I'm HIV+

Question 1

env

Answer 1

is gp160, cleaved into gp120 (CD4 attachment) and gp41 (fusion and entry)

Question 2

gag

Answer 2

capsid (aka p24)

Question 3

pol

Answer 3

reverse transcriptase, aspartate protease, integrase

Question 4

what cells does HIV infect?

Answer 4

CD4 and marcrophages

Question 5

what does HIV bind to?

Answer 5

Helper T (CD4): CCR5 (early) and CXCR4 (late) 
Macrophage: CD4 + CCR5

Question 6

HIV immunity gene

Answer 6

homozygous CCR5 mutation is immune. heterozygous is slower course

Question 7

how to test for HIV?

Answer 7

1st: ELISA (sensitive)
2nd: Western (specific)
3rd: PCR (test viral load)

Question 8

how many months may a baby test HIV + after birth from a HIV mother?

Answer 8

two months till the antibodies clear

Question 9

AIDS definition

Answer 9

Cd4 less than 200 or hiv and defining illness or hiv and ratio 4:8 is less than 1.5

Question 10

immunocompromised vs AIDS

Answer 10

Ic is cd4 less than 400

Aids is 200

Question 11

stages of HIV

Answer 11

Four Fs. Flu-like (acute), Feeling good (replication in lymph nodes), Falling count, Final crisis

Question 12

HIV: low grade fever, cough, hepatosplenomegaly, tongue ulcer. oval yeast cells within macrophages

Answer 12

Histoplasma capsulatum (not just in lungs unlike reg people)

Question 13

HIV: fluffy white cottage-cheese lesions in mouth or even esophagous if bad. pseudohyphae.

Answer 13

Candida albicans (thrush)

Question 14

HIV: superficial vascular proliferation, neutrophilic inflammation on skin.

Answer 14

bartonella henselae (angiomas)

Question 15

HIV: chronic watery diarrhea. acid fast cysts in stool

Answer 15

Cryptosporidium spp.

Question 16

HIV: encephalopathy. demyelination.

Answer 16

JC virus causing PML

Question 17

HIV: brain abscess. “ring-enhancing lesions”

Answer 17

Toxoplasma gondii

Question 18

HIV: meningitis. India ink shows yeast with narrow-based budding large capsule

Answer 18

cryptococcus neoformans

Question 19

HIV: retinitis, cotton-wool spots on funduscopic exam. esophagitis too

Answer 19

CMV

Question 20

HIV: dementia

Answer 20

HIV can do that all by itself

Question 21

HIV: superficial neoplasic proliferation of vasculature. lymphocytic inflammation

Answer 21

HHV-8 (kaposi sarcoma)

Question 22

HIV: hairy leukoplakia

Answer 22

EBV

Question 23

HIV: Non-Hodgkins lymphoma (large cell) in Waleyer’s ring

Answer 23

EBV

Question 24

HIV: Squamous cell carcinoma of anus or cervix

Answer 24

HPV

Question 25

HIV: primary CNS lymphoma

Answer 25

EBV but must distinguish from toxoplasma

Question 26

HIV: interstitial pneumonia with intranuclear inclusion bodies. "owl eyes"

Answer 26

CMV

Question 27

HIV: pleuritic pain, hemoptysis, infiltrates on imaging

Answer 27

invasive aspergillosis

Question 28

HIV: general pneumonia (most common)

Answer 28

Pneuocystis jirovecii

Question 29

HIV: tuberculosis-like disease with CD4

Answer 29

mycobacterium avium

Question 30

prophylaxis for HIV

Answer 30

TMP-SMX for anything >50. add azithromycin for

Question 31

Four classes of drugs used in HAART?

Answer 31

Protease inhibitors, Nucleoside Reverse Transcriptase Inhibitors, Non-Nucleoside Reverse Transcriptase Inhibitor, Integrase Inhibitors

Question 32

What combo of drugs are needed in HIV?

Answer 32

2 NRTIs + 1 of the others (pick one)

Question 33

name of the protease inhibitors

Answer 33

-navir (Navir tease a protease)

Question 34

mech of protease inhibs

Answer 34

inhibs the protease function of pol to make functional components of HIV

Question 35

Ritonavir toxicity

Answer 35

inhibits p-450

Question 36

general toxicity of protease inhibitors

Answer 36

hyperglycermia, GI intolerance, lipodystrophy

Question 37

toxicity of indinavir

Answer 37

nephropathy, hematuria

Question 38

NRTI names (7)

Answer 38

(-vudine) Lamivudine, Zidovudine, Stavudine | (and others) Tenofovir, Abacavir, Emtricitabine, Didanosine

Question 39

NRTI work how?

Answer 39

lack 3' OH so they are chain terminators. they are nucleosides so they require phosphorylation

Question 40

which NRTI doesn't require phosphorylation?

Answer 40

Tenofovir (it is a nucleotide)

Question 41

which NRTI is used in pregnancy to prevent fetal transmission?

Answer 41

ZDV (zidovudine)

Question 42

NRTI tox

Answer 42

bone marrow suppresion, peripheral nueopathy, lactic acidosis, rash

Question 43

NNRTI mechanism

Answer 43

bind RT at non active site and thus don't need phospho (they aren't nucleosides)

Question 44

NNRTIs names

Answer 44

nevirapine, Efavirenz, Delavirdine

Question 45

Integrase inhibitors name and mech

Answer 45

Raltegravir. inhibs HIV integrase

Question 46

Raltegravir tox

Answer 46

hypercholesterolemia

Question 47

copies of genome in HIV

Answer 47

diploid RNA