Brainscape's Knowledge GenomeTM

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


See full index

SBL Final > HIV/ AIDS and Opportunistic Infections > Flashcards

HIV/ AIDS and Opportunistic Infections Flashcards

1
Q

What is the main reason for disparities in black populations diagnosed with HIV?

A

social determinants of health such as poverty, access to care, insurance status, structural racism, and economic inequality

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

What are the high risk activities for HIV transmission?

A

receptive anal sex–> insertive anal sex–> receptive vaginal sex–> insertive vaginal sex

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

What are the 3 broad clinical presentations of HIV?

A

acute HIV infection, chronic asymptomatic HIV, and AIDS

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

how can an acute HIV infection be described?

A

within weeks of infection; 40-90% experience acute flu-like symptoms

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

how can chronic asymptomatic HIV be described?

A

can last years, asymptomatic

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

What is the first test to be positive when diagnosing HIV?

A

HIV RNA PCR/ HIV NAAT/ viral load

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

what test is second to become positive and when?

A

HIV p24 antigen; usually positive during acute HIV

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

what is the last test to become positive when trying to diagnose HIV?

A

HIV antibody test; may be negative during acute HIV

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

what is the window period associated with HIV?

A

period in early HIV infection before HIV antibody tests become positive

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

what is the first test you order when testing for HIV?

A

HIV-1/2 antigen/antibody combination immunoassay

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

if you get a positive HIV-1/2 antigen/antibody combination immunoassay test, what test do you order next?

A

the HIV-1/2 antibody differentiation immunoassay

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

what happens if the HIV-1/2 antibody differentiation immunoassay is negative or indeterminate?

A

you order the HIV RNA PCR/ HIV NAAT/ viral load

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

what happens if the HIV RNA PCR/ HIV NAAT/ viral load is positive?

A

pt has acute HIV infection

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

what happens if the HIV RNA PCR/ HIV NAAT/ viral load is negative?

A

it was a false positive; no further testing is needed

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

there are two things to monitor in HIV patients, what are they?

A

Absolute CD4 count and HIV-1 NAAT (RNA PCR or viral load)

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

what is the purpose of monitoring the absolute CD4 count in patients with HIV?

A

it is the best indicator of immunologic function

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

what are the limitations with CD4 level testing?

A

CD4 levels can fluctuate dat-to-day

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

what is considered an undetectable HIV-1 NAAT/ HIV RNA PCR/ viral load number?

A

anything less than 200 copies

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

how often do you monitor the HIV-1 NAAT/ HIV-1 RNA PCR/ viral load?

A

monitor every 3-6 months

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

viral suppression with ART leads to what?

A

immune recovery

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

there is no cure yet for HIV- why? what’s the challenge?

A

the viral reservoir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

there is chronic immune activation in HIV (even with treatment and at high CD4 counts) meaning that these patients are at increased risks for certain conditions such as what?

A

cardiovascular disease (MI or stroke) or cervical cancer

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

Who is PrEP given to?

A

to HIV-negative people at risk for HIV to help prevent them from acquiring HIV

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

What is PrEP?

A

medication taken daily to block HIV infection if patient exposed to HIV through sex or IV drug use; 2 nucleoside reverse transcriptase inhibitors

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

what are the indications for PrEP?

A

has sex partner with untreated HIV; history of recent condomless anal sex; history of recent bacterial STI, multiple sex partners of unknown HIV status

26
Q

AIDS can be defined by either:

A

CD4 count less than 200 or any AIDS defining condition such as PJP PNA (even if CD4 count is greater than 200)

27
Q

what is the most common AIDS-associated opportunistic infection?

A

pneumocystis Jirovescii (PJP) PNA

28
Q

how does PJP PNA present?

A

with fever, non-productive cough, pleuritic chest pain, dyspnea, and presentation is often sub-acute

29
Q

what is a key physical exam finding associated with PJP PNA?

A

exertional hypoxia

30
Q

what do the imaging findings (CT) usually show in pts with PJP PNA?

A

ground glass infiltrates

31
Q

what is the typical presentation of mycobacterium tuberculosis?

