L69

Question 1

Define incidence vs prevalence

Answer 1

Prev = # people living with condition
- Increasing for HIV b/c better treatment
Incidence = # new infections per year
- Constant for HIV

Question 2

Name the 5 body fluids that can transmit HIV.

Answer 2

Blood
Breast milk
Semen
Vaginal
Rectal fluids

Question 3

What is the key factor driving infectiousness of a donor? How is this measured?

Answer 3

Viral load = amt of virus in the body

Measured by PCR

Question 4

What are factors that increase your risk for transmission in an occupational setting?

Answer 4

1. Visible blood on needle
2. Needle from artery/vein
3. Hollow bore/large gauge needle
4. Deep injury
5. From pt w/ high viral load

Question 5

What is the standard diagnostic method for pots over 18 mo old? What is it testing?

Answer 5

Serum PCR (immunoassay) for plasma viral RNA
- IgM
- IgG
- p24
Testing viral load

Question 6

Name the order of HIV characteristics you see in pts.

Answer 6

Virus in blood - viral load

Question 7

What would give you a false positive serum PCR?

Answer 7

HIV vaccine

Autoimmune disease

Question 8

What is the eclipse period?

Answer 8

No signs of infection b/c localized

During first few days of infection

Question 9

What is the window period? What is characteristic of this period for diagnostics?

Answer 9

Pt is infected with HIV

False negative test b/c no Abs yet

Question 10

What is the seroconversion window?

Answer 10

Time to make Abs vs HIV

Question 11

If the serum PCR is positive, what must you follow up with?

Answer 11

Western Blot to confirm

- Look for Abs against specific HIV antigens

Question 12

How do you test infants for HIV?

Answer 12

PCR for pro-virus DNA

Abs not tested b/c inherited from mom

Question 13

What is the cell profile of acute retroviral syndrome?

Answer 13

Increase serum HIV RNA

Decline CD4

Question 14

What are the clinical symptoms of acute retroviral syndrome?

Answer 14

Fever
Lymphadenopathy
Pharyngitis 
Rash
Myalgia/arthralgia 
Aka you'd probably mistake this for mono or flu

Question 15

What are the big AIDs defining illnesses?

Answer 15

Esophageal candida
Cryptococcosis
CMG
Kaposi sarcoma 
PCP
PML (progressive multifocal leukoencephalopathy)
Toxoplasmosis

Question 16

What are the other AIDs defining illnesses you should be aware of?

Answer 16

Candida of respiratory tract
Invasive cervical cancer 
Cocci
Encephalopathy 
Herpes
Histoplasmosis
Isosporiasis
Lymphoma
MAC
Recurrent pna
Salmonella 
TB
Wasting

Question 17

What are the serum characteristics of chronic HIV infection?

Answer 17

CD4

Dets when to start drug prophylaxis

Question 18

Which 2 infections should you expect in pts with CD4 over 500?

Answer 18

Lymphadenopathy

Secondary syphilis

Question 19

Which infections should you expect in pts with CD4 ct between 200-500?

Answer 19

TB
Oral candida
Shingles
Kaposi sarcoma

Question 20

Which infections should you expect in AIDs pts (CD4

Answer 20

PCP
Toxoplasmosis 
Crypto meningitis 
CMV
JC virus --> PML

Question 21

Is PCP prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Answer 21

PCP:
1 & 2ary
CD4

Question 22

Is toxoplasmosis prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Answer 22

Toxo:
1 & 2ary
CD4

Question 23

Is crypto prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Answer 23

Crypto:
2ary
CD4

Question 24

Is MAC prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Answer 24

MAC:
1ary
CD4

Question 25

Is CMV prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Answer 25

CMV:
2ary
CD4