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Reproduction > HIV: Pathophysiology and Presentation > Flashcards

HIV: Pathophysiology and Presentation Flashcards

1
Q

What is the target site for HIV?

A

CD4+ receptors

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2
Q

What is CD4?

A

a glycoprotein found on the surface of a range of cells

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3
Q

What cells have CD4 on them?

A

T help lymphocytes (CD4+ cells); dendritic cells; macrophages and microglial cells

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4
Q

What is the function of CD4+ cells?

A

recognition of MHC2 APCs; activation of B cells; activation of CD8+ cells; cytokine release

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5
Q

What effect does HIV infection have on immune response?

A

sequestration of cells in lymphoid tissues; reduced proliferation of CD4+ cells; reduction cyctotoxic T cell activation; reduction in antibody class switching; chronic immune activation

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6
Q

What is the effect of sequestering of cells in lymphoid tissue in HIV?

A

reduced circulating CD4+ cells

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7
Q

Waht si the effect of reduced cytotoxic T cell activation in HIV?

A

dysregulated expression of cytokines and increasing susceptibility to viral infections

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8
Q

What is the the effect of a reduction in antibody class switching in HIV?

A

reduces affinity of antibodies produced

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9
Q

What types of infections are patients with HIV more susceptible to?

A

viral; fungal; mycobacterial infections and infection-induced cancers

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10
Q

What is the normal range of CD4+ cells?

A

500-1600cells/mm3

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11
Q

Below what level of CD4+ cells is there a risk of opportunistic infections?

A

<200

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12
Q

How long does it take to create a new generation of HIV virus?

A

every 6-12 hours

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13
Q

How long does it take someone to die with HIV without treatment?

A

9-11 years

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14
Q

What cells are initially infected iwth HIV?

A

infection of mucosal CD4 cells- Langerhans and Dendritic cells

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15
Q

How long does it take for HIV to become established after entry?

A

3 days

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16
Q

When does primary HIV infection usually occur after infection?

A

2-4 weeks

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17
Q

What are the symptoms of priamry HIV infection?

A

fever; rash (maculopapular); myalgia; pharyngitis; HA/aseptic meningitis

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18
Q

What organism causes pneumocystis pneumonia?

A

pneumocystis jiroveci

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19
Q

What is the typical sign with pneumocystis pneumonia?

A

exercise desaturation

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20
Q

How is PCP diagnosied?

A

BAL and immunofluorescence +/- PCR

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21
Q

What is the treatment for PCP?

A

co-trimoxazole

22
Q

What are the symptoms of cerebral toxoplasmosis?

A

HA; fever; focal neurology; seizures; reduced consciousness; raised intracranial pressure

23
Q

What is the CD4 threshold for cerebral toxoplasmosis?

A

<150

24
Q

What is the CMV CD4 threshold?

A

<50

25
Q

What is the presentaiton of CMV?

A

reduced visual acuity; floaters; abdo pain; diarrhoea and PR bleeding

26
Q

What is done to monitor CMV in HIV patients?

A

ophthalmic screening for all individuals CD4<50

27
Q

Waht is the presentation of HIV-associated neurocognitive impairment?

A

reduced short term memory +/- motor dysfunction

28
Q

What is the presentation of progressive mulifocal leukoencephalopathy?

A

rapidly progressing; focal neurology; confusion; personality change

29
Q

What causes progresive multifocal leukoencephalopathy?

A

JC virus

30
Q

Waht is the CD4 threshold for PML?

A

<100

31
Q

What are the causes of HIV-assocaited wasting?

A

chronic immune activation; anorexia; malabsorption/diarrhoea; hypogonadism

32
Q

What causes Karposi’s sarcoma?

A

human herpes virus 8

33
Q

What is Karposi’s sarcoma?

A

vascular tumour

34
Q

What virus causes non-hodgkins lymphoma?

A

EBV

35
Q

What is the presentation of non-hodgkins lymphoma?

A

B symptoms; bone marrow involvement; extranodal disease; increased CNS involvement

36
Q

What organism is responsible for cervical cancer?

A

HPV

37
Q

What are the non-opportunistic problems associated iwth HIV?

A

mucosal candidiasis; seborrhoeic dermatitis; diarrhoea; fatigue; worsening psoriasis; lypmhadenopathy; parotitis

38
Q

What factors increase the transmission risk of HIV?

A

anoreceptive sex; trauma; genital ulceration; concurent STI

39
Q

WHat is the risk of mother to child transmission if viral laod is undetected at delivery?

A

<0.1%

40
Q

What group is most likely to be undiagnosed and present late?

A

heterosexual men

41
Q

How many people in Scotland with HiV are unaware of their infection?

A

1 in 6

42
Q

What is a high prevalence area in the UK?

A

> 0.2%

43
Q

When should a patient be tested for HIV if incapacitated?

A

only if in patients best interests but if safe, wait until patient regains capacity

44
Q

Is consent from relatives required to do an HIV test on an incapacitated patient?

A

no

45
Q

What markers are used to detect HIV infection?

A

viral RNA; capsule protein p24-antigen; antibody

46
Q

What do thrid generation HIV tests look at?

A

HIV-1 and HIV-2 antibody- IgM and IgG

47
Q

What is the window period for third generation HIV antibody test?

A

20-25 days

48
Q

What do 4th generation HIV tests test?

A

combined antibody and antigen

49
Q

What is the window period for 4th generation HIV tests?

A

14-28days

50
Q

How long does it take to get results with rapid HIV tests?

A

20-30mins

51
Q

What is the function of recent infection testing algorithms?

A

used to identify if an infection occurred within the preceding 4-6 months by looking at measuring different types of antibodies or stregth of antibody binding

Reproduction (52 decks)

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