A

fever, cough, dyspnea, weight loss, night sweats, CD4 counts are usually greater than 200

32
Q

what is the typical finding on CXRs in patients with mycobacterium tuberculosis?

A

apical cavitary lesion in the upper lung lobes

33
Q

in advanced HIV with CD4 counts less than 200, how does mycobacterium tuberculosis present?

A

with disemminated disease affecting lungs in miliary pattern, can also affect GI tract, bone, brain, and lymph nodes

34
Q

what is the most common HIV associated pulmonary infection?

A

community acquired PNA

35
Q

at what CD4 level do patients with HIV run the risk of getting community acquired PNA?

A

ANY CD4 COUNT

36
Q

how does community acquired PNA present?

A

fever, cough, SOB, and infiltrate on CXR

37
Q

what are the typical causes of community acquired PNA?

A

strep pneumonia and H. influenza

38
Q

what is the pathophysiology of CNS toxoplasmosis?

A

reactivation of latent tissue cysts in patients with prior toxoplasma infection (typically toxoplasma IgG will be positive)

39
Q

what is the typical presentation of CNS toxoplasmosis?

A

fever, headache, and focal neuro deficits (seizure or stroke like symptoms)

40
Q

How do you make the diagnosis of CNS toxoplasmosis?

A

if you get an MRI and it shows multiple ring-enhancing lesions, you can begin to treat for CNS toxoplasmosis

41
Q

what can CNS toxoplasmosis be compared to?

A

primary CNS lymphoma

42
Q

what are the key differences between CNS toxoplasmosis and CNS lymphoma?

A

there is typically only a single ring-enhancing lesion on the MRI

43
Q

what is the leading cause of meningitis in patients with AIDS?

A

cryptococcal meningitis

44
Q

how does cryptococcal meningitis present?

A

fever, ams, headache, focal neuro deficits are less common

45
Q

how is the diagnosis of cryptococcal meningitis made?

A

lumbar puncture with CSF showing elevated opening pressure, cryptococcal antigen positive

46
Q

at what CD4 count are HIV patients at risk for cryptococcal meningitis?

A

less than 100

47
Q

at what CD4 count are HIV patients at risk for CNS lymphoma?

A

less than 50

48
Q

at what CD4 count are HIV patients at risk for CNS toxoplasmosis?

A

less than 100

49
Q

what is a late complication of AID (CD4 count around 10)?

A

mycobacterium avium intracellulare (MAI)

50
Q

how does mycobacterium avium intracellulare (MAI) present?

A

constitutional symptoms (fever, weight loss, night sweats) abdominal pain, and lymphadenopathy

51
Q

how do you make the diagnosis of mycobacterium avium intracellulare (MAI)?

A

mycobacterial blood cultures being positive

52
Q

how does CMV retinitis present?

A

with floaters, scotomas (flashing lights), and visual field cut; can be sight threatening if lesions are near optic nerve

53
Q

how does CMV colitis present?

A

diarrhea, abdominal pain, and weight loss

54
Q

what does the biopsy look like in a patient with CMV colitis?

A

owl’s eye cytoplasmic inclusion bodies

55
Q

when does CMV disease in HIV present?

A

when CD4 counts are less than 50

56
Q

when are HIV patients at risk for candidiasis?

A

when CD4 counts are less than 200

57
Q

how does oropharyngeal candidiasis present?

A

white plaques on an erythematous mucosa; easily scraped off

58
Q

how does esophageal candidiasis present?

A

odynophagia and retrosternal pain

59
Q

esophagitis in HIV can be caused by what?

A

candida, HSV, or CMV

60
Q

how does oral hairy leukoplakia present and what is it associated with?

A

associated with presence of EBV; presents with white frondlike lesions along the lateral tongue that DO NOT SCRAPE OFF

61
Q

how do you prophylactically treat opportunistic infections in patients with HIV?

A

when their CD4 count drops below 200 you give them TMP-SMX to prevent PJP; when their CD4 count drops below 100, you continue treating them with TMP-SMX to prevent MAI

SBL Final (21 decks)

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