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Infectious Disease > HIV Diagnosis and Tx > Flashcards

HIV Diagnosis and Tx Flashcards

1
Q

What are attributes of the HIV-1 Virus?

A 
Infects and deplets CD4+ T cells
High Mutation rate
Evades Ab and Cellular Immunity
Defies Traditional vaccines
Hides in resting memory CD4+ T cells
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2
Q

What defines diagnosis of AIDS?

A

CD4+ T cells

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3
Q

What diseases can you catch as your CD4 count drops?

A 
>750 normal
400 Kaposi's sarcoma and TB
Dementia
200 Pneumocystis
Wasting
100 Toxoplasmosis, cryptococcis
50 CMV, Myco Avium
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4
Q

What are diseases that can appear in healthy people but worse in AIDS

A 
Bacterial Pneumonia
Zoster
Thrush
Oral Hairy Leukoplakia
HPV-related dis
Anemia
Immune thrombocytopenia
Neutrosyphilis
Lymphadenopathy
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5
Q

What has happened to incidence and prevalence of HIV as Tx has improved?

A

Prevalence still increasing (people are living longer with the disease)
Incidence going down (new cases)

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6
Q

WHat Tx has changed the death rate from HIV the most?

A

Era of combination Antiretroviral Treatment (cART)

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7
Q

WHat demographic has the highest percent of new HIV diagnoses?

A

Male to Male sex

Need pre-exposure prophylaxis!

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8
Q

What race represents the highest new HIV Diagnoses?

A

African/African American

Caucasians 2nd

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9
Q

What are the signs of acute Retroviral Syndrome?

A

Flu or Mono syndrome 75%

Pharyngitis, rash, headache 50%

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10
Q

What is the time frame of Blood markers in an HIV infection?

A

HIV RNA rises first, drops then levels off
HIV p24 Antigen rises second, drops to zero
HIV Antibody rises last, drops then rises steadily

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11
Q

What are the Chosen Screening tests for HIV ab?

A

ELISA- Gold Standard

Rapid Tests

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12
Q

What are the confirmatory tests for HIV?

A

Western Blot HIV-1

Multispot HIV-1/2 test

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13
Q

What is the 2 step testing protocol process

A
  1. Reactive HIV Ag/Ab screening test
  2. Multispot HIV-1/2 Discriminatory Assay
  3. HIV1 nucleic acid testing
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14
Q

What is the age range that has the Grade A recommendation for HIV screening?

A

15-65 yo

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15
Q

What is the difference between HIV-1 and HIV-2?

A

Less transmissable and Pathogenic

Dual Infection possible

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16
Q

What are the Traits of the CCR5 tropic HIV Strain?

A

Major viral species

Essential for Transmission

17
Q

What are the Traits of the CXCR4 tropic HIV Strain?

A

80% incidence in AIDS

Associated with more rapid disease progression

18
Q

What are the benefits of the Delta 32 CCR5 mutation?

A

Homozygous: Much lower risk of infection by HIV
Heterozygous: Delayed progression to AIDS

19
Q

How can risk of transmitting HIV from mom to baby be minimized?

A

Treat Mom’s HIV
Post exposure prophylaxis for baby
Do NOT Breast feed

20
Q

What are the skin symptoms of secondary Syphilis?

A

Macular - Papular Rash
Palmar-Plantar rash
Mucous Patches
Condyloma Lata

21
Q

What is the prevalence, Tx and DDx of Pneumocystis Pneumonia?

A

Most common AIDS defining illness

CD4

22
Q

WHich Opportunistic infections require Primary Prophylaxis (Prevention)?

A

Pneumocystis
Toxoplasma
MAC

23
Q

WHich Opportunistic infections require Secondary Prophylaxis (Maintenence)?

A 
Pneumocystis
Toxoplasma
MAC
CMV
Cryptococcus 
Histoplasma
24
Q

What are the ARV Drug Classes?

A 
CCR5 co-receptor antagonist
Fusion Inhibitor
Reverse transcriptase Inh
Integrase strand transfer inhibitor
Protease inhibitor
25
Q

Which HIV drugs have the highest risk for Drug-Drug interaction?

A

PI- HIGH: Decreases effectiveness of BC pills

NNRTI- Mod: Efavirenz is teratogenic

26
Q

What needs to be dome before putting a patient on Abacavir?

A

HLA- B5701 test prior to abacavir use

27
Q

What are the components of Metabolic Syndrome?

A 
Central Obesity
Hypertension
High TRGs
Low LDL
Insulin Resistance
28
Q

What are the common causes of death in AIDS patients?

A 
AIDS-related
Liver
CVD
Non-AIDS Cancer
Other (substance abuse)

Infectious Disease (15 decks)

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