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Adult Health 2 > Musculoskeletal and Immune Disorders > Flashcards

Musculoskeletal and Immune Disorders Flashcards

1
Q

What is an arthrogram?

A

A radiographic exam where contrast medium or air injected into joint cavity and joint is moved through ROM as series of x-rays taken, used to diagnose trauma to joint capsule or ligaments

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2
Q

What is an arthroscopy?

A

A radiographic exam where contrast medium or air injected into joint cavity and joint is moved through ROM as series of x-rays taken, used to diagnose trauma to joint capsule or ligaments

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3
Q

What do the scores of a bone density scan show?

A

Bone density scan measures the bone’s mineral density and compares in the normal to produce a “T-score.” A score of 0 means the bone density is equal that of a normal healthy adult. Scores of 1-2.5 mean low bone mass, score lower than 2.5 means osteoporosis.

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4
Q

What is a bone scan?

A

A test in which a radioisotope is injected IV, it collects in areas of abnormal bone metabolism and some fractures (the isotope is excreted in urine and feces within 48 hrs. and is not harmful). Encourage fluids post exam to promote excretion.

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5
Q

Why do we monitor alkaline phosphatase levels?

A

Alkaline phosphatase is a protein found in all body tissues and particularly high in the liver, bile ducts and bone. In association with the bone disorders indicate that there are high levels of osteoclasts being produced; this may be due normal growth and repair due to a fracture or to disorders such as bone cancer.

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6
Q

What is a myelogram?

A

dye or air is injected into the subarachnoid space to detect abnormalities of spinal cord and vertebrae. Need to be well hydrated for at least 12 hours. Post procedure if air is used keep head lower than trunk, if water based dye is used elevate HOB 15-30 degrees, if oil base dye used keep the client flat.

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7
Q

What nerve is being compressed leading to carpal tunnel?

A

Median nerve

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8
Q

What is Thenar?

A

“Thenar” wasting (muscle of pad of thumb), weakness of hand with decreased grip and decreased sensation.

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9
Q

When do we look out for Tinels sign?

A

To diagnose carpal tunnel syndrome, Tap the volar surface of wrist, positive if there is tingling. Phalens maneuver is when patient Flex wrists and hold 60 seconds, positive if symptoms of tingling and numbness

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10
Q

How should patients with carpal tunnel sleep at night?

A

With a Cock-up splint to affect wrist at night to prevent hyperflexion

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11
Q

What is a strain?

A

Excessive stretching of muscle or tendon. Tx with cold & heat, exercise with activity limitation, NSAIDs, muscle relaxants. If muscle or tendon torn then surgical repair required.

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12
Q

What is a sprain?

A

Excessive stretching or bending of a ligament, usually from a twisting motion, into a position it was not designed to move. Characterized by pain & swelling. Tx with RICE (rest, ice, compression, elevation). If there is a tear then casting may be required, for severe ligament damage surgery required

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13
Q

What are the different types of fractures?

A

Simple or closed-No break from the bone to outside body
Open or Compound-Has an external wound (high risk of infection/osteomyelitis)
Comminuted-Bone breaks into many small pieces
Displaced Bone fragments separate and are deformed
Impacted Bone fragment is forced into another bone or bone fragment
Non-displaced After fracture bone sections maintain normal alignment

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14
Q

What do we do first in fracture treatment?

A

Assess ABCs first since may have been associated with trauma

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15
Q

What are some treatments for fractures?

A

Immediate immobilization by splinting limits muscle spasm, decreases angulation and prevents further injury
For exposed bone cover with clean (sterile preferred) dressing and prevent reentry of contaminated bone into wound if possible
Reduction of bone is the restoring of displaced bone segments to normal position.
Closed reduction: restore bone alignment by manual manipulation; casting may be required after procedure
Open reduction: surgical realignment of the bone. Internal or external fixation devices, traction or casting may be used post procedure.

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16
Q

What device is non-cirumferential?

