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CDM I > HIV pt 1 > Flashcards

HIV pt 1 Flashcards

1
Q

What is the MC opportunistic infection for HIV?

A

Pneumocystis pneumonia (PCP)

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2
Q

(T/F) HIV is a disease of humoral immunity.

A
  • False. - HIV is a disease of cell-mediated immunity.
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3
Q

Other than pneumocystis pneumonia, what are other very common opportunistic infections for patients with HIV?

A
  • HZV - TB
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4
Q

What type of cells are predominantly impacted by HIV?

A
  • CD4 cells
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5
Q

Host defense system: What are the two main types of immunity present on and within the body?

A
  • Innate immunity - Adaptive immunity
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6
Q

Host defense system: Innate immunity is composed of what cells or structures?

A
  • Skin, mucosa (barrier system cells) - WBCs - Macrophages - NKCs - Complement
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7
Q

Host defense system: What are the two subcategories of adaptive immunity?

A
  • Humoral immunity

- Cell-mediated immunity

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8
Q

Host defense system: What type of lymphocytes are associated with humoral immunity?

A
  • B-lymphocytes
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9
Q

Host defense system: What type of lymphocytes are associated with cell-mediated immunity?

A
  • T-lymphocytes.
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10
Q

Host defense system: A T-lymphocyte becomes a “helper cell” with the addition of what glycoprotein to it’s surface?

A

CD4

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11
Q

Host defense system: Describe CD4.

A
  • a glycoprotein that can be found on the surface of T-lymphocytes.
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12
Q

Host defense system: A T-lymphocyte becomes a “suppressor cell” with the addition of what glycoprotein to it’s surface?

A

CD8

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13
Q

HIV transmission: What are the three main routes of HIV transmission?

A
  • Blood - Sexual intercourse - Perinatal
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14
Q

HIV transmission: How can HIV be transmitted via blood?

A
  • Transfusion (very rare in US now)

- Injection drug use

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15
Q

HIV transmission: Which demographics based off of sexuality preferences and practices are the most susceptible to receiving HIV via sexual intercourse?

A
  • Heterosexual - Male-to-Male
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16
Q

HIV transmission: How can HIV be transmitted in a perinatal setting?

A
  • Intrapartum - Breast feeding
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17
Q

HIV transmission: What is “vertical transmission”?

A
  • When an infection is transferred directly from a mother to the child.
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18
Q

HIV transmission: What is the risk of HIV transmission from a needlestick?

A

0.25

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19
Q

HIV transmission: When comparing a needle stick from a hollow needle to a solid needle, which stick has a higher risk of HIV transmission? Why?

A
  • Higher risk associated with the hollow needle. - Greater surface area exposed to Blood with HIV and to the stick.
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20
Q

HIV transmission: Risk of transmission from a blood transfusion with infected blood?

A

95%

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21
Q

HIV transmission: Potential risk without antiretroviral therapy (ART)?

A

13-40%

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22
Q

HIV transmission and prevention: What are the major modes of transmission?

A
  • Mucosa (genital/rectal)
  • Blood (transfusion, MTCT, needle stick injury)
  • Breast feeding
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23
Q

HIV transmission and prevention: When considering mucosa as a major mode of HIV transmission, what would increase the risk of mucosa serving as the mode of transmission?

A
  • cracked Skin or lesion over the mucosa
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24
Q

HIV transmission and prevention: (T/F) Circumcision decreases the risk of HIV transmission.

A
  • TRUE
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25
Q

HIV transmission and prevention: What are universal precautions associated with prevention of HIV transmission?

A
  • Hand washing - Safe disposal of infected material.
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26
Q

HIV vs AIDS: Describe the diagnosis of HIV without AIDS.

A
  • HIV positive WITHOUT an AIDS defining illness

- Could be asymptomatic

27
Q

HIV vs AIDS: Describe the diagnosis of AIDS.

A
  • HIV positive WITH an AIDS defining illness. [OR]

- HIV positive with CD4 count < 200

28
Q

HIV vs AIDS: (T/F) If a patient is HIV positive and presents with thrush, that is technically enough criteria to diagnose someone with AIDS.

A
  • FALSE - HIV positive PLUS thrush (as an exclusive other condition present) is not enough to diagnose a PT with AIDS.
29
Q

HIV S/Sx: What are the non-specific symptoms associated with HIV?

A
  • Fever - Night sweats - Unexpected weight loss - Lymphadenopathy
30
Q

HIV S/Sx: What is the MC presentation of an HIV patient?

A
  • asymptomatic
31
Q

HIV S/Sx: Are patients typically symptomatic or asymptomatic at the time of diagnosis?

A
  • asymptomatic - Discovered via screening tests
32
Q

HIV S/Sx: What is the common scenario surrounding a symptomatic patient being diagnosed with HIV?

