Medicine (HIV/AIDS)

Question 1

What is HIV/AIDS?

Answer 1

-HIV: RNA retrovirus that infects CD4 cells and causes varying levels of immunosuppression and possible progression to AIDS

-Result of HIV when CD4 T cells 200 cells/microL, CD4 15% or less, AIDS defining illness

Question 2

What are AIDS defining illnesses?

Answer 2

-Burkitt’s lymphoma
-Candidiasis
-Fungal infections
-CMV
-Encephalopathy
-Karposi sarcoma
-Lymphoma
-Mycobacterium tuberculosis
-Toxoplasmosis

Question 3

What is the typical treatment for patients with HIV/AIDS?

Answer 3

-HAART (combination of multiple antiretroviral medications)
-Usually 3 drugs
-Two NRTIs (Reverse transcriptase inhibitors)
-Protease inhibitor

-Prophylactic antibiotics if CD4 levels below 100 or 50

Question 4

What is the management for a patient with HIV/AIDS?

Answer 4

-Pre-op risk stratification of immunological status (PCP/infectious disease doctor consultation)
-CBC, CHem 10, LFTs, glucose, coag, immunological status (CD4 count), viral load
-CXR and EKG (possible ABG or echo)
-Pt hypercoagulable
-Prolonged effects of lidocaine, opiates
-Caution with propofol