A

Non-circumferential (prevents pressure and skin breakdown)…splints

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17
Q

Which is the device that involves a Metal system of rods and pins inserted through the bone are used to maintain fracture fragments?

A

External fixation devices

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18
Q

Which device uses plates and screws outside the bone or with a rod inside the bone. May involve the removal of damaged bone and replacement with a prosthesis?

A

Internal fixation devices

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19
Q

What is a skeletal traction?

A

mechanically applied to the bone with pins, wires or tongs (i.e. Steinmann pin, Kirschener’s wire or crutchfield tongs). Weights are then attached to maintain alignment. Often used femur, tibia, and c-spine

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20
Q

What is an example of a skin traction?

A

Bucks extension traction (used to alleviate muscle spasms, immobilize lower limb by maintaining a straight pull on the limb. A boot appliance is applied to attach to the traction); Bryant’s (a vertical traction used to extend both lower legs used in children to stabilize a fractured femur and at times used to correct a congenital hip dislocation; rarely used); Russel traction is a balanced traction which lower leg is supported in a hammock which is attached to rope and pulleys on a Balkan frame; used to treat fractures of femur, foot of bed usually elevated. Pelvic traction is used to relieve low back, hip or leg pain and reduce muscle spasms and Dunlop’s traction a horizontal traction to align fractures of the humerus, it maintains the forearm in proper alignment

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21
Q

What are some traction care tips we need to follow?

A

Ensure that ropes and weights hang freely and do not touch floor and pulleys are not obstructed. Keep linen off ropes. Do not remove or lift weights without an order
Teach deep breathing and coughing exercises
Exercise unaffected limbs to maintain muscle tone and prevent bone demineralization
Encourage 2500/ml per day if not contraindicated to prevent constipation, UTI, and renal calculi
With bucks traction assess skin under foam boot every shift (second person hold traction during removal)

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22
Q

What is Exogen therapy?

A

low intensity pulsed ultrasound and is Applied 20 minutes daily to speed healing

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23
Q

What is Iontophoresis?

A

a synthetic steroid that is placed into skin near fracture to assist with control of pain and inflammation

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24
Q

What microbe causes gas gangrene most?

A

Clostridium perfringens

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25
Q

What are some symptoms for gas gangrene?

A

Local swelling and a serosanguineous exudate
Bronze skin color, that progresses to a blue-black color with skin blebs and hemorrhagic bullae.
The wound may be nonodorous or may have a sweet musty odor.
Crepitus follows gas production; at times, crepitus may not be detected with palpation or on x-ray.
Management Includes:
Requires debridement and possible amputation.
Penicillin type IV antibiotics
IV pain management
Hyperbaric oxygen

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26
Q

What is compartment syndrome?

A

the compression of nerves and blood vessels within an enclosed space. Diagnosis requires direct measurement of pressure in the compartment. (Done by inserting a needle attached to a pressure meter into the affected area). Diagnosis is made if the pressure is greater than 45 mmHg or when the pressure is within 30 mmHg of the diastolic blood pressure.

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27
Q

Should we elevate an extremity with compartment syndrome?

A

Limbs with compartments showing signs of inadequate blood flow should not be elevated. the arteriovenous gradient will be further diminished when blood flow is already inadequate.

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28
Q

What is the name of a fracture related to osteoporosis in the elderly?

A

Calles fracture

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29
Q

Should we sit patients up after a lower extremity fracture?

A

Avoid sitting at 90 degrees as it may cause dislocation

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30
Q

How should we transport an amputated finger?

A

it is important the finger be wrapped in gauze or cloth, the placed in a zip lock bag, placing the bag in ice water (never place the finger directly in ice)

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31
Q

What is Syme amputation?

A

midfoot or below ankle amputation

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32
Q

What med is given to prevent phantom pain?

A

Calcitonin

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33
Q

What position should we place patient in to prevent contractures of the hip?

