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Pathology -- Infectious Disease > HIV II > Flashcards

HIV II Flashcards

1
Q

Immune Cell Responses to HIV

A

Loss of CD4, CD8 (later)
Polyclonal Activation of B cells, inability to mount Ab response
Autoimmune destruction

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2
Q

What is the Window in HIV patients

A

The period before seroconversion

6-12 weeks following infection

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3
Q

How to diagnose HIV

A

Ab to HIV antigens (gp120,160 + 41/24)

Serology + Western Blot

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4
Q

A positive rapid test for HIV should be followed by…

A

a western blot

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5
Q

What antibody is typically used as a primary diagnostic for HIV

A

Anti-p24

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6
Q

What are HIV RNA levels monitored for

A

Diagnosis of Acute infection
Follow effectiveness of therapy
Indicated breakthrough of virus
Prognosis Prediction (w/CD4 level)

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7
Q

What does it mean when I call HIV RNA levels an independent prognostic factor?

A

Increases in RNA levels indicate progression of the disease

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8
Q

Three classifications of CD4 counts

A

Above 500
200-499
Less than 200

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9
Q

Strongest indicator of disease progression?

A

CD4 counts

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10
Q

Lymphoid pathology in earlier HIV patients

A

loss of T cells (esp in Peyer’s Patches)
Expansion of B cell areas
Lymphadenopathy

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11
Q

Lymphoid pathology in later HIV patients

A

Burned out pattern
Loss of most lymphoid elements
Cell Loss, Fibrosis

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12
Q

CNS pathology in HIV/AIDS patients

A

Subacute meningoencephalitis

Microglial nodules + Giant Cells

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13
Q

Why do all the opportunistic infections in AIDS present so weirdly in pathology

A

A lot of normal pathology is immune response to an organism.

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14
Q

Why is serology typically useless in diagnosing oportunistic infections?

A

IC patients can’t mount an antibody respnse

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15
Q

At time of transmission, what symptoms tend to occur

A

Acute Retroviral Syndrome
High levels of replicaton, viremia, and seeding
Lasts for 2-4 weeks

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16
Q

Role of concurrent infections in AIDS disease progress

A

Concurrent infections appear to accelerate the disease process by activating the immune system and increasing virus proliferation

17
Q

Cause of CNS dementia in AIDS patients?

A

HIV infection of microglial cells

18
Q

AIDS associated neoplastic conditions

A

Kaposi’s
Hodgkin’s
Lymphoma

19
Q

Three common fungal opportunistic infections

A

Candidiasis
Pneumocystis Pneumonia
Cryptococcus

20
Q

Presentation os Candidiasis in an AIDS patient

A

Mouth, esophagus

Appearance of thrush is an indicator of diminishing fxn

21
Q

Significance of Pneumocystis Pneumonia

A

Nearly universal

Hallmark of the original epidemic

22
Q

Cryptococcus infection is associated with what symptoms

A

Lung, Meningitis

23
Q

GI infections associated with AIDS

A

Giardia
Entamoeba
Cryptosporidiosis (More severe)

24
Q

Viral infections especially associated with AIDS

A

CMV, Herpes, Zoster

25
Q

Tell me the story of Kaposi’s Sarcoma.

A

HHV8 infection causes a cancer of skin, mucous membranes, and GI. Proliferation of endothelial cells, smooth muscle cells, and pericytes. Causes inefficient vascular formation with blood filled channels.

26
Q

Who gets Kaposi’s

A

MSM

27
Q

Non-Hodgkin’s lymphoma is…

A

Cancer of B cell origin
Polyclonal B cell activation in extranodal sites/brain
Assoc. w/ EBV

28
Q

AIDS carcinoma of cervix is associated with

A

HPV

29
Q

WHy is vaccination for AIDS so ineffective

A

More antibodies –> More macrophage eating –> more disease process

Need a vaccine to stimulate specifically Cell-mediated responses

30
Q

Complications of HAART therapy

A 
Lipoatrophy, lipoaccumulation, elevated lipids
Insulin resistance
Periph. neuropathy
Premature CV disease
Renal/Hepatic Dysfxn
31
Q

HAART stands for

A

Highly Aggressive Anti-retroviral therapy

32
Q

Why does HAART therapy have so many complications? (Maybe?)

A

Persistent inflammation/T cell dysfxn

Beats AIDS I guess…

33
Q

What tends to coinfect with cryptococus?

A

Pneumocystis

Pathology -- Infectious Disease (23 decks)

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