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Clinical Resp > HIV DSA > Flashcards

HIV DSA Flashcards

1
Q
A

200> X > 50

between 200 and 50 CD4

Pneumocystis Jirovecii

Obligate extracellular fungus that has silver stained cysts in tissues. Can cause interstitial pneumonia in AIDS patients. Causes death of type I pneumocytes and subsequent overproliferation of type II pneumocytes.

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2
Q

Acid fast rods that are obligate aerobes. Nonchromogen. Highly resistant to desiccation and many chemials including NaOH. When do you tx pts for this and with what?

A

mycobacterium avium

CD4 < 50

tx w/ macrolides+ethambutol prophylactically

Acid fast rods that are obligate aerobes. Contains mycolic acids highly resistant to desiccation and many chemials including NaOH. Causes pulmonary, GI and disseminated disease. Presents in AIDS patients, cancer patients, and those with chronic lung disease. Nonchromogen. Treat AIDS patients prophylactically for this with a CD4 of less than 50. Macrolide plus ethambutol.

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3
Q

Acid fast rods that are obligate aerobes. highly resistant to desiccation and many chemials including NaOH. Photochromogen.

how would you treat this patient and when?

A

mycobacterium Kanasii

Cavitary lesions in the apical regions of the lungs, presents almost identically to TB in AIDS pt

Acid fast rods that are obligate aerobes.

Contains mycolic acids highly resistant to desiccation and many chemials including NaOH. Causes pulmonary, GI and disseminated disease.

Presents in AIDS patients, cancer patients, and those with chronic lung disease.

Photochromogen.

Treat AIDS patients prophylactically for this with a CD4 of less than 50. Macrolide plus ethambutol.

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4
Q

Large dsDNA enveloped icosahedral virus that forms intranuclear inclusion bodies and can establish latency. reservoir in humans, can turn on VEGF. often confused with another condition.

A

Kaposi Sarcoma

Large dsDNA enveloped icosahedral virus. Forms intranuclear inclusion bodies and can establish latency. reservoir in humans and can turn on VEGF, playing a role in deveoping Kaposi sarcoma. Need to differentiate from bacillary angiomatosis in AIDS patients.

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5
Q
A

Toxoplasma gondii Cause of disease due to cat feces in pregnant women. Can cross the placenta

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6
Q

Hint: it’s not Kapsoi. What is the causative pathogen’s morphology?

A

bacillary angiomatosis: a form of angiomatosis associated with bacteria of the Bartonella genus

Gram negative rod that is the causative agent of cat scratch fever (bacillary angiomatosis in AIDS patients).

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7
Q
A

Cryptococcus neoformans

Encapsulated yeast that is monomorphic.

Found in soil enriched with pigeon droppings.

Diseases such as hodgkin’s lymphoma and AIDS can dispose to infection (leading cause of meningitis in these disease states).

NOT the leading meningitis cause in transplant patients. (that would be Listeria monocytogenes).

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8
Q

Acid fast rods that are obligate aerobes. Nonchromogen

A

Mycobacterium avium intracellular (a complex formed by myco intracellulare and myco avium)

Acid fast rods that are obligate aerobes. Contains mycolic acids highly resistant to desiccation and many chemials including NaOH. Causes pulmonary, GI and disseminated disease. Presents in AIDS patients, cancer patients, and those with chronic lung disease. Nonchromogen. Treat AIDS patients prophylactically for this with a CD4 of less than 50. Macrolide plus ethambutol.

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9
Q
A

hairy leukoplakia (EBV)

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10
Q
A

vaginal candidiasis

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11
Q

pharm to tx pneumocystis jirovecii

A

tmp/smx bactrim

Trimethoprim/sulfamethoxazole

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12
Q

pharm to tx toxoplasma gondii

A

tmp/smx

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13
Q

MAC tx

A

azithromycin

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14
Q

TB tx

A

TST >/= 50

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15
Q

patches of creamy white exudate with reddish brown base cover the mucous membranes of the mouth

A

oral thrush

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16
Q

vaginal itching, cottage cheese appearing white clumbs affixed to vaginal wall

A

vaginal candidiasis

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17
Q

burning substernal pain, worse with swallowing. patches of creamy white exudate on walls of esophagus

A

candida: esophagitis

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18
Q

seizures, gait instability, weakness, sensory loss, no meningeal signs

A

toxoplasma gondii

most common CNS infection in AIDS patients

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19
Q

pt has fever, shortness of breath, non-productive cough.

flying saucer appearing morphology. what kind of pneumonia do we expect to see with this agent?

