NUR 370 INTEGRATIVE PATHO

Question 1

Immunodeficiency

Answer 1

• diminished or absent immune response

- primary vs. secondary

Question 2

Primary immunodeficiency

Answer 2

• defect with immune system
• developmental failures
• genetic or congenital abnormalities

Question 3

Secondary immunodeficiency

Answer 3

• suppression of immune system because of a specific cause

- ex: infection, stress, drugs, malnutrition

Question 4

Stages of virus replication

Answer 4

• virus adheres to cell surface
• virus enters by phagocytosis
• virus sheds coat
• replication of viral nucleic acids
• synthesis of viral protein of capsid
• assembly of new virions
• release

Question 5

Characteristics of AIDS

Answer 5

• immunosuppression: opportunistic infections
• autoimmunity: arthritis, lymphoid interstitial pneumonitis
• neurologic dysfunction: dementia, peripheral neuropathy

Question 6

Transmission of HIV/AIDS

Answer 6

• direct contact with infected blood or body fluids
• human milk
• vaginal secretions
• semen
• CSF
• saliva (low amount unless open sores are present)

Question 7

Life cycle of HIV

Answer 7

• HIV virus invades CD4 cells
• sheds viral coat
• uses reverse transcriptase enzyme to convert RNA to DNA
• DNA combines and integrates with CD4 DNA
• CD4 cell then replicates and produces “bad” cells with HIV virus
• HIV virus also replicates inside cell
• when cell bursts, HIV virus is introduced into the blood stream to find new hosts

Question 8

HIV Diagnostics

Answer 8

• HIV antibody tests (ELISA, EIA)
• Western blot assay most sensitive
• PCR: measures viral load - most appropriate for infants (indicator of treatment success and CD4 count and presence of opportunistic infections)
• CD4 counts of > 800 cells
• CD4 percentage (high risk < 20%)

Question 9

CD4 classification system categories

Answer 9

• 3 categories based on CD4 counts
• category 1: CD4 cell count > 500
• category 2: CD4 cell count 200-499
• category 3: CD4 cell count < 200

Question 10

Signs/symptoms of acute HIV

Answer 10

• fever
• fatigue
• rash
• headache
• lymphadenopathy
• pharyngitis
• arthralgia
• myalgia
• night sweats
• GI problems
• aseptic meningitis
• oral/genital ulcers

Question 11

Opportunistic infections

Answer 11

• categorized by type of organism
• bacterial: pneumonia, TB
• fungal: candidiasis
• protozoal
• viral: herpes, cytomegalovirus

Question 12

Respiratory manifestations

Answer 12

• P. jiroveci: bacterial in environment that multiplies quickly in lungs, thickens alveoli walls
• pulmonary TB: leading cause of death for people with hIV

Question 13

GI tract manifestations

Answer 13

• diarrhea or gastroenteritis

- esophagitis: esophageal candidiasis (thrush), CMV, herpes simplex

Question 14

Nervous system manifestations

Answer 14

• HIV-associated neurocognitive disorders (HANDs)