cytomegalovirus (CMV)?

A

Reduced visual acuity
Floaters
Abdo pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which skin infections are associated with HIV?

A

Herpes zoster
Herpes simplex
Human papilloma virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are some neurological conditions associated with HIV?

A

HIV-associated neurocognitive impairment (HIV-1)
Progressive multifocal leukoencephalopathy (PML) (JC virus)
Aseptic meningitis
Guillain-Barre syndrome
Viral meningitis (CMV, HSV)
Cryptococcal meningitis
Neurosyphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are some symptoms of HIV-associated neurocognitive impairment (HIV-1)?

A

Reduced short term memory

Motor deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are some symptoms of Progressive multifocal leukoencephalopathy (PML) (JC virus)?

A

Rapid progress focal neurology

Confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which cancers are associated with HIV?

A

Kaposi’s sarcoma (Human herpes virus 8)
Non-Hodgkin’s lymphoma (EBV)
Cervical cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is a derogatory descriptive name for AIDS?

A

‘Slim’s disease’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are some symptoms of wasting associated with HIV?

A

Metabolic (chronic immune activation)
Anorexia (multifactorial)
Malabsorption/diarrhoea
Hypogonadism

36
Q

Why is HIV called ‘Slim’s disease’?

A

Due to it causing wasting.

37
Q

Who should you test for HIV?

A

Universal testing in high prevalence areas
Screen high risk groups
Testing in the presence of “clinical indicators”

38
Q

Who is tested in universal HIV testing?

A

All new patients

All general medical admissions

39
Q

What counts as a high prevalence of HIV?

A

HIV>0.2%

40
Q

Which groups are at an increased risk of HIV?

A 
Men who have sex with men
Female partners of bisexual men
People who inject drugs 
Partners of people living with HIV
Endemic areas
41
Q

What are some endemic area for HIV?

A

Sub-Saharan Africa
Caribbean
Thailand

42
Q

If HIV is in the differential should you test for it?

A

Yes!

43
Q

What are some good ways to approach gaining consent for an HIV test?

A

Normalize it/explain why- ‘Do this to all’
Benefits- Protect them and partners
Reassure about confidentiality

44
Q

What are some points for testing an incapacitated individual for HIV?

A

Only test if in patient’s best interest
Consent from relative not required
If safe, wait until patient regains capacity

45
Q

What are the two main testing methods for HIV?

A

Rapid HIV Test (POCT)

Venous sample for testing

46
Q

How does a Rapid HIV Test (POCT) work?

A

Fingerprick blood specimen or saliva

47
Q

How long does Rapid HIV Test (POCT) take?

A

Results within 20-30 minutes

48
Q

What does a Rapid HIV Test (POCT) test?

A

3rd generation (Ab only) or 4th generation (Ab/Ag)

49
Q

What are some advantages to a Rapid HIV Test?

A 
Simple to use
No lab required
No venepuncture required
No anxious wait
Reduce follow-up
Good sensitivity
50
Q

What are some disadvantages of Rapid HIV Test?

A 
Expensive ~£10
Quality control
Poor positive predictive value in low prevalence settings
Not suitable for high volume
Can’t be relied on in early infection
51
Q

What are some potential ways of detecting HIV?

A

RNA (Viral genome)
Capsule protein (p24)
Antibody

52
Q

What does RNA (Viral genome) detect?

A

Viral load

53
Q

Describe how viral load changes throughout infection

A

Peak in 1st three months
Drop during chronic
Increase in late stage

54
Q

What does Capsule protein (p24) detect?

A

Antigen

55
Q

Describe how viral load changes throughout infection?

A

Peak in 1st three months
Drop during chronic
Increase in late stage

56
Q

Describe how HIV antibody levels vary during infection

A

Peak during chronic

Decrease in late stage

57
Q

What does 3rd generation antibody test detect?

A

IgM and IgG

Very sensitive in established infection

58
Q

How long can 3rd generation antibody test take to show a positive infection?

A

25 days

59
Q

What does 4th generation testing detect?

A

Combined antibody and antigen

60
Q

What is an advantage of 4th generation testing over 3rd?

A

Shorter window to positivity

61
Q

Who should you treat for HIV?

A 
Cd4+ count <350
Nervous system involvement
Co-infection
Cd4+ between 351-500 with:
   Hepatitis B or  C infection
   Low CD4 percentage (<14%)
   Established or high risk of cardiovascular disease
62
Q

How do you treat HIV?

