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Year 2 MIS > HIV and AIDs > Flashcards

HIV and AIDs Flashcards

1
Q

What does HIV stand for?

A
  • Human Immunodeficiency Virus

- leads to a gradual loss of immune function

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2
Q

What does AIDs stand for?

A
  • acquired immunodeficiency syndrome
  • following HIV the reduced immune system leads to systemic immunodeficiency
  • increases the risk of infections and tumours, which would not generally infect
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3
Q

What is the association between Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency (AIDs)?

A
  • patient is infected with AIDs

- once immune system is severely compromised patients are then classed as having AIDs

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4
Q

In early acute phase of the HIV infection the viral load will increase as the virus infects the patient. How does this present in the patient?

1 - rash on the skin
2 - flu like symptoms
3 - fatigue and rash on skin
4 - hair loss and rash on skin

A

2 - flu like symptoms

- immune system mounts an immune response

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5
Q

In the acute phase of HIV which cell type is targeted and gradually declines?

1 - dendritic cells
2 - macrophages
3 - CD4 T helper cells
4 - CD8 T cytotoxic cells

A

3 - CD4 T cells

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6
Q

What determines when a patient moves from HIV to AIDs?

A
  • when the level of T cells is severely depleted
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7
Q

What is often the first presenting symptoms of AIDs?

1 - hair loss
2 - anaemia
3 - infection
4 - cardiac problems

A

3 - infection

- opportunistic infections which the immune system would normally resist

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8
Q

The first presenting symptoms of AIDs is an infection with opportunistic infections which would not normally cause infection. Which of the following are common in AIDs and can ultimately lead to death?

1 - Pneumocystis jirovecii and Kaposi’s sarcoma (HHV8-induced tumour, ‘KSAV’)
2 - MRSA and Pneumocystis jirovecii
3 - Pneumocystis jirovecii and meningitis
4 - Kaposi’s sarcoma (HHV8-induced tumour, ‘KSAV’) and MRSA

A

1 - Pneumocystis jirovecii and Kaposi’s sarcoma (HHV8-induced tumour, ‘KSAV’)

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9
Q

Which receptor on T helper cells does the HIV bind with?

1 - Toll Like Receptors
2 - CD4
3 - IL-6 receptors
4 - CD8

A

2 - CD4

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10
Q

CD4 on T helper cells is what HIV will bind with to infect cells. However, it also requires a 2nd co-stimulation. What is this receptor on the HIV called?

1 - CD40
2 - Gp100
3 - B7
4 - Gp120

A

4 - Gp120

- refers to enveloped glycoprotein

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11
Q

CD4 on T helper cells is what HIV will bind with to infect cells, with co-stimulation from Gp120 receptor on the HIV cell. However, it also requires a further co-stimulation from a receptor that is present on T cells, macrophages, monocytes and dendritic cells. What is this co-stimulatory receptor called?

1 - CXCR4 and CCR5
2 - CD4XR and CCR5
3 - CTXR8 and CCR5
4 - CXC and CCR5

CXC = chemokine
R = receptor
A

1 - CXCR4 and CCR5

  • doesn’t need to bind both, one or the other
  • CCR5 is MOST COMMON IN EARLY INFECTION
  • CXCR4 IS MORE COMMON IN LATE INFECTIONS
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12
Q

Once the HIV has bound to a CD4 cell, it is able to release its contents into the cell. HIV contains ssRNA retrovirus. What does the virus require in order for its viral DNA to be incorporated into the CD4 DNA within the nucleus?

1 - to be copied by the ribosome
2 - to bind with receptors on nucleus
3 - to bind with reverse transcriptase
4 - to destroy lysosomes within the cell

A

3 - to bind with reverse transcriptase

  • this is where the retro part of the virus comes from
  • this allows the ssRNA to be copied and integrated into the host DNA
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13
Q

Once HIV has been incorporated its DNA into the CD4 T helper cell. When does the T cell then copy its DNA and in doing so replicate the HIV code instead, resulting in the production of HIV proteins?

