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Immune > HIV (ch.21) > Flashcards

HIV (ch.21) Flashcards

1
Q

What cells do HIV hijack?

A

CD4 T-cell (aka CD4 cell, helper/inducer T-cell, or T4-cell)

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2
Q

What do CD4 cells do?

A

Directs immune system defenses and regulates activity of all immune system cells.

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3
Q

If HIV successfully enters CD4 cell, what happens?

A

More virus particles are created.

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4
Q

What is the name of the viral family that HIV belongs to?

A

Retrovirus

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5
Q

What do integrase inhibitors do?

A

Prevents viral DNA from integrating into cell’s normal human DNA

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6
Q

What distinguishes HIV from AIDS?

A

The number of CD4 cells the patient has and whether any opportunistic infections have occurred.

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7
Q

What is the normal CD4 count in a healthy adult?

A

800-1000 cells per cubic millimeter of blood.

The number of CD4 cells is reduced in someone with HIV disease.

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8
Q

Manifestations of acute HIV infection?

A

Fever, night sweats, chills, headache, muscle aches.

But, because these are all symptoms of virus (namely flu), the HIV patients also have rash and sore throat .

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9
Q

What is an opportunistic infection?

A

Infection caused by organisms that are present as part of the body’s normal environment and kept in check by normal immune function.

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10
Q

What makes a diagnosis of AIDS?

A

Person is HIV positive and have either a CD4 count of

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11
Q

What lab tests confirm HIV?

A

ELISA (enzyme-linked immunosorbent assay)
and
Western Blot Analysys
PLUS…
CD4 count or percentage and the presence or absence of the 26 AIDS-defining conditions.

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12
Q

When are HIV patients most infectious?

A

Recently infected patient with high viral load and those at end stage without drug therapy are the most infectious.

**Note that they can transmit the virus at all stages of the disease, just that they are most infectious at the above stages.

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13
Q

Stage 1 of HIV

A

Confirmed HIV infection and CD4 count of >500, or cell percentage of 29% or greater.
No AIDS-defining illnesses at this stage.

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14
Q

Stage 2 of HIV

A

CD4 between 200 and 499, or percentage of 14%-28%.

No AIDS-defining illnesses at this stage.

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15
Q

Stage 3 of HIV

A

CD4

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16
Q

Stage 4 of HIV

A

Confirmed HIV infection, but no information regarding CD4 counts, or percentages, and AIDS-defining illnesses.

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17
Q

What may be a first sign of HIV in women?

A

Recurring vaginal candidiasis.

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18
Q

What body fluids contains HIV?

A

Blood, semen, vaginal secretions, breast milk, amniotic fluid, urine, feces, saliva, tears, CSF, lymph nods, cervical cells, corneal tissue, and brain tissue.

Highest concentrations of HIV are in semen and blood.

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19
Q

Three most common ways HIV is transmitted

A

Sexual (genital, anal, oral)

Parenteral (sharing needles, receiving infected blood)

Perinatal (from placenta, contact with maternal blood and body fluids during birth, also from breast milk)

20
Q

Is HIV transmitted by sharing utensils, towels, linens?

A

Nope! It is not spread these ways. You can’t get it from sharing a utensil, sitting on the same toilet, being bitten by a mosquito, bumping in to an HIV patient….

21
Q

Safer sex methods for not getting HIV?

A

Abstinence
Be faithful
Condoms

Abstinence and mutually monogamous sex with a noninflected partner are the only absolutely safe methods of preventing HIV infection from sexual contact.

22
Q

What is the most risky sexual act to contract HIV?

A

Anal. Gross.

23
Q

What is viral load?

A

Amount of virus present in the blood and other body fluids.

24
Q

What is viremia

A

amount of virus in blood.

25
Q

What is HAART?

A

Highly Active Anti Retroviral Therapy

26
Q

Which vaginal gels contain antiretroviral agents?

A

tenofovir or raltegravir

27
Q

What are the main means of occupational-related HIV infections for health care workers?

A

needlestick or ‘sharps’ injuries.

28
Q

What is the best prevention for health care providers when working with HIV patients?

A

Consistent use of standard precautions for all patients.

29
Q

What are pathogenic infections?

A

Caused by virulent organisms and occur even among people whose immune systems are functioning normally.

30
Q

What are opportunistic infections?

A

Caused by organisms that are present as part of body’s normal environment and are kept in check by normal immune function.
They occur because of the profound immunosuppression of the person with HIV infection.

31
Q

Priority nursing action when caring for an HIV patient?

A

Continually assessing for presence of opportunistic infection and monitoring the patient’s response to therapy.

32
Q

Do opportunistic infections pose a threat to immunocompetent health care worker caring for a patient with HIV or AIDS?

A

Nope!

It is, however, important for health care personnel to use precautions appropriate to the specific disease to prevent disease spread.

33
Q

What is the most common opportunistic infection in an HIV patient?

A

Pneumocystitis jiroveci pneumonia (PCP)

34
Q

How to assess for PCP?

A 
Dyspnea on exertion
Tachypnea
persistent dry cough
low-grade, persistent favor. 
May report fatigue and weight loss.
Listen for crackles
35
Q

How does an HIV patient contract Toxoplasmosis encephalitis?

A

Touching contaminated cat feces or ingesting infected, undercooked meat.

Assess for subtle changes in metal status, neurological defects, headaches, fever. Also, difficulty speaking, gait, vision, seizures, lethargy, confusion.

36
Q

Intestinal infection in AIDS patients?

A

Cryptosporidiosis.
Intestinal infection causing mild diarrhea to severe wasting with electrolyte imbalance. Diarrhea can result in loss of 15-20L/day.

37
Q

Fungal infections in AIDS patients?

A

Candiasis.

Occurs because weakened immune system can no longer control fungal (candida) growth.

38
Q

Most common bacterial infection in AIDS patients?

A

Mycobacterium avicum complex (MAC).

39
Q

The person with TB and a CD4 cell count below 200 may not have a positive TB PPD skin test because ____

A

of the inability to mount an immune response to antigen, a condition known as anergy.

40
Q

How would you test for TB in an AIDS patient?

A

Blood analysis by an interferon release gamma assay (IRGA).

41
Q

What is Kaposi’s Sarcoma?

A

Most common AIDS-related malignancy.

Small, purplish-brown raised lesions that are usually not painful or itchy.

42
Q

When is Western blot testing done?

A

When ELISA is positive.

43
Q

What kinds of drugs therapy is used to manage pain in HIV/AIDS patients?

A

NSAIDs and/or pregabalin (Lyrica) for arthralgia and myalgia

For neuropathic paint: amitriptyline (Elavil) or other tricyclic antidepressants, anticonvulsant drugs such as gabapentin (Neurontin), phenytoin (Dilantin), carbamazepine (Tegretol), but these interact with antiretroviral drugs

Stronger pain may be controlled with opioids such as oxycodone or codeine, and more intense pain is treated with morphine, hydromorphone (Diluaudid), or fentanyl

44
Q

Drug therapy for HIV/AIDS patients with candidaisis

A

ketoconazole (Nizoral), fluconazole (Diflucan) orally

amphotericin B (Fungizone) IV

45
Q

What kind of diet should an HIV/AIDS patient eat?

A

High-calorie, high-protein, nutritionally sound diet.

Teach to avoid dietary fat because fat intolerance often occurs as a result of disease and side effect of some antiretroviral meds.

Should eat small, frequent meals.

Immune (7 decks)

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