HIV/AIDS II

Question 1

a CD4 count below ____ is when opportunistic infections start appearing in HIV patients

Answer 1

a CD4 count below 200 cells/mm3 is when opportunistic infections start appearing in HIV patients

Question 2

list the AIDS-defining illnesses

Answer 2

Question 3

describe the illnesses associated with specific CD4 cell counts

Answer 3

Question 4

____ is the leading cause of death among AIDS patients, mainly because many of the strains are ____

Answer 4

TB is the leading cause of death among AIDS patients, mainly because many of the strains are multidrug resistant

Question 5

a CD4 T cell count <50 cells/mm3 puts AIDS patients at an increased risk for infection with ____

Answer 5

a CD4 T cell count <50 cells/mm3 puts AIDS patients at an increased risk for infection with MAC and MAI

Question 6

transmission of MAC is via ___ or ____

Answer 6

transmission of MAC is via inhalation or ingestion

Question 7

describe the clinical presentation of MAC

Answer 7

Question 8

MAC infection mimics pulm. TB in patients with _____

Answer 8

MAC infection mimics pulm . TB in patients with underlying lung disease (e.g. COPD)

Question 9

MAC ____ is common with IRIS in HIV patients

Answer 9

MAC lymphadenitis is common with IRIS in HIV patients

Question 10

Bartonella spp. can cause ___ in advanced HIV patients

Answer 10

Bartonella spp. can cause bacilliary angiomatosis in advanced HIV patients

Question 11

Bacilliary angiomatosis affecting the liver is called ____

Answer 11

Bacilliary angiomatosis affecting the liver is called Bacilliary peliosis

Question 12

what is seen in the image?

Answer 12

Question 13

Bacilliary angiomatosis start as ___ to ___ patches/papules and then gradually expand into large ___ lesions or ___ that have which 3 characterstics?

Answer 13

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

Question 14

CMV establishes latent infection in ___, ___ cells, ___ and ____ cells in the bone marrow

Answer 14

CMV establishes latent infection in monocytes, dendritic cells, megakaryocytes and myeloid progenitor cells in the bone marrow

Question 15

in CMV retinitis, there is full-thickness retinal ___ and ___ that is subsequently replaced by thin, _____ and leads to ____

Answer 15

in CMV retinitis, there is full-thickness retinal necrosis and edema that is subsequently replaced by thin, atrophic scar tissue and leads to detachment

Question 16

“AIDS patients complains of blurry vision and blind spots with increased floaters and flashing lights”

diagnosis?

Answer 16

CMV - retinitis

Question 17

progressive multifocal leukoencephalopathy (PML) is a severe ___ disease of the CNS caused by reactivation of the ____ virus

Answer 17

progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the CNS caused by reactivation of the polyomavirus - JC virus

Question 18

JC virus remains latent in ___ and ___

Answer 18

JC virus remains latent in kidneys and lymphoid organs

Question 19

PML becomes reactivated in immunocompromised patients, spreads to ___ and induces a lytic infection of ____

Answer 19

PML becomes reactivated in immunocompromised patients, spreads to the brain and induces a lytic infection of oligodendrocytes

Question 20

“AIDS patient presents with altered mental status, motor deficits and hemianopia and diplopia”

family of the virus causing this?

Answer 20

polyomavirus - JC virus

Question 21

the gold standard for diagnosing PML is ____

Answer 21

the gold standard for diagnosing PML is brain biopsy

Question 22

in a brain biopsy of PML, there are irregular areas of ____ in ____ which bear some resemblance to ____

Answer 22

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

Question 23

describe other viral infections in HIV patients

Answer 23

Question 24

HIV infection + hepatitis = more likely to develop _____

Answer 24

HIV infection + hepatitis = more likely to develop liver toxicity from medications

Question 25

in HIV patients infected with HPV, there is a higher risk of \_\_\_\_

Answer 25

in HIV patients infected with HPV, there is a higher risk of **cervical cancer even with low-risk types**

