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COMAT - IM > HIV/TB > Flashcards

HIV/TB Flashcards

1
Q

Primary TB infectious usually is asymptomatic and then becomes latent. How do you evaluate for latent disease?

A

PPD +/- CXR

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2
Q

Whose PPD is (+) at > 5mm?

A

Those with close contacts that have TB

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3
Q

Whose PPD is (+) at > 10mm?

A

Healthcare workers
Homeless
Foreigners

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4
Q

Whose PPD is (+) at > 15mm?

A

Normal people with no risk factors

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5
Q

Once REactivation of latent TB occurs, the patient will be?

A

Symptomatic

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6
Q

What will be seen on CXR with TB?

A

Upper lobe cavitation

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7
Q

If you suspect TB but see fine nodular densities on CXR, that is likely?

A

Miliary TB

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8
Q

What is the treatment for Latent TB?

A

Isoniazid for 9 months

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9
Q

What is the treatment for Active TB?

A

RIPE for 2 months
RI for 4 months

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10
Q

RIPE

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

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11
Q

Side effect of Rifampin?

A

Turns body fluids orange

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12
Q

Side effects (2) of Isoniazid?

A

Peripheral neuropathy
Drug-induced hepatitis

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13
Q

What can you give to prevent peripheral neuropathy with Isoniazid?

A

B6

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14
Q

Side effect Pyrazinamide?

A

Hyperuricemia/Gout

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15
Q

Side effect of Ethambutol?

A

Eyes
– Optic neuritis
– Color vision changes

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16
Q

What is the treatment for active TB?

A

RIPE for 2 months
RI for 4 months

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17
Q

Describe how HIV infects CD4 cells?

A
  • Enters via CCR5/CXCR4
  • Reverse Transcriptase to turn RNA to DNA
  • DNA is replicated
  • Protease to exit cell
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18
Q

What is the mainstay of treatment for HIV?

A

2+1
= 2 Nucleotide Reverse Transcriptase (-)’ers
+ 1 Integrase/Protease (-)’er

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19
Q

What is used as prophylaxis against HIV?

A

2+1 for 4 weeks
(2NRTI + 1 Integrase/Protease Inhibitor)

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20
Q

If a mother with HIV is not on ART at delivery, what should be given to her and baby?

A

Zidovudine

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21
Q

How may an acute HIV infection present?

A

Flu-like illness or asymptomatic

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22
Q

During the Acute HIV phase, what test can be done to establish diagnosis?

A

HIV PCR to assess viral load
– antibodies not yet (+)

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23
Q

Once someone with HIV is past the acute illness, what tests can be done to assess?

A
  • ELISA antibodies confirmed with Western blot
  • HIV viral load
  • CD4 count
24
Q

Once someone with HIV is past the acute illness, what tests can be done to assess?

A
  • ELISA antibodies confirmed with Western Blot
  • HIV Viral load
  • CD4 count
25
Q

CD4 count < _____ you should prophylactically treat against Pneumocystis Jirovecii

A

< 200

26
Q

What is the prophylactic/treatment for Pneumocystis Jirovecii?

A

TMP-SMX OR Dapsone

27
Q

What is the prophylactic/treatment for Pneumocystis Jirovecii?

A

TMP-SMX OR Dapsone

28
Q

CD4 count < ____ you should prophylactically treat against Toxoplasmosis

A

< 100

29
Q

What is the treatment for Toxoplasmosis infection?

A

Pyrimethamine
Sulfadiazine
Leucovorin

30
Q

What is the prophylaxis for Toxoplasmosis?

A

TMP-SMX

31
Q

CD4 < ____ you should prophylactically treat against Myocbacterium Avium Complex

A

< 50

32
Q

What is the prophylactic treatment for Mycobacterium Avium Complex?

A

Azithromycin +/- Ethambutol

33
Q

What lab finding may be seen with Mycobacterium Avium Complex infection?

A

HIGH Alk Phos

34
Q

How will oropharyngeal candidiasis present?

A

White plaques on a red base of the tongue that can be scraped off

35
Q

What are the treatment options for oral candidasis?

A

Nystatin suspension
Oral Fluconazole

36
Q

Where is Cryptococcus Neoformans found?

A

Pigeon droppings

37
Q

What does Cryptococcus Neoformans commonly cause?

A

Meningitis

38
Q

Signs of Cryptococcal Meningitis?

A

Fever
Headache
Elevated ICP
AMS

39
Q

What will be unique on LP if Cryptococcal Meningitis is to blame?

A

HIGH opening pressure!!
– Low glucose, High protein/WBC too

40
Q

What is the best test to perform on CSF if worried about Cryptococcal Meningitis?

A

CSF antigen better than India Ink

41
Q

What is the treatment for Cryptococcal Meningitis?

A

Amphotericin B + Flucytosine
– Followed by Fluconazole

42
Q

Where is Histoplasmosis and Blastomycosis found?

A

Ohio/MI River Valleys

43
Q

Histoplasmosis can present with a wide range of symptoms, what are 2 unique ones?

A

Palatal ulcers
Pancytopenia

44
Q

What findings are CXR are associated with Histoplasmosis?

A

Hilar LAD
Nodular densities

45
Q

How is Histoplasmosis diagnosed?

A

Urine histoplasma antigens

46
Q

Treatment for Histoplasmosis?

A

Amphotericin B followed by Itraconazole
– Just Itraconazole if mild

47
Q

Blastomycosis can have _____ involvement

A

Skin/Bone/Prostate

48
Q

What will be seen on biopsy with Blastomycosis?

A

Broad budding yeast

49
Q

Where is Coccidioidomycosis found?

A

Southwestern US

50
Q

How is Coccidioidomoycosis diagnosed?

A

Bronchiolar lavage that shows an endospore containing many spherules

51
Q

What test should be done to confirm Pneumocystis Jirovecii?

A

Silver stain of sputum

52
Q

How will Pneumocystis Jirovecii look on silver stain?

A

Comma shaped spores in folded cysts

53
Q

Bilateral ground glass appearance is seen with Pneumocystis Jirovecii. What lab finding can be present?

A

HIGH LDH

54
Q

Bilateral ground glass appearance is seen with Pneumocystis Jirovecii. What lab finding can be present?

A

HIGH LDH

55
Q

Histoplasmosis/Blastomycosis/Coccidioidomycosis present with wide symptoms. What are 2 unique features of Histoplasmosis?

A

Palatal ulcers
Pancytopenia

COMAT - IM (17 decks)

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