A
  • Commonly presents with an opportunistic infection - then found to have HIV
33
Q

HIV S/Sx: It is recommended to screen anyone for HIV who has just been diagnosed with what STI?

A
  • Syphilis
34
Q

HIV S/Sx: (T/F) While it is recommended to test a patient recently diagnosed with syphilis for HIV, it is not recommended to test a patient recently diagnosed with HIV for syphilis.

A
  • FALSE - If one is positive test for the other.
35
Q

HIV S/Sx: (T/F) Acute HIV PTs are most likely to have symptoms.

A
  • TRUE
36
Q

HIV S/Sx: Briefly describe Acute HIV.

A
  • When a PT presents with symptoms shortly after exposure. - can be a very serious condition.
37
Q

PCP: What does PCP (the infection) stand for?

A

Pneumocystis pneumonia

38
Q

PCP: This infection goes by a new name in humans. What is it?

A

Pneumocystis jiroveci

39
Q

PCP: Is this infection classified as a virus, bacteria, or as a fungus?

A
  • a fungus
40
Q

PCP: Gold standard test?

A
  • Silver stain on sputum sample
41
Q

PCP: What is the newer test for diagnosis that actually now has a higher sensitivity than the gold standard test?

A
  • PCR based methodology
42
Q

PCP: What is the characteristic finding(s) on CXR?

A
  • Bilateral hilar infiltrate
43
Q

PCP: Bilateral hilar infiltrate is also described as what due to it’s appearance?

A
  • “butterfly appearance” [or] - “bilateral butterfly appearance”
44
Q

PCP: S/Sx?

A
  • Fever - Dry cough - SOB - Fatigue
45
Q

PCP: These patients are sometimes described as “happy hypoxemics.” What does that mean?

A
  • They don’t appear to be as dyspneic as the SpO2 or ABG says they are. - SpO2 is usually much lower than how the patient is presenting in clinic.
46
Q

PCP: Tx drug, route, doseage, and frequency?

A
  • TMP/SMX (Bactrim) - IV - 15-20 mg/kg per day divided into Q6-8H dosing
47
Q

PCP: While TMP-SMX serves as the primary antibiotic therapy, what other medication is commonly added to the therapy?

A
  • Prednisone 40 mg PO BID
48
Q

PCP: When is prednisone indicated in the therapy?

A
  • When paO2 < 70 mmHg
49
Q

PCP: When you do you prophylax HIV PTs for PCP?

A
  • When CD4 count is < 200 mmHg
50
Q

PCP: Prophylaxis Tx for HIV PTs (first line only)?

A
  • TMP-SMX PO
51
Q

PCP: If the patient is allergic to sulfa drugs but is indicated for PCP prophylaxis, what are your second-line medication options?

A
  • Dapsone - Inhaled pentamidine
52
Q

Kaposi’s sarcoma: (T/F) Macules associated with KS are exclusively found on the back and extremities.

A
  • FALSE - Oropharyngeal cavity is an opportunistic location as well. - can be body-wide.
53
Q

Kaposi’s sarcoma: Associated with what virus?

A
  • Human herpes virus 8
54
Q

Kaposi’s sarcoma: Describe the appearance of a KS lesion.

A
  • Purplish, brownish lesion.
55
Q

Kaposi’s sarcoma: Tx?

A
  • Tx by reconstituting the immune system. - Get the PT on HIV medications as soon as possible.
56
Q

CD4: What is a normal range for a CD4 count?

A

~500 to 1,500

57
Q

CD4: What are some complications you may see even if the CD4 count is technically within a normal range?

A
  • Acute retroviral syndrome - thrush - Esophagitis - PCP
58
Q

CD4: What kind of complications might you expect when the CD4 count is between 200 and 500?

A
  • thrush - Oral hairy leukoplakia - TB - Shingles
59
Q

CD4: What kind of complications might you see when the CD count is between 100 and 200?

A
  • HSV - Candida Esophagitis - PCP
60
Q

CD4: What kind of complications might you see when the CD4 count is between 50 and 100?

A
  • Disseminated histoplasmosis - Toxoplasmosis - Cryptococcosis - Cryptoporcollosis - Microsporcollosis
61
Q

CD4: What kind of complications might you see when the CD4 count is below 50?

A
  • Mycobacterium avium complex (MAC) - CMV
62
Q

Early indicators of HIV infection: In cases of overwhelming and/or recurring cases of thrush, HIV should be considered in addition to what other condition?

A
  • Hyperglycemia - Metabolic syndrome - DM2
63
Q

Early indicators of HIV infection: In addition to recurring and severe cases of thrush, what is another condition that may appear in a severe recurring manner that makes you suspect HIV?

A
  • HZV

CDM I (9 decks)

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