A

Prone position every 3-4 hours

34
Q

We shouldn’t elevate recent amputations for longer than?

A

24 hours as may cause flexion contractures

35
Q

What is OA?

A

Osteoarthritis OA is distinguished by cartilage degeneration and body overgrowth and often associated to the “wear and tear” joints undergo due to age, obesity, trauma, and use of the joint over time. Pathologically you see radiographic changes (joint space narrowing, osteophytes and bony sclerosis). Signs and symptoms include Joint stiffness after rest that resolves within 30 minutes with exercise. Stiffness that is worse when it is wet outside, As the disease progresses and joint pain and stiffness are more prolonged and joint enlargement and crepitus (grating sensation in joint) develop. Distal joint deformity (bony enlargement)
Heberden’s nodes (calcific spurs of the articular cartilage at joint nearest fingernail).
Bouchard’s nodes (bony outgrowths or gelatinous cysts on the proximal or middle interphalangeal joints of fingers). While more common in OA may be present in RA

36
Q

What are some meds we see given to OA patients?

A

Analgesics, Celebrex is seldom given, Halagen joint injections, glucosamine supplements

37
Q

What is RA?

A

Immunologically mediated chronic (inflammatory disease of unknown origin. Primarily affects joints but may have generalized manifestations. Cartilage becomes rough and pitted. Joint destruction begins 1-2 yrs. after onset of disease. May be triggered by viruses (i.e. Epstein Barr). May be a genetic component as risk doubles if there is a 1st degree relative with the condition.
Onset may be acute, slowly progressive, or insidious.
Fatigue, wt. loss, muscle weakness & vague musculoskeletal discomfort that eventually settles in joint is common.
Joint involvement is bilateral/symmetric with wrists, fingers, knees, feet & ankles most often affected.

38
Q

How is RA diagnosed?

A

ESR >60 during exacerbation
Elevated C-reactive protein and elevated platelet count indicates severe inflammation
Rheumatoid factor 1:80 or>, positive in 75% with RA
Low hematocrit (normocytic, hypochromic, iron does not help)
SLEP testing to determine if due to inflammation
Serum complement; decreased values indicate active autoimmune disease
x-rays usually not helpful until after 6-8 months of onset. There is soft tissue swelling, articular demineralization, joint-space narrowing and erosion. C1-C3 subluxation may be seen after several years of chronic disease

39
Q

Who would corticosteroids benefit? OA or RA patients?

A

Corticosteroids have an immediate effect on flare up of RA, do not alter disease. Due to side effects (bruising, psychosis, osteoporosis, cataracts, wt. gain, diabetes, HTN, impaired immunity) limit to lowest possible effective dose

40
Q

What are some anti-rheumatic drugs seen used in RA?

A

have been shown to slow disease process, reduce inflammation and limit joint damage. These take up to six months to work and may have toxic side effects, monitor closely
Antimalarial drug Plaquenil
Antineoplastic drugs especially methotrexate and Imuran
Sulfasalazine
Enbrel which inhibits the inflammatory protein tumor necrosis factor
Other drugs disease modifying drugs include Rituximab, Abatacept, Tocilizumab, Golimumab, Anakinra, Humira

41
Q

What is SLE?

A

Systemic Lupus Erythematosus, Chronic inflammatory autoimmune, multi-system (including kidneys, joints, nervous system, hematopoietic organs) disorder ranging from mild to life-threatening. The antibodies affect collagen, decreasing the effects of connective tissue healing. End organ damage (especially renal failure) is a result of the chronic autoimmune response
SLE predisposes the individual to arterial insufficiency of the lower extremities and subsequent formation of non healing wounds. Antibodies also affect the phospholipid components of blood clotting and interfere with coagulation, results in prolonged PTT, at times making the individual more prone to bleed and other times more prone to develop thrombosis

42
Q

What disease process affects females 10x more than men?