1 - only when the T cell has been activated
2 - only when the T cell has been activated and clonally expands
3 - as soon as it is incorporated into the T cells DNA
4 - whenever HIV instructs it to do so

A

2 - only when the T cell has been activated and clonally expands
- occurs once the patient is infected with HIV

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14
Q

To gain entry into a host cell, HIV will need to bind with CD4 through its Gp120 receptors, followed by co-stimulation with CXCR4 or CCR5. The function of CXCR4 or CCR5 is chemotaxis and HIV suppression. So when a cell becomes infected with HIV the CD4 T helper cell up-regulates CXCR4 or CCR5 receptors to signal an immune response and fight the HIV. Why is this bad though?

A
  • provides more binding sites for HIV

- cells are more vulnerable to HIV

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15
Q

What is thought to be the main sites for HIV infection to occur?

1 - genitourinary, gut and oral mucosa
2 - vagina, oral mucosa and bronchi
3 - penis, oral and gut
4 - intravenous, gut and oral

A

1 - genitourinary, gut and oral mucosa

- high number of CD4 cells with CCR5 receptors are present, so lots of chance to infect

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16
Q

The GIT is thought to be the main site for HIV infection to occur due to the high number of CD4 cells with CCR5 receptors present, so lots of chance to infect. In early infection the mucosa is able to shed and the HIV virus with CD4 are removed from the GIT as faeces. However, as a large number of CD4 cells have been removed alongside the HIV, what infection does this increase the risk of?

1 - inflammatory bowel disease
2 - cytomegalovirus causing colitis
3 - coeliac disease
4 - salmonella

A

2 - cytomegalovirus causing colitis

17
Q

The R5 strain of the HIV is following infection in the GIT, where the virus then travels to lymph nodes where it is able to infect other immune cells. Where does the name R5 come from?

1 - name given when it was discovered
2 - name given by person who discovered it
3 - R5 HIV strain binds to CCR5 co-receptor
4 - R5 HIV strain binds to CXCR5 co-receptor

A

3 - R5 HIV strain binds to CCR5 co-receptor

18
Q

The X4 strain of the HIV generally comes on in chronic late infections with HIV. Where does the name X4 strain come from?

1 - name given when it was discovered
2 - name given by person who discovered it
3 - X4 HIV strain binds to CCR5 co-receptor
4 - X4 HIV strain binds to CXCR4 co-receptor

A

4 - X4 HIV strain binds to CXCR4 co-receptor

19
Q

In the acute infection phase of HIV, why is it crucial that infected patients do not have sex?

A
  • largest viral load is present

- most infection at this point

20
Q

In a patient infected with HIV, due to the reduction in CD4 T helper cells there is a loss of control of commensal bacteria, resulting in an increase in what?

1 - gram negative peptides
2 - gram positive peptides
3 - gram negative lipopolysaccharide
4 - gram positive lipopolysaccharide

A

3 - gram negative lipopolysaccharide

- leads to inflammation NF-Kb and TNF-a activation

21
Q

In a patient infected with HIV, due to the reduction in CD4 T helper cells there is a loss of control of commensal bacteria, resulting in an increase in gram negative lipopolysaccharides that can then lead to inflammation NF-Kb and TNF-a activation. Why is this a bad thing?

A
  • causes an immune response

- an immune response up-regulates CCR5 meaning more HIV can bind

22
Q

In a patient infected with HIV, due to the reduction in CD4 T helper cells there is a loss of control of commensal bacteria, resulting in an increase in gram negative lipopolysaccharides that can then lead to inflammation NF-Kb and TNF-a activation. Why is this a bad thing?

A
  • causes an immune response

- an immune response up-regulates CCR5 meaning more HIV can bind

23
Q

What is the most common test used to diagnose HIV?

1 - antibody only tests
2 - antibody/antigen tests
3 - RNA/DNA test
4 - FBC and blood film

A

2 - antibody/antigen tests

- detects the p24 HIV protein antigen as well as conventional HIV antibodies produced by B cell

24
Q

In HIV we used a term called the eclipse period. What does this mean?