Question 26

it is recommended to screen HIV infected patients for ___ and \_\_\_

Answer 26

it is recommended to screen HIV infected patients for **HBV** and **HCV**

Question 27

\_\_\_\_ is a characteristic symptom of esophagitis caused by Candida

Answer 27

**odynophagia** is a characteristic symptom of esophagitis caused by Candida

Question 28

diagnosis of Candida infection can be confirmed by _____ test being positive

Answer 28

diagnosis of Candida infection can be confirmed by **germ tube test being positive**

Question 29

risk of Cryptococcal infection is highest when CD4 cell counts are below \_\_\_\_

Answer 29

risk of Cryptococcal infection is highest when CD4 cell counts are below **100 cells/mm3**

Question 30

describe 2 features of Cryptococcus on culture

Answer 30

**encapsulated yeast** **narrow base budding yeast**

Question 31

describe CSF levels in the condition seen in the image

Answer 31

**increased protein** **decreased glucose** **WBCs \<50 (mononuclear cell predominance)**

Question 32

list 3 major virulence factors of Cryptococcus neoformans

Answer 32

* polysaccharide capsule * phenol oxidase enzyme * ability to grow at 37 C

Question 33

Pneumocystis jirovecii is an unusual fungus because it lacks \_\_\_\_

Answer 33

Pneumocystis jirovecii is an unusual fungus because it **lacks ergosterol in cell walls**

Question 34

what is the hallmark of PJ infection?

Answer 34

**interstitial pneumonitis w/ mononuclear infiltrate (predominantly plasma cells)**

Question 35

describe Toxoplasmosis in HIV

Answer 35

Question 36

Toxoplasmosis in HIV patients occurs almost exclusively due to \_\_\_\_

Answer 36

Toxoplasmosis in HIV patients occurs almost exclusively due to **reactivation of latent tissue cysts**

Question 37

"AIDS patients presents with headache, confusion, fever, focal neurological deficits, seizures" dx?

Answer 37

Question 38

\_\_\_\_ is seen on imaging in HIV patients infected with Toxoplasmosis

Answer 38

**multiple ring-enhancing lesions** is seen on imaging in HIV patients infected with Toxoplasmosis

Question 39

"AIDS patient with severe, chronic diarrhea" how did the patient acquire the causal agent?

Answer 39

**ingestion of contaminated food, water**

Question 40

\_\_\_ are the diagnostic stage of Cryptosporidiosis and can be seen with ____ stain

Answer 40

**oocysts** are the diagnostic stage of Cryptosporidiosis and can be seen with **modified acid fast** stain

Question 41

\_\_\_\_, ____ and ____ are frequent complications of small-bowel cryptosporidial infections

Answer 41

**dehydration**, **malnutrition** and **acalculous cholecystitis** are frequent complications of small-bowel cryptosporidial infections

Question 42

list the 6 countries associated with Leishmaniais

Answer 42

Bangladesh Brazil Ethiopia India South Sudan Sudan

Question 43

describe the clinical presentation of visceral Leishmaniasis

Answer 43

Question 44

Kaposi's sarcoma is a tumor of \_\_\_\_

Answer 44

Kaposi's sarcoma is a tumor of **the blood vessel walls**

Question 45

the shape of the macular/papular lesions in Kaposi's sarcoma are ____ (shape) and arranged in a ___ fashion

Answer 45

the shape of the macular/papular lesions in Kaposi's sarcoma are **elliptical** and arranged in a **linear** fashion

Question 46

describe Non-Hodgkin's lymphoma in HIV patients

Answer 46

Question 47

Immune Reconstruction Inflammatory Syndrome (IRIS) is a paradoxical worsening of preexisting infectious processes following \_\_\_\_

Answer 47

Immune Reconstruction Inflammatory Syndrome (IRIS) is a paradoxical worsening of preexisting infectious processes following **the initiation of HAART in HIV-infected individuals**

Question 48

paradoxical IRIS is \_\_\_\_ while unmasking IRIS is \_\_\_\_

Answer 48

paradoxical IRIS is **worsening of a recognized infection** while unmasking IRIS is **worsening of an unrecognized pre-existing infxn**

Question 49

describe the recovery of CD4 T cell count following HAART

Answer 49

**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

Question 50

"HIV patient has CT scan which shows a tumor growing" dx?

Answer 50

**B-cell lymphoma in the brain**