A 
SLE. Symptoms include “Butterfly” rash that extends over both cheeks and bridge of nose
Fever lasting >3 weeks
Neuro changes ranging from confusion to CVA and seizures
Muscle pain
Optic neuritis
Pleural or pericardial effusion
Hematological changes such as anemia, leukopenia, or thrombocytopenia
Lymphedema &/or splenomegaly
Blood and protein in the urine
Pneumonitis and/or pulmonary bleeding
Pulmonary hypertension
Chest pain
Ischemic abdominal pain
Abnormal liver function tests
43
Q

What are the criteria used to diagnose SLE?

A

The American College of Rheumatology criteria for classification include malar rash, discoid rash, photosensitivity, oral ulcers, nonerosive arthritis, pleuritis or pericarditis, renal disorder, neurologic disorder, hematologic disorder, immunologic disorder, and positive antinuclear antibody. If the patient meets 4 of 11 of these criteria the diagnosis can be made with 95% specificity and 85% sensitivity

44
Q

What is some of the treatment used for severe SLE?

A

Immediate corticosteroids (i.e. Prednisone), helps prevent inflammatory processes such as pericarditis, CNS lupus, thrombocytopenia purpua, and lupus nephritis
Regular CBC, LFT, and urinalysis to monitor SLE activity and effects of drugs
Skin manifestations treated with topical steroids or antimalarial agents (Plaquenil)
Immunosuppressive drugs (Imuran) are used for hemolytic anemia and thrombocytopenia, CNS lupus, and renal nephritis
New drug treat SLE, belimumab (Benlysta) is a monoclonal antibody
Anticoagulant therapy is used for the thromboembolic manifestations of SLE

45
Q

What is Scleroderma?

A

Chronic progressive autoimmune disease that causes abnormal growth of connective tissue resulting in the thickening and tightening of the skin. It may also cause life threatening damage to internal organs. Symptoms of localized scleroderma include:
1) discolored patches on skin called morphea
2) streaks/bands of thick hard skin on arms and legs known as linear scleroderma. When linear scleroderma occurs on face and forehead called en coup de sabre.
Key feature of systemic scleroderma is vascular injury due to accumulation of collagen that reduces blood flow through small arteries, arterioles and capillaries of skin and organs.
Reduced skin circulation results in Raynaud’s phenomenon, most common initial symptom, present in 95% of clients.

46
Q

What meds are usually given for Reynauds?

A

Calcium channel blockers, ACE inhibitors, ACEII, or nitroglycerin topical ointment to dilate blood vessels.

47
Q

What is fibromyalgia?

A

means pain in the muscles, ligaments, and tendons. Chronic rheumatologic syndrome characterized by spontaneous, widespread soft tissue pain/ tenderness, areas of pain are known as tender points

48
Q

What are some symptoms of fibromyalgia?

A

History of widespread pain on both sides of the body and above and below the waist for at least three months
Pain located in 11 of 18 (nine pairs located on each side of the body) designated areas of the occiput, neck, shoulders, thoracic and lumbar spine, paraspinous regions, buttocks, hips, elbows and knees. Site of pain or tender points may shift over time
There will be pain on palpation without the classic signs of inflammation (heat, redness, swelling)
Other symptoms may include headache, morning stiffness, numbness and tingling in hands and feet.

49
Q

In what disease process are analgesics not usually helpful?

A

Fibromyalgia, Tramadol (due to its combined tricyclic and opioid properties) may be helpful

50
Q

What is multiple myeloma?

A

Plasma cell disorder in which a clone of malignant plasma cells forms in the bone marrow, producing an abnormal amount of dysfunctional immunoglobulin.
Affects the mature B lymphocyte.

51
Q

Which disease processes usually sees unexplained back pain?

A

MM, Pain that is not relieved with usual treatment methods
Pain worse in supine position
Pain at night wakens from sleep
Progressive neurologic deficits

52
Q

What are some exams used to diagnose MM?