1 - time until a patient presents with symptoms
2 - time until a patient dies from HIV
3 - time before HIV is detectable in blood
4 - time before AIDs is detectable in the blood

A

3 - time before HIV is detectable in blood

- normally lasts 10 days, but not test will be able to detect HIV

25
Q

The window period in HIV is the time between exposure to HIV and when the 4th generation antibody/antigen tests are able to detect HIV. How long is this window from time of infection and what level of accuracy does this test have?

1 - 45 days and >80% accuracy
2 - 55 days and >80% accuracy
3 - 55 days and >99% accuracy
4 - 45 days and 99% accuracy

A

4 - 45 days and 99% accuracy

- takes >45 days to accurately detect the presence of the HIV using antigen/antibody testing

26
Q

The 4th generation antibody/antigen tests are 99% accurate if measured after 45 days. What antigen are these tests able to detect from the HIV?

1 - p24
2 - Gp120
3 - CD4 bound Gp120
4 - CCR5

A

1 - p24

- a structural protein of HIV

27
Q

If a patient tested negative at 45 days but they were a high risk of HIV, would they be tested again?

A
  • yes at 8 weeks
28
Q

If a patient tests negative at 45 days for HIV, is that a definitive diagnosis?

A
  • no
  • same material must be confirmed with a 2nd test
  • a 3rd test is often confirmed on another occasion
29
Q

In HIV treatment, are patients prescribed with one drug?

A
  • no
  • given combination therapy (generally 3 different drugs combined)
  • medication is lifelong
30
Q

When assessing the level of infection in a patient with or suspected of having HIV we use viral load. What is viral load?

1 - measure of molecular density of HIV
2 - measure of molecular weight of HIV
3 - measure of viral replication
4 - measure viral virulence

A

3 - measure of viral replication

31
Q

If a patients viral load (level of viral replication) is undetectable, does this mean that the patient is cured?

A
  • no

- just means levels are undetectable using current methods and is dormant

32
Q

When assessing a patient with HIV we can measure CD4 count. What are the normal levels of CD4 T helper cells?

1 - 100
2 - 500
3 - 1000
4 - 2000

A

2 - 500

- <200 leads to acquired immunodeficiency disease (AIDs)

33
Q

When assessing a patient with HIV we can measure CD4 count. When the CD4 T helper cells drop below 200, patients are said to have AIDs. What are some of the AIDs defining conditions?

A
  • candidiasis
  • pneumonia
  • pneumocystis pneumonia
  • toxoplasmosis (parasitic infection)
  • lymphoma
34
Q

What does treatment as prevention, termed TasP relate to?

1 - treating the patient to prevent the infection
2 - treating a patient with combination therapy prior to infection
3 - treating a patient following exposure and preventing spread of HIV

A

1 - treating the patient to prevent the infection

35
Q

Treatment as prevention, termed TasP relates treating the patient to prevent the infection. Pre Exposure Prophylaxis (PrEP) is for patients who are at high risk of encountering HIV. When should these patients take PrEP?

1 - every day
2 - 48h before and 24 hours after or every day
3 - 1 week before and 1 week after
4 - one month before and 1 month after

A

2 - 48h before and 24 hours after or every day

  • medicine given to patients at high risk of contracting HIV
  • given prior to HIV exposure, if a man has sex with another man for example
  • 99% effective if used correctly
36
Q

What does Post-Exposure Prophylaxis – PEP relate to in relation to HIV?

1 - treating the patient to prevent the infection
2 - treating a patient with combination therapy prior to infection
3 - treating a patient following exposure and preventing spread of HIV

A

3 - treating a patient asap following exposure and preventing spread of HIV

  • combination of HIV drugs that can stop HIV from replicating
  • given following suspected exposure to HIV
37
Q

What is post exposure prophylaxis (PeP) in relation to HIV?

A
  • combination of HIV drugs that can stop HIV from replicating
  • given following suspected exposure to HIV
  • taken for 28 days

Year 2 MIS (48 decks)

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