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Infectious Diseases > Human Immunodeficiency Virus (HIV) > Flashcards

Human Immunodeficiency Virus (HIV) Flashcards

1
Q

What cells does the HIV virus infect.

A

CD4+ cells (T helper cells).

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2
Q

What does HIV do to the immune cells that it infects. (3)

A

It destroys them.
Viral RNA is converted into DNA by reverse transcriptase.
As the cell replicates proteins, it also replicates the HIV virus.

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3
Q

When is it said that a patient has AIDS.

A

When their CD4+ count is

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4
Q

How is HIV transmitted. (5)

A

Via bodily secretions: IVDU, sexual intercourse, vertical, tattoos, blood transfusions.

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5
Q

What are the symptoms of HIV infection. (6)

A

Often there is a flu like illness at the time of seroconversion.
Usually the first symptoms are due to opportunistic infections.
Common symptoms include:
Fever.
Weight loss.
Lymphadenopathy.
Weakness.

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6
Q

What tests should be ordered if you suspect a patient has contracted HIV. (3)

A

HIV test.
CD4+ count.
Viral load.

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7
Q

What are the complications of HIV infection. (3)

A

Opportunistic infections.
Death.
Drug resistance.

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8
Q

What is an opportunistic infection.

A

Infections which do not normally cause problems in a fully functioning immune system, which can cause fatal disease in patients with AIDS.

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9
Q

What are the opportunistic fungal infections that a patient with AIDS can contract. (4)

A

Candidiasis.
Coccidioidomycosis.
Aspergillosis.
Cryptococcal meningitis.

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10
Q

What are the opportunistic bacterial infections that a patient with AIDS can contract. (2)

A

Tuberculosis.

Mycobacterium avium complex.

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11
Q

What are the opportunistic protozoa infections that a patient with AIDS can contract. (3)

A

Toxoplasmosis.
Cryptosporidiosis.
Pneumocytis carinii pneumonia (PCP).

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12
Q

What are the opportunistic viral infections that a patient with AIDS can contract. (6)

A 
CMV.
HSV. 
HPV. 
HZV. 
Oral hairy leucoplakia. 
Progressive multifocal leucoencephalopathy.
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13
Q

What are the opportunistic malignant infections that a patient with AIDS can contract. (3)

A

Lymphoma (EBV).
Kaposi’s sarcoma (Human herpesvirus-8).
Anal/cervical cancer (HPV).

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14
Q

What are the opportunistic neurological infections that a patient with AIDS can contract. (3)

A

AIDS dementia.
Peripheral neuropathy.
Toxoplasma gondii is the main CHS pathogen in AIDS.

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15
Q

What is HIV1.

A

It is a retrovirus responsible for most HIV infections.

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16
Q

How many people are HIV positive.

A

Over 30million people.

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17
Q

How many deaths are caused by HIV every year.

A

2million deaths/year.

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18
Q

What is the prevalence of HIV in the UK.

A

100,000.

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19
Q

What is the incidence of HIV in the UK.

A

6,280 year in 2011.

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20
Q

What is the ratio of men:women who suffer from HIV.

A

3:1.

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21
Q

How does HIV invade cells.

A

HIV binds via its GP120 protein to CD4 receptors on helper T lymphocytes, monocytes, macrophages and neural cells.
CD4+ cells migrate to the lymphoid tissue where the virus replicates, producing billions of new virions, which are in turn released and so the cycle recommences.

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22
Q

What occurs to CD4+ cells as HIV infection progresses.

A

Depletion or impaired function of the CD4+ cells (impairing the immune function).

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23
Q

What predicts the progression of HIV infection to AIDS.

A

The viral load.

24
Q

What are the stages of HIV infection. (5)

A 
Seroconversion (primary infection). 
Asymptomatic infection. 
Persistent generalized lymphadenopathy. 
AIDS related complex.
AIDS.
25
Q

What are the features of the seroconversion phase of HIV infection. (6)

A 
Infection may be related to a transient illness (2-6weeks). 
Fever. 
Malaise. 
Myalgia. 
Pharyngitis. 
Maculopapular rash. 
Meningoencephalitis (rare).
26
Q

What percentage of patients infected with HIV develop early persistent generalized lymphadenopathy.

A

(30%.

27
Q

How do you define persistent generalized lymphadenopathy. (3)

A

Nodes >1cm diameter.
At >2 extra inguinal sites.
Persistent for 3 months or longer.

28
Q

What constitutional B symptoms develop in HIV infection. (5)

A 
Fever. 
Night sweats. 
Diarrhoea. 
Weight loss. 
Minor opportunistic infections.
29
Q

What opportunistic infections are HIV positive patients vulnerable to. (6)

A 
Oral candida. 
Oral hairy leucoplakia. 
Herpes zoster. 
Recurrent herpes simplex. 
Seborrhoeic dermatitis. 
Tinea.
30
Q

What are the collection of B symptoms developed in HIV positive individuals referred as.

A

AIDS related complex.

31
Q

What is the CD4 count in a patient who has progressed to AIDS.

A
32
Q

What is the timescale for the development of HIV into AIDS.

A

8 years.

33
Q

What is the usual timescale for death to occur after a patient has developed AIDS.

A

2 years.

34
Q

What are the complications of HIV due to. (2)

A

Psychological.

The result of suppression of T cell mediated immunity.