A

Exams include CBC with Differential, Comprehensive metabolic panel, immunoglobulin, serum protein electrophoresis, C-reactive protein,
M and Bence Jones Protein in the Urine (often called the hallmark of multiple myeloma)
CT scan and X-ray shows osteolytic lesion that appears “punched out” in affected bone
Bone marrow aspiration identifies number and properties of myeloma cells of marrow.
Staging of disease done by Durie and Salmon system that examines level of M and Bence Jones protein, bone lesions and location, level hypercalcemia and anemia

53
Q

What are some treatments used for MM?

A

Chemotherapy with drugs such as melphalan (Alkeran), prednisone, vincristine, adriamycin and dexamethasone
Stem cell transplantation; person’s own or donor stem cells from marrow harvested and frozen. Then after extensive radiation therapy or chemo then cells given back to person. It is helpful in clients under 60 years of age. Great risk of infection during process.
Other therapies include alpha interferon and Thalidomide
Bisphosphonate agents to control bone disease and prevent hypercalcemia
Radiation Therapy for bony lesions, must be limited due to affect on bone marrow.

54
Q

What is Multiple sclerosis?

A

A chronic progressive autoimmune disease of the central nervous system with a disseminating demyelination of the nerve fibers of the brain and spinal cord, characterized by exacerbation and remission of varied multiple neurological symptoms. Three pathologic processes: inflammation, demyelination and plaque formation*

55
Q

What are some late course manifestations of MS?

A

Dementia, Charcot’s triad (scanning speech, nystagmus, intention tremor), hemiplegia, generalized muscular weakness and atrophy, inability to stand and walk, loss of bowel and bladder control (retention or incontinence), and respiratory failure

56
Q

How is MS diagnosed?

A

CSF shows increased leukocytes, myelin basic protein, immunoglobulin G, coupled with normal serum IgG, normal CSF protein. Kappa light chains also support diagnosis of MS
Slowed or absent nerve conduction in evoked potential studies
CT and MRI scans show demyelination lesions

57
Q

What are some meds used for MS?

A

To reduce frequency and length of exacerbation—corticosteriods, immunosuppressives, Baclofen, Dantrolene, Valium, Tegretol, Inderal, Clonopin, Urecholine, Dirtopan, and Stool softeners

58
Q

What is Sjogren’s syndrome?

A

Group of symptoms/problems often associated with autoimmune disorders
Manifestations include dry eyes, dry mucous membranes of nose & mouth, vaginal dryness due to autoimmune destruction of lacrimal, salivary and vaginal mucus producing glands

59
Q

What are some meds used for Sjogren’s syndrome?

A

Keep eyes lubricated with artificial tears; new medication cyclosporine (Restasis) eyedrops help with tear production
Salagen (systemic pilocarpine) helps with saliva production
Water soluble vaginal lubricants
Immunosuppressive drugs such as Methotrexate and Cytoxan.

60
Q

What is type 1 hypersensitive state?

A

IgE antibodies fixed to tissue mast cells react with antigen and trigger release of histamine and other cheomtactic factors (anaphylaxis, urticaria, atopy, angioedema)

61
Q

What is type II hypersensitive state?

A

IgM or IgG antibodies react with antigen on target cells (usually RBCs) and activate complement causing cell wall lysis in serum or tissues (drug reactions, transfusion reactions, erythroblastosis fetalis)

62
Q

What is type III hypersensitive state?

A

IgG or IgM antibodies form complexes with antigen and complement causing local tissue inflammation and destruction (SLE)

63
Q

What is type IV hypersensitive state?

A

T cells react directly with antigen to produce local inflammation (TB skin test, contact dermatitis)

64
Q

What is anaphylaxis?

