HIV (Lec 3) Flashcards
About 2/3 of new cases of HIV are from what location?
sub-saharan africa
What is a classic clinical clue of primary HIV infection?
abrupt onset: “10 signs and symptoms in 24 hours”
Cough/Upper resipiratory infections indicate that it is ______ primary HIV
probably not
_____ is a highly sensitive screening test for initial testing of HIV
ELISA
If the ELISA tests is negative, the HIV antibody test is reported as ____. If the result is positive, the ELISA is ___
negative;
repeated
If a repeat ELISA test is positive, a _____ assay, which is more _____, is performed for confirmation
western-blot
specific
___ out of 3 characteristic bands on Western Blot present = reported as positive
2
Supplemental testing includes _____
viral load, RNA testing
Normal range of CD4 = _____ cells/mm3
Average decline of CD4 in untreated HIV patients: _____ cells/mm3 per year
350-1100
75-100
High levels of viral loads correlates with CD4 Cell count ____ and clinical disease _____
decline, progression
CD Cell count less than _____ has the highest risk of what cancer? _____
50
lymphoma
CD Cell count > 500:
most patients are _____
some bacterial infections such as _____; viral infections such as shingles
asymptomatic
pnemococcus, staph, TB
CD4 cell count associated with generalized adenopathy, thrush, and _____ ____: _______
kaposi’s sarcoma
500
CD4 count less than _____ is associated with PCP, toxo, and cryptococcus
200
Complications of HIV treatment include:
_______ = body morphology changes, central adiposity; ____Acidemia, peripheral ____, avascular necrosis of _____
lipodystrophy syndrome;
lactic; neuropathy; hip
Live vaccines such as ____ and ____ should be avoided in patients with HIV
MMR; zoster
The ______ type of influenza vaccine should be avoided
intranasal
Post exposure use of _____ has been shown to be protective against HIV in health care workers
Zidovudine (although it’s a “crappy drug”)
Highest risk of aquisition of HIV by exposure route:
blood transfusion
Symptoms: gradual onset of fever, dry cough, dyspnea; CD4 Count of 200
Pneumocystis jiroveci
Chest x-ray of Pneumocystis Jiroveci shows typical ______ opacity and bilateral _____ infiltrates
ground glass
interstitial
____ dehydrogenase is elelvated in the majority of Pneumocystis patients
lactate
Treatment of pneumocystis:
Bactrim or pentamidine
Cryptococcal meningitis usually presents in patients with a CD count less than ____
100
Treatment of cryptococcus: _____ and _____ followed by _____
Ampho B and flucytosine; followed by fluconazole
CMV typically presents as _____ or ____ in patients with CD counts less than _____
retinitis, colitis
50
In advanced HIV disease, TB usually presents in the ____ lobe rather than the _____ lobe
lower, upper
_____ manifestations are more common withl higher levels of ______ staining bacteria in HIV patients with Tb
Extrapulmonary; acid-fast
There is often a notable absence of _____ in patients with HIV + Tb
granuloma
______ is an independent predictor of mortality in HIV patients. Symptoms include fever, weight loss, diarrhea, lymphadenopathy, sweats.
Mycobacterium Avium Complex (MAC)
CD4 counts are often less than ____ in patients with MAC. Other abnormal lab values include ____ and elevated ____
50;
anemia, alkaline phosphatase
What antibiotic should you use for MAC prophylaxis in patients with CD counts less than 50?
azithromycin (1st line)
Toxoplamosis infections classically present as ______ lesions in the brain on MRI
ring-enhancing
Toxoplasmosis can be differentiated from ______ by seeing a response on imaging to empiric treatment of toxo.
Primary CNS lymphoma
Primary CNS lymphoma usually presents (with/without) fever, as opposed to _______
without; toxoplasmosis
_____ enhancement is seen in Primary CNS lymphoma, as opposed to toxo
subependymal
______ virus causes progressive multifocal leukoencephalopathy
JC
