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Infectious diseases > HIV, opportunisitic infections and STIs > Flashcards

HIV, opportunisitic infections and STIs Flashcards

1
Q

what cells does HIV target?

A

CD4

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2
Q

how can HIV transmission be prevented?

A

Post-exposure prophylaxis
- tenofivir + raltegravir for 28 days

Pre exo[posure prophylaxis

ART in pregnant women to prevent vertical transmission

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3
Q

what are the symptoms of primary HIV infection and when do they occur?

A

2-4 weeks post infection

  • fever
  • rash
  • myalgia
  • pharyngitis
  • mucosal ulceration
  • lymphadenopathy
  • headache
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4
Q

Diagnosing primary HIV is a unique opportunity to prevent transmission. what test should be done and why?

A

HIV RNA levels as antibody testing will be negative

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5
Q

what are the late features of HIV?

A 
fever and night sweats 
weight loss 
maculopapular rash 
AIDS defining illness 
Oral ulcers, angular chelitis or thrush 
Lymphadenopathy
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6
Q

how can HIV be diagnosed?

A

ELISA for HIV antibody and antigen

Western blot

Rapid point of care testing

Viral load testing (HIV RNA)

Nucleic acid testing

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7
Q

what test is used to measure response to ART?

A

CD4 count

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8
Q

what are some aids defining illnesses?

A 
pneumocystis jirovecii 
candidiasis 
cryptococcus neoformans 
toxoplasmosis 
cytomegalovirus 
cryptosporidium 
Kaposi sarcoma
lymphoma 
HSV 
TB
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9
Q

how does pneumocystis jirovecii present? How is it diagnosed?

A

SOB on exertion
Malaise
Dry cough
occasionally haemoptysis and pleuritic pain

Sp02 low on exertion compared to rest
CXR shows perihilar infiltrates
Sputum staining or NAAT

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10
Q

how is pneumocystis jirovecii treated?

A

IV Co-trimoxazole

Steroids if severe

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11
Q

how does candidiasis present? What is the treatment?

A

oral or oesophageal white fur appearance
pain
dysphagia

fluconazole

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12
Q

how does crytpococcus neoformans present, how is it diagnosed and treated?

A

meningitis
headache
molluscum like papules
fever

LP with manometry (increased opening pressure)
CSF stain and antigen testing

Amphotericin B and fluconazole

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13
Q

what is toxoplasmosis?

A

caused by toxoplasma gondii

commonest cause of intracranial mass lesions with low CD4 count

Ring enhancing lesion on MRI with CSF PCR positive for T. Gondii

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14
Q

how does CMV present?

A 
retinitis 
encephalitis 
oesophagitis/colitis 
hepatitis 
pneumonia
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15
Q

how does cryptospordium present and how is it investigated?

A

chronic diarrhoea in pre ART HIV

  • watery diarrhoea
  • cholangitis and pancreatitis may also occur

Stool microscopy
PCR
Enzyme immunoassay

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16
Q

what drugs are used in anti retroviral treatment?

A

Nucleoside reverse transcriptase inhibitors
- tenofivir and emtricitabine

Non - Nucleoside reverse transcriptase inhibitors
- rilpivirine and efavirenz

Protease inhibitors
- atazanavir and darunavir

integrase inhibitors
- dolutegravir and elvitegravir

17
Q

what virus causes infectious mononucleosis?

A

Epstein Barr virus

18
Q

how does IM present?

A 
fever 
pharyngitis (exudative or non-exudative) 
Cervical lymphadenopathy 
petechiae on soft palate 
malaise 
hepatosplenomegaly
19
Q

what InV are done in IM?

A

FBC
- lymphocytosis

LFTs
- transaminitis

Heterophile antibodies

PCR for EBV

Abdo US - hepatosplenomegaly

20
Q

what are the treatment options for IM?

A

hydration, ibruprofen, paracetamol

Prednisolone if upper airway obstruction or haemolytic anaemia

IVIG if immune thrombocytopenia develops

21
Q

how does chlamydia trachomatis present, diagnosed and treated?

A

dysuria, discharge, post coital bleeding, dyspareunia

NAAT of first pass urine or oral/anal/vag swab

Azithromycin 1g PO or 100mg doxycyline for 7 days

22
Q

how does neisseria gonorrhoeae present, diagnosed and treated?

A

dicharge, dysuria, pharyngeal or rectal infection

NAAT

Ceftriaxone 500mg IM and Azithromycin 1g PO

23
Q

how does trichomatis vaginalis present, diagnosed and treated?

A

vaginal discharge and itch

NAAT, culture microscopy

metronidazole

24
Q

how does bacterial vaginosis present, diagnosed and treated?

A

thin white fishy smelling vaginal discharge. No itch or soreness

Gram stain to examine vaginal flora, vaginal pH >4.5

Metronidazole

25
Q

what bacteria causes syphilis?

A

treponema pallidum

26
Q

what are the S&S of syphilis?

A 
anogenital ulcer 
lymphadenopathy 
diffuse maculopapular rash 
constitutional symptoms 
patchy alopecia 
ataxia 
hepatosplenomegaly
27
Q

how is syphilis investigated?

A

dark field microscopy of lesion swab
serum treponema enzyme assay
rapid plasma antigen test
CSF analysis

28
Q

how is syphilis treated?

A

Benzylpenicillin

Infectious diseases (5 decks)

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