HIV/AIDS II Flashcards
a CD4 count below ____ is when opportunistic infections start appearing in HIV patients
a CD4 count below 200 cells/mm3 is when opportunistic infections start appearing in HIV patients
list the AIDS-defining illnesses
describe the illnesses associated with specific CD4 cell counts
____ is the leading cause of death among AIDS patients, mainly because many of the strains are ____
TB is the leading cause of death among AIDS patients, mainly because many of the strains are multidrug resistant
a CD4 T cell count <50 cells/mm3 puts AIDS patients at an increased risk for infection with ____
a CD4 T cell count <50 cells/mm3 puts AIDS patients at an increased risk for infection with MAC and MAI
transmission of MAC is via ___ or ____
transmission of MAC is via inhalation or ingestion
describe the clinical presentation of MAC
MAC infection mimics pulm. TB in patients with _____
MAC infection mimics pulm . TB in patients with underlying lung disease (e.g. COPD)
MAC ____ is common with IRIS in HIV patients
MAC lymphadenitis is common with IRIS in HIV patients
Bartonella spp. can cause ___ in advanced HIV patients
Bartonella spp. can cause bacilliary angiomatosis in advanced HIV patients
Bacilliary angiomatosis affecting the liver is called ____
Bacilliary angiomatosis affecting the liver is called Bacilliary peliosis
what is seen in the image?
Bacilliary angiomatosis start as ___ to ___ patches/papules and then gradually expand into large ___ lesions or ___ that have which 3 characterstics?
Bacilliary angiomatosis start as purple to red patches/papules and then gradually expand into large pedunculated lesions or nodules that are friable, erode and bleed
CMV establishes latent infection in ___, ___ cells, ___ and ____ cells in the bone marrow
CMV establishes latent infection in monocytes, dendritic cells, megakaryocytes and myeloid progenitor cells in the bone marrow
in CMV retinitis, there is full-thickness retinal ___ and ___ that is subsequently replaced by thin, _____ and leads to ____
in CMV retinitis, there is full-thickness retinal necrosis and edema that is subsequently replaced by thin, atrophic scar tissue and leads to detachment
“AIDS patients complains of blurry vision and blind spots with increased floaters and flashing lights”
diagnosis?
CMV - retinitis
progressive multifocal leukoencephalopathy (PML) is a severe ___ disease of the CNS caused by reactivation of the ____ virus
progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the CNS caused by reactivation of the polyomavirus - JC virus
JC virus remains latent in ___ and ___
JC virus remains latent in kidneys and lymphoid organs
PML becomes reactivated in immunocompromised patients, spreads to ___ and induces a lytic infection of ____
PML becomes reactivated in immunocompromised patients, spreads to the brain and induces a lytic infection of oligodendrocytes
“AIDS patient presents with altered mental status, motor deficits and hemianopia and diplopia”
family of the virus causing this?
polyomavirus - JC virus
the gold standard for diagnosing PML is ____
the gold standard for diagnosing PML is brain biopsy
in a brain biopsy of PML, there are irregular areas of ____ in ____ which bear some resemblance to ____
in a brain biopsy of PML, there are irregular areas of granularity in white matter which bear some resemblance to the plaques of demyelination with MS
describe other viral infections in HIV patients
HIV infection + hepatitis = more likely to develop _____
HIV infection + hepatitis = more likely to develop liver toxicity from medications
in HIV patients infected with HPV, there is a higher risk of ____
in HIV patients infected with HPV, there is a higher risk of cervical cancer even with low-risk types
it is recommended to screen HIV infected patients for ___ and ___
it is recommended to screen HIV infected patients for HBV and HCV
____ is a characteristic symptom of esophagitis caused by Candida
odynophagia is a characteristic symptom of esophagitis caused by Candida
diagnosis of Candida infection can be confirmed by _____ test being positive
diagnosis of Candida infection can be confirmed by germ tube test being positive
risk of Cryptococcal infection is highest when CD4 cell counts are below ____
risk of Cryptococcal infection is highest when CD4 cell counts are below 100 cells/mm3
describe 2 features of Cryptococcus on culture
encapsulated yeast
narrow base budding yeast
describe CSF levels in the condition seen in the image
increased protein
decreased glucose
WBCs <50 (mononuclear cell predominance)
list 3 major virulence factors of Cryptococcus neoformans
- polysaccharide capsule
- phenol oxidase enzyme
- ability to grow at 37 C
Pneumocystis jirovecii is an unusual fungus because it lacks ____
Pneumocystis jirovecii is an unusual fungus because it lacks ergosterol in cell walls
what is the hallmark of PJ infection?
interstitial pneumonitis w/ mononuclear infiltrate (predominantly plasma cells)
describe Toxoplasmosis in HIV
Toxoplasmosis in HIV patients occurs almost exclusively due to ____
Toxoplasmosis in HIV patients occurs almost exclusively due to reactivation of latent tissue cysts
“AIDS patients presents with headache, confusion, fever, focal neurological deficits, seizures”
dx?
____ is seen on imaging in HIV patients infected with Toxoplasmosis
multiple ring-enhancing lesions is seen on imaging in HIV patients infected with Toxoplasmosis
“AIDS patient with severe, chronic diarrhea”
how did the patient acquire the causal agent?
ingestion of contaminated food, water
___ are the diagnostic stage of Cryptosporidiosis and can be seen with ____ stain
oocysts are the diagnostic stage of Cryptosporidiosis and can be seen with modified acid fast stain
____, ____ and ____ are frequent complications of small-bowel cryptosporidial infections
dehydration, malnutrition and acalculous cholecystitis are frequent complications of small-bowel cryptosporidial infections
list the 6 countries associated with Leishmaniais
Bangladesh
Brazil
Ethiopia
India
South Sudan
Sudan
describe the clinical presentation of visceral Leishmaniasis
Kaposi’s sarcoma is a tumor of ____
Kaposi’s sarcoma is a tumor of the blood vessel walls
the shape of the macular/papular lesions in Kaposi’s sarcoma are ____ (shape) and arranged in a ___ fashion
the shape of the macular/papular lesions in Kaposi’s sarcoma are elliptical and arranged in a linear fashion
describe Non-Hodgkin’s lymphoma in HIV patients
Immune Reconstruction Inflammatory Syndrome (IRIS) is a paradoxical worsening of preexisting infectious processes following ____
Immune Reconstruction Inflammatory Syndrome (IRIS) is a paradoxical worsening of preexisting infectious processes following the initiation of HAART in HIV-infected individuals
paradoxical IRIS is ____
while
unmasking IRIS is ____
paradoxical IRIS is worsening of a recognized infection
while
unmasking IRIS is worsening of an unrecognized pre-existing infxn
describe the recovery of CD4 T cell count following HAART
biphasic:
- rapid increase during first 3-6 months of HAART mainly due to increase in the number of memory T cells
- slower increase of predominantly naive CD4 T cells due to expansion of T cell clones produced by the thymus