A

Antiretrovirals

63
Q

What does the single HIV pill include?

A

Tenofovir (NtRTI)
Emtricitabine (NRTI)
Efavirenz (NNTRI)

64
Q

What are the 4 main types of antiretrovirals?

A

Nucleoside reverse transcriptase inhibitors (NRTI)
Non-nucleoside reverse transcriptase inhibitors (NNTRI)
Protease Inhibitor (PI)
Entry inhibitors

65
Q

How do Nucleoside reverse transcriptase inhibitors (NRTI) work?

A

Inhibit reverse transcriptase.

66
Q

What are some side effects of Nucleoside reverse transcriptase inhibitors (NRTI)?

A

Mitochondrial toxicity

Lactic acidosis

67
Q

Give some examples of Nucleoside reverse transcriptase inhibitors (NRTI)

A 
Emtricitabine
Tenofovir
Zidovudine
Abacavir
Lamivudine
68
Q

How do Non-nucleoside reverse transcriptase inhibitors (NNTRI) work?

A

Inhibits reverse transcriptase by binding to an allosteric site.

69
Q

Do Inhibits reverse transcriptase by binding to an allosteric site work against both strains of HIV?

A

Don’t work against HIV 2

70
Q

Name some examples of Inhibits reverse transcriptase by binding to an allosteric site.

A

First gen- Nevirapine and efavirenz

Second gen- Etravirine and rilpivirine

71
Q

Protease Inhibitor (PI)

A

Block the viral protease enzyme necessary to produce mature virions upon budding from the host membrane.

72
Q

What are some side effects of protease inhibitors (PI)?

A

Liver enzyme inhibitor

GI side effects

73
Q

Give some examples of protease inhibitors (PI)?

A

Darunavir and atazanavir- first line

Lopinavir, indinavir, nelfinavir, amprenavir and ritonavir

74
Q

How do entry inhibitors work?

A

Interfere with binding, fusion and entry of HIV-1 to the host cell

75
Q

Give some examples of entry inhibitors

A

Maraviroc and enfuviritide

76
Q

What is the standard formula for treating HIV?

A

2 NRTIs as a “backbone” along with 1 NNRTI, PI or INSTI as a “base”

77
Q

What are the two major side effects of antiretrovirals?

A

Lipodystrophy syndrome

Highly active antiretroviral therapy toxicity (HAART)

78
Q

Describe Lipodystrophy syndrome

A

Loss of subcutaneous fat in the arms, legs and face
Deposition of visceral, breast and local fat
Raised cholesterol, HDL cholesterol and triglycerides
Insulin resistance with hyperglycaemia
Syndrome is associated with increased cardiovascular morbidity

79
Q

Give some examples of Highly active antiretroviral therapy toxicity (HAART)

A

GI side effects (Protease Inhibitors)
Skin: rash, hypersensitivity, Stevens-Johnsons (abacivir, nevirapine)
CNS side effects: mood, psychosis (efavirenz)
Renal toxicity: proximal renal tubulopathies (tenofovir, atazanavir)
Bone: osteomalacia (tenofovir)
CVS: increased MI risk (abacivir, lopinavir)
Hematology: anemia (zidovudine)
GI: transaminitis, fulminant hepatitis (nevirapine, most others)

80
Q

What should you immunise people with HIV against?

A

Hep B
Pneumococcal disease
Haemophilus influenza type b

81
Q

What should you not immunise people with HIV against?

A

BCG/TB,
Yellow fever,
Oral typhoid
Live polio vaccine

82
Q

How can an HIV positive male and negative female reproduce?

A

Sperm washing with IUI or IVF

Timed unprotected sex with HAART +/- Pre-Exposure Prophylaxis

83
Q

How can an HIV positive female and negative male reproduce?

A

Self-insemination

Timed unprotected sex with HAART

84
Q

What are some methods to prevent mother-to-child HIV transmission?

A

HAART during pregnancy
Vaginal delivery if undetected viral load
Caesarean section if detected viral load
4/52 Post-Exposure Prophylaxis for neonate
Exclusive formula feeding

85
Q

Must partners of those with HIV be notified?

A

Yes

86
Q

What are some barriers to partner notification with HIV?

A

Fear- Rejection, Isolation, Violence
Stigma
Confidentiality

Reproduction (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions