HIV/AIDS and Opportunistic Infections Flashcards
The risk for HIV increases with what feature to mucosa?
Inflamed or ulcerative mucosa
What geographical location bears the heaviest burden of HIV and AIDS worldwide?
Sub-Saharan Africa
What are some specific symptoms pointing towards HIV infection?
1) Hairy leukoplakia of tongue
2) Kaposi sarcoma
3) Cutaneous bacillary angiomatosis
4) LAD
Testing for HIV combines immunoassay for HIV Ab with a test for what antigen?
p24 Ag
A positive result on HIV-1/2 Ag/Ab combination assay is followed by testing of the sample with?
HIV-1/2 Ab differentiation immunoassay
Samples that are negative on Ab differentiation are tested with?
HIV-1 nucleic acid amplification test (NAAT)
If the NAAT result is positive with a negative Ab then?
If specimens are positive on initial combination assay and then are negative on Ab differentiation immunoassay and NAAT then?
1) Acute HIV is diagnosed
2) It is a false-positive test
What is the most widely used marker to provide prognostic info and to guide therapy decisions?
Absolute CD4 Lymphocyte count
In regards to the CD4 lymphocyte count, what is more important than a single determination?
The trend
What is a patient more susceptible to when CD4 count is less than 200? (6)
1) Pneumocystis jiroveci pneumonia
2) Histoplasmosis
3) Kaposi Sarcoma
4) Extrapulmonary/miliary TB
5) Non-Hodgkin’s Lymphoma
6) CNS lymphoma
What is a patient more susceptible to when CD4 count is less than 100? (3)
1) Cryptococcosis
2) Esophageal candidiasis
3) Toxoplasmosis
What is a patient more susceptible to when CD4 count is less than 50? (3)
1) Mycobacterium-avium complex
2) Cytomegalovirus
3) Primary CNS lymphoma
What assesses the level of viral replication and provides useful prognostic info that is independent of the info provided by CD4 counts?
HIV viral load
What is the most common opportunistic infection associated with AIDS?
What does this infection typically cause?
1) Pneumocystis jiroveci
2) Hypoxemia
What is the cornerstone of diagnosis for Pneumocystis jiroveci pneumonia?
What is most commonly seen?
1) Chest radiograph
2) Diffused or perihilar infiltrates
What would give a definitive diagnosis for pneumocystis?
1) Wright-Giemsa stain
2) Direct fluorescent antibody (DFA) test
3) Bronchoalveolar lavage
What enzyme is elevated in Pneumocystis jiroveci pneumonia?
What is a more sensitive and specific test compared to the one above?
1) Lactate dehydrogenase (LDH)
2) Serum beta-glucan test
What can be seen on CXR in HIV infected patients with a history of Pneumocystis pneumonia?
Pneumothorax
What is the most common cause of pulmonary disease in HIV infected persons?
What do we know if they are recurrent?
1) Community acquired pneumonia
2) AIDS defining
What is the most common space-occupying lesion in HIV?
What is the second?
1) Toxoplasmosis
2) Primary CNS lymphoma
How would you characterize the lesion seen in toxoplasmosis on an unenhanced CT scan?
Multiple subcortical lesions most commonly at the basal ganglia
When does toxoplasmosis commonly occur in HIV patients?
CD4 count less than 100
In AIDS patients, toxoplasmosis is a common cause of?
Focal encephalitis
What does MRI imaging typically shows when detecting toxoplasmosis?
Multiple ring enhancing lesions with surrounding areas of edema
Primary CNS lymphoma is highly associated with?
How is it detected?
1) EBV
2) CSF PCR
When does primary CNS Lymphoma commonly occur in HIV patients?
CD4 count less than 50
What type of lesion do CNS lymphomas typically present with?
Single ring-enhancing lesion
What is a common GI problem in HIV-infected patients?
Enterocolitis
What is a major problem that in encountered with CMV?
Retinitis
Kaposi Sarcoma is a low grade vascular tumor associated with?
Human herpesvirus-8
Where do skin lesions from kaposi sarcoma most often appear?
1) LEs
2) Face (nose)
3) Oral mucosa
4) Genitalia
Diagnosis of Kaposi Sarcoma can be confirmed by?
Bronchoscopy
When does Pneumocystis jirovecii commonly occur in HIV patients?
What is a common co-infection?
1) CD4 count less than 200
2) Oropharyngeal candidiasis
What is the treatment for pneumocystis jiroveci?
What is the dosage?
1) Trimethoprim-sulfamethoxazole (TMP-SMX)
2) 1 double strength (DS) tablet daily PO
What immunizations are generally recommended for HIV patients?
1) Hepatitis B and A
2) Influenza virus
3) Streptococcus pneumonia
4) HPV
What type of vaccines should be avoided in HIV patients?
Live vaccines