A

Rapid dramatic, acute atopic reaction, marked by sudden onset of rapidly progressing urticaria, respiratory distress, and vascular collapse, leading to systemic shock and sometimes death
Caused from ingestion or exposure to a substance that causes a severe IgE mediated antigen-antibody allergic response. As with all IgE antigen-antibody reactions prior sensitization must have occurred. Previous exposure may are may not have caused an untold reaction
Histamine, leukotrienes, and other mediators are released when the antigen agent reacts with the IgE on the basophils and mast cells. This causes smooth muscle contraction, increased capillary permeability, and vascular dilation.

65
Q

What are some mild symptoms of anaphylaxis?

A 
Queasiness & anxiety, 
Hives, itching, flushing
Sneezing, nasal congestion, runny nose, cough
Conjunctivitis 
Abdominal cramps
Tachycardia
66
Q

What is some emergency management of anaphylaxis?

A

Have intubation equipment and cricothyrotomy/tracheostomy set on standby
Followed by nebulization of beta agonist or racemic epinephrine
Epinephrine should be given as soon as anaphylaxis identified. The proper dose of epinephrine in adults is 0.3 to 0.5 mL of a 1:1000 solution given intramuscularly or IV
Immediate injection of 1:1,000 (1mg per 1 mL) aqueous solution of epinephrine; give 0.3-0.5 mg every 5-15 minutes, massage the site to speed absorption. Thigh is the preferred site.
In severe cases may give IV but dose is 100-200 mcg repeated every 1-2 minutes; must be on a cardiac monitor as may cause cardiac arrhythmias.

67
Q

What is Stevens Johnson Syndrome?

A

It is an immune-complex–mediated hypersensitivity disorder that may be caused by many drugs (antibiotics such as sulfa & Penicillins, anticonvulsants, NSAIDs), viral infections, cocaine and malignancies. Half of cases no specific etiology
Pathologically, cell death results causing separation of the epidermis from the dermis.
SJS is a serious systemic disorder with the potential for severe morbidity and even death.

68
Q

What are some symptoms of Stevens Johnson Syndrome?

A

Typically, the disease process begins with a nonspecific upper respiratory tract infection during with a cough & thick purulent sputum, fever, sore throat, chills, headache, arthralgia, vomiting and diarrhea and malaise.
Lesions develop abruptly; clusters of outbreaks last from 2-4 weeks
The rash begins as macules that develop into papules, vesicles or bullae that later rupture and cause sloughing of epidermis.
Although lesions may occur anywhere, the palms, soles, dorsum of the hands, and extensor surfaces are most commonly affected.
Rash may have appearance of a “target”
Mucosal involvement may include erythema, edema, sloughing, blistering, ulceration, and necrosis. Conjunctivitis and Corneal ulcerations
Erosive vulvovaginitis or balanitis (inflammation of foreskin and head of penis)

69
Q

Management for Steven Johnson syndrome is similar to that of?

A

Burn victims; Management is like thermal burns, fluid and lyte loss is the priority with crystalloid, large bore IV. Denuded skin (where all skin has sloughed off) areas must be covered with compresses of saline or Burrow solution.

70
Q

Who is at risk for developing latex allergies?

A

health care workers, those in manufacturing of latex, females, spina bifida, those who wear gloves frequently, and anyone allergic to kiwi, pineapple, banana, avocados, potatoes, chestnuts and tropical fruit

71
Q

What is AIDS?

A

A terminal, secondary immunodeficiency syndrome characterized by gradual and accelerating dysfunction of cell mediated immunity and manifested by opportunistic infections and malignancies. A diagnosis of AIDS is made when the a person is HIV positive and has either a CD 4 count below 200 or an opportunistic infection such as: Candidiasis of bronchi, esophagus, trachea or lungs; Invasive cervical cancers; Coccidiodomycosis that has spread; Cryptococcosis affecting organs outside the lungs; HIV encephalopathy; Herpes simplex lasting >month of mouth, bronchitis, pneumonititis or esophagitis; Kaposi’s sarcoma

72
Q

What is stage 1 of HIV?

