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MS: NCM 112 > IMMUNODEFICIENCY 1.2 > Flashcards

IMMUNODEFICIENCY 1.2 Flashcards

ASSESSMENT AND DIAGNOSTIC METHODS-MEDICAL MANAGEMENT

1
Q

ASSESSMENT AND DIAGNOSTIC METHODS

A
  1. Enzyme immunoassay (EIA)
  2. Western Blot
  3. Viral Load Test
  4. OraSure Saliva Test
  5. OraQuick Rapid HIV-1 antibody test
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2
Q

ASSESSMENT AND DIAGNOSTIC METHOD:

  • Formerly enzyme-linked immunosorbent assay [ELISA]
  • One of the most commonly used tests to screen for HIV antibodies. This test detects antibodies that the body produces in response to HIV infection
A

Enzyme Immunoassay (EIA)

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2
Q

ASSESSMENT AND DIAGNOSTIC METHOD:

  • A blood sample is taken from the individual, and the test is performed in a laboratory. The test uses antigens from HIV to capture any antibodies present in the blood.
  • If the test detects antibodies, it produces a positive result.
  • However, because this is a screening test, any positive result must be confirmed by a more specific test, such as the Western blot assay.
A

Enzyme Immunoassay (EIA)

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3
Q

ASSESSMENT AND DIAGNOSTIC METHOD:

FALSE POSITIVE RESULT OF Enzyme Immunoassay (EIA)

A
  • Cross-Reactivity
  • Recent Vaccination
  • Technical Errors
  • Biological Factors
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3
Q

ASSESSMENT AND DIAGNOSTIC METHOD:

FALSE NEGATIVE RESULT OF Enzyme Immunoassay (EIA)

A
  • Window Period
  • Test Sensitivity
  • Genetic Variants of HIV
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3
Q

FALSE POSITIVE RESULT:

Improper handling, contamination, or incorrect interpretation of the test results

A

Technical Errors

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3
Q

FALSE POSITIVE RESULT:

Can sometimes react with antibodies produced in response to other infections or conditions such as autoimmune disorders or other viral infections (EBV)

A

Cross-Reactivity

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4
Q

FALSE POSITIVE RESULT:

Rarely, individuals may naturally produce proteins that mimic HIV antibodies

A

Biological Factors

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4
Q

FALSE POSITIVE RESULT:

Can sometimes trigger the production of antibodies that cross-react with HIV antigens

A

Recent Vaccination

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4
Q

FALSE NEGATIVE RESULT:

The time between initial HIV infection and the point when the body produces enough antibodies to be detected by the EIA.

A

Window Period

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5
Q

FALSE NEGATIVE RESULT:

Antibody levels are very low in cases of early HIV infection and advanced HIV infection.

A

Test Sensitivity

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5
Q

ASSESSMENT AND DIAGNOSTIC METHODS:

  • The confirmatory test for HIV.
  • It is more specific than the EIA and is used to confirm the presence of HIV antibodies after a positive EIA test.
A

Western Blot

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6
Q

FALSE NEGATIVE RESULT:

Incorrect sample handling, dilution errors

A

Technical Errors

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6
Q

FALSE NEGATIVE RESULT:

While rare, certain genetic variants of HIV might not be detected by the antigens used in the standard EIA

A

Genetic Variants of HIV

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7
Q

ASSESSMENT AND DIAGNOSTIC METHODS:

Target Amplification Methods of Viral Load Test

A
  • Polymerase Chain Reaction (PCR)
  • Branched DNA (bDNA) Test
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7
Q

ASSESSMENT AND DIAGNOSTIC METHODS:

  • The test separates viral proteins by size using gel electrophoresis, and these proteins are then transferred to a membrane where they are exposed to the patient’s serum.
  • If HIV antibodies are present, they will bind to the viral proteins, confirming the infection.
A

Western Blot

8
Q

ASSESSMENT AND DIAGNOSTIC METHODS:

The test is highly specific and is used to avoid false positives that might occur with the EIA.

A

Western Blot

Interpretation: A positive Western blot test confirms an HIV infection.

8
Q

ASSESSMENT AND DIAGNOSTIC METHODS:

  • Viral load tests measure the amount of HIV RNA in the blood, rather than antibodies.
  • These tests are often used to monitor the effectiveness of antiretroviral therapy (ART) and to determine the stage of the infection.
A

Viral Load Test

8
Q

Target Amplification Methods of Viral Load Test

Detects HIV RNA by amplifying small amounts of viral RNA to detectable levels.

A

Polymerase Chain Reaction (PCR)

9
Q

Target Amplification Methods of Viral Load Test

Measures the amount of HIV RNA in a sample using a signal amplification method.