A

Pneumocystis Jirovecii

most common opportunistic infection of AIDS patients:

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20
Q

PCP infection

A

pneumocystis jirovecii

21
Q

fever, night sweats, weight loss, often diarrhea, elevated liver function tests. often classified as “FUO” fever of unknown origin. Not TB.

A

MAC

22
Q

what would this expect to cause in a pt with HIV and when?

A

CMV retinitis; CD4 < 50

23
Q

HHV-8

A

Kaposi’s sarcoma

24
Q

meningitis, headache, nausea, confusion, staggering gait, sometimes cranial nerve deficits: what does this hint in an HIV patient?

A

cryptococcus neoformans: major manifestation is meningoencephalitis. commonly seen in pigeon doppings. 75% cases occur in immunocompormised pts.

25
Q

what symptoms would we anticipate finding in a patient with this biopsied specimen?

A

meningitis, headache, nausea, confusion, staggering gait, sometimes cranial nerve deficits:

26
Q

what would we see in a patient w/this condition who is HIV+?

A

cryptosporidum parvum, intestinal protozoa : diarrhea 3-17L a day.

27
Q

how would we identify this organism in a pt?

A

cryptosporidum: fecal exam reveals oocyst.

28
Q

motile, bulls eye shaped nucleus with red blood cells in the cytoplasm

A

Entamoba histolytica

amoeba

29
Q

cysts in the fecal matter, liver abscesses, trophozoites with RBCs in their cytoplasm

A

entamoeba histolytica

30
Q

tetra nucleated cysts, chromatoid bodies, causes flecks of blood in the stool. how would you tx?

A

entamoeba histolytica: metronidazole

31
Q

stools are packed with fat–> horrendous odor. No blood in the stool. Does not invade the intestinal wall. Fecal exam reveals both trophozoits and cysts in the stool.

A

giardia lamblia

32
Q
A

molloscum contagiosum: a pox virus (poxviridae)

causes dome shaped lesion with central dimple

similar to warts with benign hyper proliferation

33
Q

“brick shaped box” like virus with complex DNA genome

A

molloscum contaiosum

34
Q
A
35
Q

DNA is organized into a dumbell shape and surrounded by 2 envelopes

A

molloscum contagiosum

36
Q

Guarenierni bodies

A

molloscum contagiosum: seen in cytoplasm

37
Q

a painless lesion with regional nontender lymph node swelling. lesion erupts 3-6 wks after initial contact. highly infectious

A

cancre (ulcer): primary syphilis

38
Q

maculopapular rash, widespread, small and flat near palms, soles, and oral cavity, pt may also exhibit patchy bald spots, diffuse LAD, and a painless wart in the vulva or scrotum

A

secondary syphilis

39
Q

Necrotic lesions on skin and bones, pt once tested + for an STD.

A

gummatous syphilis: tertiary syphilis.

40
Q

RULES OF SIXES

A

Syphilis: Six Sexual Transmission:

6 axial filaments

6 weeks of incubation

6 weeks for ulcer to heal

6 weeks after ulcer heals, secondary syphilis develops

6 weeks for secondary syphilis to resolve

66% of latent stage patients have resolution– no tertiary syphilis

6 years to develop tertiary syphilis

41
Q

Saddle nose, saber shins, hutchinson’s teeth, mulberry molars. how would you view the organism causing this condition?

A

congenital syphilis: treponema pallidum would be viewed under darkfield microscopy

42
Q

High fevers, rash, headache, severe back and leg pains

A

Barontella quintana: trench fever.

43
Q

what causes bacillary angiomatosis?

A

cat scratch disease = bartonella henslea

44
Q
A

HSV

45
Q
A

HSV cowdry bodies

46
Q
A

histoplasma capulatum

47
Q
A

coccidiomycosis

48
Q
A

Clinical Resp (5 decks)

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