A

HIV positive, may or may on have symptoms, usually have flu like symptoms, fever, lymphadenopathy, skin rash, & malaise. This may be followed by a variable length of time where client is asymptomatic. T-cell count >500; no AIDS defining illness

73
Q

What is stage II of HIV?

A

HIV positive, CD 4 T cell count between 200-499 and no AIDS defining illness but may have the following: bacterial endocarditis, meningitis, pneumonia, sepsis, wide spread candidiasis, cervical dysplasia or cancer, persistent fever, weight loss, chronic diarrhea, fatigue, night sweats lasting more than a month, Herpes zoster, ITP, Listeriosis, TB, peripheral neuropathies

74
Q

What is stage III of HIV?

A

HIV positive, CD 4 T cell count below 200 and AIDS defining disorders such as candidiasis of respiratory tract, invasive cervical cancer, disseminated or etrapulmonry coccidoidomycosis, cytomegalovirus, HIV related encephalopathy, Kaposi’s sarcoma, lymphoma, Pneumocystis carinii pneumonia, Toxoplasmosis of brain, Salmonella septicemia, wasting syndrome

75
Q

What is stage IV of HIV?

A

used to describe clients with confirmed HIV infection but no information related to CD4 T-cell count

76
Q

How is HIV diagnosed?

A

If ELISA positive then Western blot to confirm results
Reverse transcription polymerase chain reaction (RT by PCR) use to detect HIV and measure viral load. It is used also to screen neonates, high risk seronegative people before antibody development, determine the exact strain of virus
CD 4 count to determine immune status and HIV activity. Levels below 500 are indicator of increased risk for infection and below 200 very high risk
Viral load to determine the level of disease in the body, used to monitor progression and treatment effectiveness of disease

77
Q

What is the form of pneumonia seen with AIDS patients?

A

Pneumocystis pneumonia or pneumocystosis is a form of pneumonia caused by the yeast like fungus Pneumocystis jirovecii (pronounced “Yee-row-vet-zeeis) and specific to humans only. It is a fungal infection associated with AIDS but can occur whenever there is a state of immunosuppression, it is often the initial manifestation of AIDS once the CD4 count drops below 200.

78
Q

What is HAART?

A

HAART combines drugs from at least two different classes of antiretroviral drugs
HAART works by suppressing the virus and decreasing the rate of opportunistic infections.
Although the use of HAART has greatly reduced the number of deaths due to HIV/AIDS, and possibly the transmission of HIV/AIDS as well, this powerful combination of drugs does not totally suppress HIV virus.
Those with HIV on HAART can still transmit HIV to others through unprotected sex and needle-sharing.

79
Q

How many antiretroviral drugs are there (approved by FDA for HIV)?

A

30

80
Q

What are some treatments for opportunistic disorders associated with AIDS?

A

Bactrim or Septra is an antibacterial agent is used both for prevention and treatment of PCP. Pentamidine may be used if Bactrim is ineffective, but it has many adverse side effects. Clindamycin may also be used
Treatment for Mycobacterium avioum requires multiple prolonged drug therapy with Biaxin, Zithromax, Myambutal, Cipro, and amikacin. Usually a combination of two to five drugs are required.
Crytococcal meningitis is treated with Amphotericin B with or without oral Diflucan. These drugs, especially Amphotericin have many adverse side effects including anaphylaxis, renal and hepatic impairment, electrolyte imbalance, anemia, and fever.

81
Q

How soon after should health care providers exposed to HIV through needle stick begin prophylaxis?

A

(or splash) should begin post-exposure prophylaxis immediately (within 24-36 hours), after 72 hours it is ineffective. Use for up to 6 weeks.
Begin treatment with two to three drugs (depending on site and source of contamination)
Treatment is with a reverse transcriptase inhibitor, non-nucleoside reverse transciptase inhibitor, and protease inhibitor
HIV antibody testing should be performed for at least every 6 weeks for 6-months.

Adult Health 2 (5 decks)

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