A

Branched DNA (bDNA) Test

10
Q

ASSESSMENT AND DIAGNOSTIC METHODS

Low or undetectable levels suggest effective suppression of the virus

A

Viral Load Test

Interpretation: High viral load levels indicate active viral replication and a higher risk of disease progression.

11
Q

ASSESSMENT AND DIAGNOSTIC METHODS

  • A non-invasive method that uses a saliva sample to detect HIV antibodies.
  • It is useful for individuals who are reluctant to provide a blood sample.
A

OraSure Saliva Test

12
Q

ASSESSMENT AND DIAGNOSTIC METHODS

A special collection device is used to obtain a saliva sample from the gums and inner cheek. The sample is then tested in a laboratory.

A

OraSure Saliva Test

Interpretation: A positive result indicates the presence of HIV antibodies and should be confirmed with a blood-based test, such as the Western blot.

13
Q

ASSESSMENT AND DIAGNOSTIC METHODS

A rapid point-of-care test that provides results within 20-40 minutes. It can be performed using a blood sample or an oral fluid sample.

A

OraQuick Rapid HIV-1 antibody test

14
Q

ASSESSMENT AND DIAGNOSTIC METHODS

For the oral test, the device is swabbed along the gums, and the sample is placed in a solution. For the blood test, a small blood sample is taken from the finger.

A

OraQuick Rapid HIV-1 antibody test

15
Q

ASSESSMENT AND DIAGNOSTIC METHODS

The rapid test is widely used for its convenience, especially in settings where quick results are needed.

A

OraQuick Rapid HIV-1 antibody test

Interpretation: A positive result on the OraQuick test should be confirmed with a follow-up laboratory test.

16
Q

MEDICAL MANAGEMENTS FOR AIDS

A
  1. Antiretroviral Therapy (ART)
  2. Treatment of Opportunistic Infection
17
Q

MEDICAL MANAGEMENTS FOR AIDS:

A combination of medications that target the HIV.
ITS GOAL INCLUDES:
* To reduce the viral load in the body to undetectable levels
* To maintain or increase the number of CD4+ T cells
* To prevent the progression of HIV to AIDS
* To manage or prevent opportunistic infections and complications.

A

Antiretroviral Therapy (ART)

17
Q

Examples of Opportunistic Infection

A
  • Pneumocystis Pneumonia
  • Mycobacterium Avium Complex
  • Cryptococcal Meningitis
  • CMV Retinitis
  • Other Infections:
  • - Herpes simplex or herpes zoster
  • - Esophageal or oral candidiasis
18
Q

CMV Retinitis:

Adverse reaction to Ganciclovir:

A

Severe Neutropenia

18
Q
  • Treatment of choice for Pneumocystis Pneumonia (PCP)
  • Adjunctive corticosteroids should be started as early as possible (and certainly within 72 hours).
A

Trimethoprim-sulfamethoxazole (TMP-SMZ)

18
Q

MEDICAL MANAGEMENT:

  • A synthetic analog of somatostatin
  • Shown to be effective in managing chronic severe diarrhea
A

Octreotide acetate (Sandostatin)

Antidiarrheal Therapy

19
Q

CMV Retinitis:

Adverse reactions to Foscarnet:

A
  • Nephrotoxicity
  • Electrolyte imbalances -life threatening.
19
Q

MEDICAL MANAGEMENT:

Treatment Goals:
* reduce symptoms by decreasing the size of the skin lesions
* reduce discomfort associated with edema and ulcerations
* control symptoms associated with mucosal or visceral involvement.

A

Chemotherapy

Kaposi’s Sarcoma

20
Q

MEDICAL MANAGEMENT:

Radiation therapy is effective as a palliative measure; alphainterferon can lead to tumor regression and improved immune system function.

A

Chemotherapy

Kaposi’s Sarcoma

20
Q

MEDICAL MANAGEMENT:

Treatment of depression involves psychotherapy integrated with pharmacotherapy antidepressants and possibly a psychostimulant

A

Antidepressant Therapy

20
Q

MEDICAL MANAGEMENT:

For patients with severe depression who do not respond to pharmacologic interventions.

A

Electroconvulsive therapy

20
Q

MEDICAL MANAGEMENT:

  • Calorie counts should be obtained to evaluate nutritional status and initiate appropriate therapy for patients experiencing unexplained weight loss.
  • Appetite stimulants can be used in patients with AIDS related anorexia.
  • Oral supplements may be used to supplement diets that are deficient in calories and protein.
A

Nutrition Therapy

21
Q

What kind of diet should a patient with diarrhea consume?

A

A diet low in fat, lactose, insoluble fiber, and caffeine and high in soluble fiber

MS: NCM 112 (14 decks)

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