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MS_Primers for Exam 3 Content > HIV Primer > Flashcards

HIV Primer Flashcards

1
Q

What is the goal of antiretroviral therapy?

A
  • to lower the level of HIV in your blood – your “viral load” – to an undetectable level.
  • This gives your immune system a chance to make more CD4 cells and strengthen your immune system
  • It also makes it far less likely to pass HIV on to sexual partners
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2
Q

True or False
With careful ART treatment, many people can go on for decades or more without progressing to the third and most serious stage of HIV infection, acquired immunodeficiency syndrome (AIDS).

A

• True

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3
Q

What are CD4 cells?

A

• a type of WBC (T cells) that move throughout your body to find and destroy bacteria, viruses, and other invading germs.

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4
Q

A CD4 count is a test that measures

A

• how many CD4 cells you have in your blood

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5
Q

What Does HIV Do to CD4 Cells?

A
  • HIV damages your immune system by targeting CD4 cells.
  • The virus grabs on to the surface of a cell, gets inside, and becomes a part of it.
  • When the infected CD4 cell dies, it releases more copies of HIV into your bloodstream which infiltrate more CD4 cells
  • This leads to fewer and fewer HIV-free, working CD4 cells.
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6
Q

What happens if CD4 counts get very low?

A

• you may need to take drugs to prevent opportunistic infections in addition to taking ART

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7
Q

True or False
Once your CD4 count goes up in response to ART, you may be able to stop taking these OI medications

A

• True

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8
Q

A normal CD4 count is from ___ to ___ cells per cubic millimeter of blood. CD4 counts go down over time if you do not take ART.

A
  • 500 to 1,400
  • Down
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9
Q

At CD4 levels below ___ cells per cubic millimeter, you are more likely to get to a wide variety of OIs, many of which can be deadly. This is also the level where progression to AIDS is diagnosed.

A

• 200

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10
Q

What are the 3 stages of HIV?

A
  • Acute
  • Chronic
  • AIDS
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11
Q

What happens during the Acute stage of HIV infection?

A
  • HIV is reproducing in large amounts and destroying CD4 cells.
  • That’s why CD4 levels typically fall quickly at first.
  • Then, as the immune system responds, the viral load begins to fall and CD4 levels start to rise again.
  • However, they might not return to pre-infection levels.
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12
Q

What happens during the Chronic stage of HIV infection?

A
  • HIV is still active but reproduces much more slowly.
  • ART treatment can maintain this stage for many decades.
  • This can help maintain CD4 at healthy levels, sometimes indefinitely.
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13
Q

What will indicate a transition from stage 2 to stage 3 is underway?

A

• The viral load will go up and CD4 levels go down

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14
Q

In order to facilitate wound healing and ability to withstand infection, and HIV+ pt’s diet should contain…

A

• Small frequent meals high in calories, proteins and required supplements

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15
Q

What are the two types of resistance tests used to determine if a patient’s HIV is resistant to drugs used in ART:

A

• the genotype assay and the phenotype assay

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16
Q

True or False
Highly active antiretroviral therapy (HAART) which usually comprises three drugs, has reduced the mother-to-child transmission rates to around 1-2%

A

• True

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17
Q

What does PrEP stand for?

A

• Pre-Exposure Prophylaxis

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18
Q

What doe PEP stand for?

A

• Post exposure Prophylaxis

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19
Q

True or False
PrEP only works if your are HIV positive

A

• False, it only works if you are HIV negative. The whole point of PrEP is to prevent the infection!

20
Q

What is the target demographic for PrEP?

A

• Those who are regularly at risk for acquiring HIV (high risk sexual activities, needle sharers, etc)

21
Q

How does PrEP work?

A
  • PrEP contains the same medicines that people with HIV use to stay healthy.
  • If exposed to HIV, these medicines can stop the virus from multiplying and spreading throughout the body.
  • PrEP only works if you have enough medicine in the body, so it needs to be taken every day.
22
Q

What organ functions are checked prior to starting PrEP?

A

• Kidneys and liver

23
Q

What are the sfx of PrEP?

A
  • Nausea/HA and weight loss, especially at the beginning of treatment.
  • Rare side effects include kidney or bone problems.
24
Q

How does PEP work?

A
  • PEP contains some of the same medicines that people with HIV take to stay healthy.
  • If exposed to HIV, it takes a few days for an HIV infection to take hold in the body.
  • As soon as PEP is started, it begins to stop the virus from multiplying.
  • As PEP is continued for the full 28–days, cells with HIV die and the virus stops spreading to the rest of your body.
25
Q

When must PEP start in order to be effective?

A

• W/in 24hrs of exposure

26
Q

In addition to a CD4 count of ≤200, what are the MAJOR dx criteria for AIDS?

