Miscellaneous Flashcards
What are the 6 stages of viral replication?
- Attachment
- Cell entry
- Interaction with host cell
- Replication
- Assembly
- Release
Give 3 functions of CD4 cells?
CD4 - Recognise peptides on MHC class 2 Secrete cytokines and activate, B- lymphocytes and cytotoxic T cells
In order to have immunity to HIV what do you need to possess?
Absence of CCR5 co-receptor
Name 3 enzymes used in HIV replication?
Reverse transcriptase
DNA integrase
Protease
What is cell tropism?
Host cell preference, chose which host cells affected
After how long does HIV enter the clinically latent phase?
12 weeks
Name 5 clinical findings you would see in the clinically latent phase?
- Oral candidiasis
- Recurrent shingles
- Persistant generalised lymphadenopathy
- Hairy Leukoplakia (white patch on tongue)
- Raised protein level
Which 2 markers are used to monitor HIV infection?
- CD4+ T-cell count
2. HIV viral load
At what CD4+ count would classify as AIDS?
<200
What would be the clinical presentation of primary (acute) HIV (2-4 weeks after infection)?
Abrupt onset of non-sepfici symptoms, diarrhoea, headache, sweating, sore throat, rash, mouth ulcers
What is a differential diagnosis of primary/acute HIV infection?
Secondary syphillis (rash on hands)
What is the clinical presentation of cerebral toxoplasmosis?
Headaches, seizures left hemiparesis, personality changes - cause by reactivation of latent condition
How do you treat cerebral toxoplasmosis?
Sulfadiazine, pyrimethamine
How do you treat cerebral toxoplasmosis?
Sulfadiazine, pyrimethamine
Which stain identifies cryptococcal meningitis?
India Ink Stain
Which two types of meningitis are most commonly asscoiated with AIDS?
Cryptococcal and pneumococcal
Which virus is non-hodkisn lymphoma strongly associated with?
EBV
Which virus is non-hodkisn lymphoma strongly associated with?
EBV
Give 5 drugs that can be used at HAART drugs and their mechanism?
Nucloside/non-nucleoside reverse transcriptase inhibitors (stop RNA transcription), Protease inhibitors (prevent packaging of viral DNA), Integrase inhibitor, fusion inhibitors, CCR5 inhibitors
Which 3 drugs are commonly used in HAART?
2 Nucleoside reverse transcriptase inhibitor and 1 non-nucleoside reverse transcriptase inhibitor OR protease inhibitor
What does HAART stand for?
Highly active anti-retroviral therapy
Give 5 problems of using HAART in the developing world?
- Awareness and education
- Clinical services eg staff and monitoring facilities
- Cost/choice of drug
- Adherence
- Delivery of care
- efficacy
Give 3 reasons why there is an increased number of HIV in 50-60 age group?
Divorce rate higher
Less sexual education at a young age
Stop using contraception as no worry of getting pregnant
If you have a needle stick injury what should you do?
Take HIV drugs within 72 hours
Give 7 methods of HIV prevention?
- Circumcision
- Post-exposure prophylaxis eg needle stick
- Pre-exposure prophylaxis
- STI control (ulcerative STI increased risk)
- Microbiocides (vaginal gels)
- HIV diagnosis. partner notification
- Behavioural therapy
- HAART treatment as prevention
Give 4 benefits of knowing your HIV status?
- Abscess to appropriate medical care
- Reduction in morbidity and mortality
- Reduction in mother - child transmission
- Reduction of sexual transmission
Give 5 benefits of knowing your HIV status?
- Abscess to appropriate medical care
- Reduction in morbidity and mortality
- Reduction in mother - child transmission
- Reduction of sexual transmission
- Cost-effective
Name 3 groups you would include in targeted screening?
- Pregnant women
- High risk groups eg IVDU or truck drivers
- Clinical indications of immunosipressions
Give 4 reasons as to why do doctors not always test for HIV?
- Failure to recognise HIV as a modifiable prognostic indicator
- Misconception
- Anxieties about false positive
- Underestimate risk of HIV in patients eg married
In HIV how is early diagnosis cost-effective?
Saving on social care, lost working days, benefits claimed, cost associated with further onward travel
Give 3 methods of HIV screening?
Venous blood sample (first choice)
Salivary antibody screening
Point of care tests- finger prick blood (false positives and negatives)
Name 4 advantages of point of care testing for HIV?
- Outreach into community settings
- Increased patient choice
- Increased access to test and case detection
- Earlier diagnosis in non-healthcare seeking individuals
- Reduce risk of complication
- Reduce transmission
Give 3 pit-falls of self-testing for HIV?
Incubation periods, misdiagnoses, inadequate partner notification (re-infection)
Name 5 groups of people who are more at risk of getting HIV?
- Men who have sex with men
- injecting drug users
- Truck drivers
- Migrant workers
- Commercial sex workers
- Heterosexual men and women
What are the 3 stages of the HIV epidemic?
Nascent <5% prevalence in all risk groups
Concentrated >5% prevalence in one or more at risk groups
Generalised >5% prevelence in general population
Which age group is most affected by HIV worldwide?
15-24
How does circumscion reduce HIV spread?
Reduces ability of HIV to penetrate due to removal of langerhans cells in inner foreskin which are targets for HIV
Give 4 methods to reduce HIV spread in IVDU?
Needle syringe programmes
Drug dependence treatment
Drug detention and rehabilitation centres
Management of TB and vital hepatitis
Give 3 methods to reduce mother to child transmission in HIV?
- Antepartum Zidovudine
- HAART until exposure to breast milk ended
- Lifelong ART
Give 5 methods of HIV transmission?
- Unprotected sex - mucous membranes
- Contaminated needles eg IVDU
- Mother to child during birth
- Breastfeeding
What does ELISA stand for?
Enzyme linked sorbent assay
Which two diagnostic tests would confirm HIV diagnosis?
Positive ELISA and western Blot
How does venous blood sampling for HIV work?
Test for p24 using ELISA
