Immunodeficiency

Question 1

Iatrogenic

Cytotoxic drugs
Corticosteroids: immunosuppressive, anti-inflammatory
Cyclosporine- used in transplants against cell mediated immunityAntilymphocyte serum- anti T cell antibodies in transplant
Radiation therapy
Splenectomy

Answer 1

secondary immunodef.

Question 2

Infection of the immune systemimmune suppression

Advances to AIDS

Answer 2

HIV

Question 3

Progressive destruction of cell mediated immunity via T4 lymphocytes/CD4 and changes to humoral immunity
Allows for opportunistic infections- CA, TB
Diagnostic when are HIV(+) AND CD4 count

Answer 3

AIDS

Question 4

Risk Factors

Exchange of body fluids (blood, semen)High risk sexual behaviors



Unprotected sex (anal, oral, vaginal)
>6 sexual partners in 1 year
Sex with someone who has HIV
IV drug use (heroin)
Infected mother to child transmission

Answer 4

AIDS

Question 5

HIV infection leads to destruction of ???? cells

Answer 5

CD4/T helper

Question 6

3 HIV enzymes

Answer 6

reverse transcriptase
integrase
protease

Question 7

transcribes RNA into viral DNA

Answer 7

reverse transcriptase

Question 8

integrates viral DNA into cell DNA

Answer 8

integrase

Question 9

final assembly of new HIV virion

Answer 9

protease

Question 10

emergence of HIV antibodies in bloodstream, 3-6 wks after infection up to 6 mos

Answer 10

seroconversion

Question 11

when HIV from serum infects CD4 of lymph tissuekills CD4 cells

Answer 11

symptomatic

Question 12

4 stages of HIV

Answer 12

1] acute infection
2] HIV no sx
3] early sx
4] advanced HIV –> AIDS

Question 13

1-6 wks after exposure
Flu like sx, lymphadenopathy
HIV antibody screen: negative

Answer 13

stage 1 HIV

Question 14

CD4 count >500 cells/mm³

Answer 14

stage 2 HIV

Question 15

1-20 yrs after exposure
HIV antibody screen: positiveNo to mild symptoms
 Fatigue, lymphadenopathy

Answer 15

stage 2 HIV

Question 16

CD4 200-500 cells/mm³

Answer 16

stage 3 HIV

Question 17

Symptoms:
Persistent adenopathy
Diarrhea
Weight loss
Fatigue
Night sweats
Fever
Neurologic? (encephalopathy)Cancer
Opportunistic infection
Dyspnea, exertion

Answer 17

stage 3 HIV

Question 18

AIDS, CD4

Answer 18

stage 4 HIV

Question 19

AIDS encephalopathy (CNS, ANS, PNS)Opportunistic infections
Dermatologic conditions
Severe fatigue
Side effects of medications

Answer 19

stage 4 hIV

Question 20

MSK
Arthralgia
Rheumatolgic sx
HIV muscle wasting syndromeAVN
Pain syndrome
Delayed healing

Answer 20

HIV manifestations

Question 21

CNS
HIV encephalitis
periperal neuropathy

Answer 21

neuro manifestations of HIV

Question 22

Caused by HIV meds (neurotoxic), 
infections, vitamin deficiencies, ETOHDistal>proximal, Sensory>Motor
Symmetric
Decreased DTRs
Hypersensitivity, burning pain
Dx with EMG/NCV
Tx: reduce meds, pain meds

Answer 22

peripheral neurpathy manifestation of HIV

Question 23

CMVperipheral neuropathy
Fungal pneumoniadyspnea, chest discomfort, nonproductive cough
Toxoplasmosis (parasite)
Cancer (non Hodgkin lymphoma)

Answer 23

opportunistic manifestation HIV

Question 24

Kaposi sarcoma,

Answer 24

integumentary manifestation HIV

Question 25

the antiretroviral tx for HIV

Answer 25

HAARt

Question 26

when does HAART start>

Answer 26

after CD4 count is less than 500

Question 27

Prevent the enzymes (reverse transcriptase, protease) that are involved in the replication process (HIV RNA to DNA)

Answer 27

HAART

Question 28

Achieve sustained suppression of HIV replication

Reduce the amt of virus in blood

Answer 28

goals of HAART

Question 29

congenital, rare

Answer 29

primary immunodef.