HIV Diagnosis and Clinical manifestations Flashcards
Patient has HIV 1/2 + indeterminate test. Next best step?
HIV-1 NAT
patient has positive HIV 2 antibodies detected. Next best test?
HIV 2 RNA PCR
when does HIV antibody test become positive?
around 25-30 days
when does HIV viral Nucleic acid tests detect HIV?
around 10 days
which group is the most common in HIV-1?
Group M (major)
which is the most common group to be missed on routine HIV test?
group O (outlier)
which is the most common group in the US?
group B
what is the most common group location for southern africa?
group C
what is this association?
flower nucleus, think HTLV1 T-cell leukemia syndrome
what are the associated syndromes with HTLV-1?
Infectious
- TB, MAC, leprosy, recurrent strongyloides, norweigan scabies
Noninfectious hypercalcemia + lytic bone lesions
what geographic location associated with HTLV-1?
Jamaica, and japan
what does HTLV-1 infection cause?
- HALF URI
- HTLV-associated myelopathy
- Asymptomatic, acute T-cell leukemia
- lymphocytic pneumonitis/bronchiectasis
- Flower cells
- Uveitis
- rheumatologic syndromes
- infective dermatitis (pediatric)
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what are the two types of transmissible spongiform encephalopathies?
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)
what is the typical spontaneous CJD presentation?
- rapid progression
- Classic triad of Dementia, myoclonsu, EEG with periodic sharp waves
- CSF 14-3-3
what 2 countries has the most caes of vCJD?
UK followed by France
Illness script of vCJD?
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
Illness script for sCJD?
68 year old short progression, abnormal EEG, with double hockey stick in MRI basal ganglia with abnormal prion protein deposits
what are definitive causes of iCJD?
- Pituitary extracts (HGH, gonadotropin,Delay may be >30 years)
- Dura mater grafts (lyodura brand)
- Transplants (corneal, pericardium, liver)
- Instrumentation (implantable Neurosurgicla EEG, sterotatic)
what are the symptoms of kuru?
“shivering and trembling” Progressive ataxia with dementia