35
Q

What are the pulmonary complications associated with HIV. (5)

A 
Pneumocysitis juroveci pneumonia. 
M avium intracellulare. 
CMV. 
HHV-8 (Kaposi's sarcoma). 
Lymphoid interstitial pneumonitis.
36
Q

What are the GI complications associated with HIV. (8)

A 
Candidiasis. 
Oral candida. 
Oesophageal involvement causing dysphagia and retrosternal pain. 
Anorexia/weight loss. 
Hepatomegaly and raised LTFs.
MAI. 
Chronic diarrhoea. 
Perianal disease.
37
Q

What is the main complication that can arise from HIV in the eyes.

A

CMV retinitis.

38
Q

What are the main complications that can arise in the CNS from HIV. (7)

A

Acute HIV is associated with transient meningoencephaltitis, myelopathy and neuropathy.
Chronic HIV associated neurocognitive disorder (dementia and encephalopathies).
Toxoplasma gondii is the main CNS pathogen.
Cryptococcus neoformans causing chronic meningitis.
Tumours (central lymphoma, B cell lymphoma).

39
Q

What do the symptoms of HIV infection resemble.

A

Infective mononucleosis.

40
Q

What are the symptoms of infective mononucleosis. (5)

A 
Lymphadenopathy. 
Myalgia. 
Rash. 
Headache. 
Rarely meningitis.
41
Q

What are the main physical signs that might make you consider HIV. (4)

A

Oral candidiasis.
Recurrent shingles.
Leucopenia.
CNS signs.

42
Q

What is the best diagnostic test for HIV.

A

HISTORY.

43
Q

What are some direct effects of HIV (other). (2)

A

Osteoporosis.

Dementia (the brain is a sanctuary for HIV, and HAART may not prevent dementia from developing).

44
Q

Where should HIV testing be offered. (5)

A 
GUM/sexual health clinics.
Antenatal services. 
Termination of pregnancy servicies. 
Drug dependency programmes. 
Healthcare services for tuberculosis, hepatitis B, hepatitis C and lymphoma.
45
Q

What patients are suggested have an HIV test. (8)

A

All patients with diagnosed STIs.
Sexual partners of men or women who are known to be HIV positive.
Men who have disclosed sexual contac with other men.
Female ssexual contacts of men who have sex with men.
People with a history of IVDU.
Men and women from a country of high HIV prevalence.
Patients who report sexual contact abroad or in the UK with individuals from countresi of high HIV prevalene.
Patients presenting for healthcare where HIV enters the differential diagnosis.

46
Q

What are some respiratory indications of HIV infection. (4)

A

Tuberculosis.
Pneumocystis.
Bacterial pneumonia.
Aspergilloisis.

47
Q

What are some neurological indications of HIV. (11)

A 
Cerebral toxoplasmosis. 
Primary cerebral lymphoma. 
Cryptococcal meningitis. 
Progressive multifocal leukoencephalopathy. 
Aseptic meningitis/encephalitis. 
Cerebral abscess. 
Space occupying lesion of unknown cause. 
Guillain-Barre syndrome.
Transverse myelitis. 
Peripheral neuropathy. 
Dementia.
48
Q

What are some dermatological indications of HIV. (4)

A

Kaposi’s sarcoma.
Severe/recalcitrant seborrheic dermatitis.
Severe/recalcitrant psoriasis.
Multidermatomal/recurrent herpes zoster.

49
Q

What are some GI indications of HIV. (10)

A 
Persistent cryptosporidiosis.
Oral candidiasis. 
Oral hairy leukoplakia. 
Chronic diarrhoea of unknown cause. 
Weight loss of unknown cause. 
Salmonella. 
Shigella. 
Campylobacter. 
Hepatitis B infection. 
Hepatitis C infection.
50
Q

What are some oncological indications of HIV infection. (8)

A 
Non-Hodgkin's lymphoma. 
Anal cancer. 
Anal intraepithelial dysplasia. 
Lung cancer. 
Seminoma. 
Head and neck cancer. 
Hodgkin's lymphoma. 
Castleman's disease.
51
Q

What are some gynaecological indications of HIV infection. (3)

A

Cervical cancer.
Vaginal intraepithelial neoplasia. .
Cervical intraepithelial neoplasia, grade 2 or above.

52
Q

What are some haematological indications of HIV infection.

A

Any unexplained blood dyscrasia including thrombocytopenia, neutropenia and lymphopenia.

53
Q

What are some opthalmological indications of HIV. (3)

A

Cytomegalovirus retitinitis.
Infective retinal disease including herpesviruses and toxoplasma.
Any unexplained retinopathy.

54
Q

What are some ENT indications of HIV infection. (3)

A

Lymphadenopathy of unknown cause.
Chronic parotitis.
Lymphepeithelial parotic cysts.

55
Q

What other indications of HIV are there. (4)

A

Mononucleosis like syndrome (primary HIV infection).
Pyrexia of unknown origin.
Any lymphadenopathy of unknown cause.
Any sexually transmitted infection.

56
Q

What are some routes of transmission of HIV. (4)

A 
Sexual intercourse (vaginal and anal). 
Mother to child (transplacental, perinatal, breast feeling). 
Contaminated blood, blood products and organ donations. 
Contaminated needles (IVDU, injections, needle stick injuries).

Infectious Diseases (8 decks)

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