HIV Opportunistic Infections - Grinn Flashcards
CNS Toxoplasmosis is seen when pts CD4 is lower than
100
-Can be reactivated via prior infection
If CD4+ Count is less than 200 then how does Tb present?
What organs are commonly affected
1) Disseminated Disease with miliary pattern
2) GI, Bone, Brain, LN
When is CMV typically seen
<50
How would you get a definitive diagnosis of Toxo
Brain Biopsy
Oropharyngeal Candidiasis (Thrush) Signs
White plaques on erythematous mucosa
HIV+ pts may have a reactivation or new infection of ___ when their CD4+ count is less than 500.
Mycobacterium Tb
How is retinitis Dx
Retinal Exam by ophthalmologist
How do you Dx Primary CNS Lymphoma
1) Brain Biopsy for Definitive Diagnosis
2) CSF presents with malignant lymphoid cells
MRI catches ___ in a pt who has CNS toxoplasmosis
1) Multiple ring enhancing lesions
Sx of Colitis
1) Diarrhea
2) Abdominal Pain
3) Weight Loss
Sx of Mycobacterium Tb
1) Fever
2) Cough
3) Dyspnea
4) Weight Loss
5) Night Sweats
How would you treat a Toxo infection
Empirically and Monitor for Improvement
Sx of Cryptococcal Meningitis
1) Fever
2) Altered Mental Status
3) Headache
** Focal Deficits are less common
What bacteria normally causes Community acquired pneumonia
1) Strep. Pneumonia
2) H. Influenza
Dx of Colitis
Colonoscopy w. mucosal ulcerations
- owls eye - cytoplasm inclusion bodies
Mycobacterium avium intracellular infection (MAI) is seen in pts with a CD4 less than ___ but normally less than ___
1) 50
2) 10
Location of Oral Hairy Leukoplakia
Lateral Tongue
Imaging indications of Tb
1) Apical Cavitary Lesion in Upper Lung Lobe
Conditions of CMV in an AIDS pt
1) Retinitis
2) Colitis
What is the leading cause of meningitis in AIDS pts
1) Cryptococcal Meningitis
Sx of retinitis
1) Floaters
2) Scotomas (Flashing lights)
3) Visual Field Cut
What prophylaxis is used for PJP and Toxo
Trimethoprim-sulfamethoxazole (TMP-SMX) Daily
Esophageal Candidiasis Signs
1) Odynophagia
2) Retrosternal pain
What is shown on a CXR when a pt has community acquire pneumonia
1) Infiltrate
Esophageal Candidiasis can be caused by
1) HSV
2) CMV
Candidiasis in HIV can lead to ____ or ___
1) Oropharyngeal Candidiasis
2) Esophageal Candidiasis
What is the most common infection with pts who have a CD4 count less than 200
Pneumocystis Jirvoecii Pneumonia
CD4+ Count: Immune System is healthy
> 500
When a pt has PJP, CXR may be normal, but On a CT what in indicative of PJP
Ground-glass infiltrates
What causes Oral Hairy Leukoplakia
EBV
MRI shows a single ring enhancing lesion in ___
Primary CNS Lymphoma
How to receive the Definitive Diagnosis of PJP
1) Analysis of Sputum
2) Bronchoalveolar Lavage
Sx of CNS Toxoplasmosis
1) Fever
2) Headache
3) Focal Neuro Deficits: Seizure, Aphasia, and Hemiparesis
CD4+ Count: Weak Immune System
200-500
CD4+ Count: <200 or and defining conditions
AIDS
PJP is common when the CD4+ count is less than ___
200
Indications of PrEP
1) Sex with untreatedHIV
2) Hx of recent condomless sex (anal)
3) Hx of recent bacterial STI
4) Multiple sex partners of unknown HIV status
Primary CNS Lymphoma is seen when CD4 count drops lower than ___
50
Sx of Mycobacterium Avium Intracellular Infection
1) Constitutional Sx
- Fever
- Weight Loss
- Night Sweats
2) Abdominal Pain
3) Lymphadenopathy
Clinical Sx of PJP
1) Fever
2) Non-productive cough
3) Pleuritic Chest Pain
4) Dyspnea
An HIV+ pt is at risk for ___ at any CD4 count
Community Acquired Pneumonia
-Most common pulm infection
CD4 count for Cryptococcal Meningitis
<100
Lab abnormalities in PJP
Increased LDH
Hypoxemia on ABG
After a Bronchoalveolar Lavage in order to receive a Definitive Diagnosis you must do a: ___ or ___
1) Wright-Giemsa Stain
2) PCR
Physical Findings in Pneumocystis J Pneumonia
Exertional Hypoxia
How is MAI Dx
Mycobacterium Blood Cultures
Dx of Cryptococcal Meningitis
1) CSF lumbar puncture shows elevated opening pressure
2) Cryptococcal antigen +
Candidiasis in HIV occurs with a CD4 count less than ___
200
Sx of Community Acquired Pneumonia
1) Fever
2) Cough
3) SOB
