HIV Diagnosis and Clinical manifestations

Question 1

Patient has HIV 1/2 + indeterminate test. Next best step?

Answer 1

HIV-1 NAT

Question 2

patient has positive HIV 2 antibodies detected. Next best test?

Answer 2

HIV 2 RNA PCR

Question 3

when does HIV antibody test become positive?

Answer 3

around 25-30 days

Question 4

when does HIV viral Nucleic acid tests detect HIV?

Answer 4

around 10 days

Question 5

which group is the most common in HIV-1?

Answer 5

Group M (major)

Question 6

which is the most common group to be missed on routine HIV test?

Answer 6

group O (outlier)

Question 7

which is the most common group in the US?

Answer 7

group B

Question 8

what is the most common group location for southern africa?

Answer 8

group C

Question 9

what is this association?

Answer 9

flower nucleus, think HTLV1 T-cell leukemia syndrome

Question 10

what are the associated syndromes with HTLV-1?

Answer 10

Infectious

• TB, MAC, leprosy, recurrent strongyloides, norweigan scabies

Noninfectious hypercalcemia + lytic bone lesions

Question 11

what geographic location associated with HTLV-1?

Answer 11

Jamaica, and japan

Question 12

what does HTLV-1 infection cause?

Answer 12

• HALF URI
• HTLV-associated myelopathy
• Asymptomatic, acute T-cell leukemia
• lymphocytic pneumonitis/bronchiectasis
• Flower cells
• Uveitis
• rheumatologic syndromes
• infective dermatitis (pediatric)
  *

Question 13

what are the two types of transmissible spongiform encephalopathies?

Answer 13

Spontaneous

• Associated with ingesting cows “variant CJD” and human brains (kuru)
• Associated with medical procedures (iatrogenic) - iCJD

Hereditary

• Familiar, gestmman-straussler-sheinker (GSS)
• Fatal familial insomnia (FFI)
• Fatal sporadic insomnia (FSI)

Question 14

what is the typical spontaneous CJD presentation?

Answer 14

• rapid progression
• Classic triad of Dementia, myoclonsu, EEG with periodic sharp waves
• CSF 14-3-3

Question 15

what 2 countries has the most caes of vCJD?

Answer 15

UK followed by France

Question 16

Illness script of vCJD?

Answer 16

ingested beef from the UK in a 28 year old, not typically abnormal EEG with pulvinar sign in the MRI basial ganglia and florid plaques

Question 17

Illness script for sCJD?

Answer 17

68 year old short progression, abnormal EEG, with double hockey stick in MRI basal ganglia with abnormal prion protein deposits

Question 18

what are definitive causes of iCJD?

Answer 18

• Pituitary extracts (HGH, gonadotropin,Delay may be >30 years)
• Dura mater grafts (lyodura brand)
• Transplants (corneal, pericardium, liver)
• Instrumentation (implantable Neurosurgicla EEG, sterotatic)

Question 19

what are the symptoms of kuru?

Answer 19

“shivering and trembling” Progressive ataxia with dementia