A
  • Wasting syndrome (≥10% loss of ideal body mass)
  • Chronic diarrhea (>1 month)
  • Prolonged fever (>1 month)
27
Q

In addition to a CD4 count of ≤200, what are the MINOR dx criteria for AIDS?

A
  • Recurrent oral pharyngeal candidiasis
  • Persistent generalized lymphadenopathy (lymph nodes of abnormal size (>1cm)/consistency
  • Persistent cough >1 month
  • Recurrent herpes zoster (shingles)
28
Q

True or False
Rapid testing is highly reliable and provides immediate feedback to patients who can then be counselled about treatment and prevention.

A

• True

29
Q

How long does a rapid HIV test take?

A

• 20 mins

30
Q

What happens if a rapid HIV test has a positive result?

A

• A more accurate (and expensive) test will be run for confirmation

31
Q

What two tests are used to confirm a positive rapid HIV test?

A
  • Western Blot (WB)
  • Immunofluorescence assay (IFA)
32
Q

Progression of HIV monitored by CD4+ T-cell counts and viral load as well as what other conditions?

A
  • Neutropenia, Thrombocytopenia, lymphopenia
  • Anemia
  • Altered liver function tests
  • Electrolyte imbalances
33
Q

If a pts rapid HIV test returns negative and they participate in risky behavior, when should they test again? Why?

A
  • 3wks, 6wks, 6 months
  • It may take 2 months to detect antibodies
34
Q

What are the main opportunistic infections associated w/ HIV?

A
  • Pneumonia
  • Cryptococcal meningitis
  • Cytomegalovirus (CMV)
  • Mycobacterium avium complex
  • Influenza
  • Hepatitis B, C
  • Herpes simplex
  • CNS Lymphoma
  • Cryptosporidium muris
35
Q

Pneumonia is an opportunistic infections associated w/ HIV. What are the two common types, their causes and s/s?

A
  • • Pneumocystis pneumonia (PCP)
    • caused by the fungus Pneumocystis jirovecii.
    • difficulty breathing, high fever, and dry cough.
  • • Pneumonia
    • bacteria, viruses, and fungi, can cause pneumonia
    • cough (with mucous), fever, chills, and trouble breathing
36
Q

Cytomegalovirus (CMV) is an opportunistic infections associated w/ HIV. What secondary conditions can arise from CMV?

A
  • Retinitis
  • Esophagitis/stomatitis
  • Pneumonitis
  • Neurological disease
37
Q

What parts of the body does CMV affect?

A
  • CMV can infect multiple parts of the body and cause
    • Pneumonia
      • Pneumonitis
    • Gastroenteritis (especially abdominal pain caused by infection of the colon)
      • Esophagitis/stomatitis
    • Encephalitis (infection) of the brain
      • Neurological disease
    • Sight-threatening retinitis (infection of the retina at the back of eye).
38
Q

What are the s/s of esophagitis/stomatitis?

A

• difficulty swallowing, colitis, gastritis weight loss, pain and bloody diarrhea

39
Q

Why is CMV retinitis a medical emergency?

A

• It can cause blindness if not treated promptly

40
Q

Candidiasis (Candida albicans) is an opportunistic infection associated w/ HIV. Why is this of concern?

A

• It can cause severe or persistent infections in the mouth or vagina, or when it develops in the esophagus or lower respiratory tract, or deeper lung tissue.

41
Q

Cryptococcal meningitis is an opportunistic infection associated w/ HIV. What is it, where does it come from and how does its onset manifest?

A
  • It is a fungal infection of the meninges
  • It comes from soil all over the world
  • It comes on slowly, over a few days to a few weeks
42
Q

Mycobacterium avium complex is an opportunistic infection associated w/ HIV. What is it, how does it present and what are the s/s?

A
  • It is an atypical mycobacterial infection which can occur in the later stages of AIDS
  • s/s: fever, fatigue, and weight loss if bone marrow is involved there will also be anemia and neutropenia.
43
Q

Hepatitis B and C are opportunistic infections associated w/ HIV. What are their s/s?

A

• Shared: Jaundice, fatigue, abdominal pain, loss of appetite, nausea and joint pain (for B) and dark urine (for C)

44
Q

CNS Lymphoma is an opportunistic infection associated w/ HIV. What are its s/s?

A
  • Cognitive dysfunction
  • Motor impairment
  • Seizure
  • HA
45
Q

Cryptosporidium muris is an opportunistic infection associated w/ HIV that results in…

A
  • Gastroenteritis
  • Watery diarrhea
  • Abdominal pain
  • Weight loss

MS_Primers for Exam 3 Content (13 decks)

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