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Opportunistic illnesses Flashcards

1
Q

What type of infections usually create more complications with HIV infections?

A

Opportunistic illnesses (OIs)

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2
Q

How are OIs suppressed?

A

with antimicrobial prophylaxis regimens in HIV and other immunocompromised patients

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3
Q

What is CD4 cell levels in AIDS?

A

<200/uL

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4
Q

T/F; A patient with >500/ul CD4 cells is generally not at a risk for an AIDS-defining OI

A

True

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5
Q

What pathogen causes primary or reinfection of latent infection TB?

A

M. Tuberculosis

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6
Q

What effect does Rifamycins have on CYP450?

A

Inducers

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7
Q

What does Rifamycin do to ART drugs?

A

decrease the plasma levels of ART drugs

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8
Q

What drugs replace rifampin in HIV patients; and why?

A

Rifabutin and Rifepentine; due to weaker CYP450 inducers

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9
Q

What Pathogen disseminates MAC in AIDS?

A

M. Avium

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10
Q

What does M. Intracellulare causes?

A

Pulmonary disease

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11
Q

What is the coverage of MAC infections?

A

Clarithromycin or Azithromycin + anti- TB drugs

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12
Q

T/F; Cytomegalovirus usually is activated in as a latent infection (Subacute) in AIDs pts?

A

True

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13
Q

When does CMV disease arises?

A

when CD4 count drops

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14
Q

How is CMV manifested?

A

Retinitis: Lesions occur near or on the retina; It causes irreversible blindness

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15
Q

What Medications cover CMV?

A

Ganciclovir, Valganciclovir, Foscarnet, Cidofovir

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16
Q

What pathogen reactivation cause Progressive Multifocal Leukoencephalopathy?

A

Papovavirus JC (JCV)

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17
Q

What organ is infected by JCV?

A

Gi tract and it remains latent

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18
Q

What is the pathogenesis of PML?

A

Virus reactivated in HIV pts

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19
Q

JCV destroys what part of body?

A

White matter of the brain

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20
Q

What pathogen causes Kaposi Sarcoma?

A

Human herpesvirus 8 (HHV8)

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21
Q

What immune cell is infected by HHV8?

A

infects B-cells

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22
Q

what is pathogenesis of of Kaposi’s Sarcoma?

A

Promote B-cells growth and prevent apoptosis

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23
Q

What effect does Kaposi’s Sarcoma have on skin cells?

A

cells from benign tumors (Skin cancer)

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24
Q

What causes Pneumocystis Pneumonia?

A

Pneumocystis Jirovecii pneumonia (PCP)

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25
Q

Is Pneumocytis pneumniea active in healthy patient, Why?

A

No, Suppressed by immune system via CD4 cells in healthy persons

26
Q

When does PCP in AIDS patients arises?

A

when immune system can no longer contain of latent organisms

27
Q

What is pathogenesis of PCP?

A

P. Jirovecii is a yeast-like fungi. the fungi are able to colonize and grow causing damage to alveoli

28
Q

How is PCP manifested?

A

reactivated latent infections in the lungs give rise to pneumonia (Fluid in the lungs)

29
Q

What is the coverage of PCP?

A

Bactrim and trimetrexate;
Pentamidine and atovaquone

30
Q

How do Bactrim and Trimetrexate work?

A

Bactrim and trimetrexate (used with leucovorin to reduce drug toxicity) inhibit folic acid synthesis in P. jirovecii.

31
Q

How do Pentamidine and atovaquone work?

A

inhibit electron transport (respiration = ATP synthesis) in P. jirovecii

32
Q

What is Cryptococcosis?

A

Cryptococcus neoformans is an opportunistic yeast

33
Q

Cryptococcosis occurs primarily in what patients?

A

in HIV pts

34
Q

How is Cryptococcosis transmitted?

A

by aerosol inhalation

35
Q

What is the pathogenesis of Cryptococcosis

A

Yeast spores germinate in alveoli. In AIDS pts, the CD4+ T-cells deficiency allows the disease to disseminate into the bloodstream and CNS

36
Q

What is the manifestation of of Cryptococcosis?

A

Occurs as meningoencephalitis in AIDS pts.
Causes pulmonary (Pneumonia) and Cryptococcal CNS disease

37
Q

What is Cryptococcal CNS disease?

A

Usually disseminates from lungs; Most common cryptococcosis presentation and it causes CNS lesions

38
Q

What is the coverage of Cryptiococcosis?

A

Amphotericin B,
Flucytosine,
Fluconazole

39
Q

How does Amphotericin B work? (Cryptococcosis)

A

causes leaks in ergosterol-rich fungal membranes; ADR = Nephrotoxic

40
Q

How does Flucytosine work? (Cryptococcosis)

A

given with amphotericin B; disrupts nucleic acid synthesis; ADR = Bone marrow suppression

41
Q

How does Fluconazole work? (Cryptococrossing)

A

Inhibits ergosterol synthesis; CYP3A4 inhibitor

42
Q

what is the most frequent OI occurring in nearly all AIDS pts that are not on anti fungal prophylaxis?

A

Candidiasis

43
Q

What is Candida?

A

commensal yeast of skin, genitals, and GI tract

44
Q

Describe the Pathogenesis of Candidiasis?

A

Candidiasis occurs when CD4 cells are depleted and candida can colonize mucocutaneous surface

45
Q

How is Candidiasis manifests?

A

Oropharyngeal and esophageal candidiasis

46
Q

What is the coverage for Candidiasis?

A

Azole antifungals (Fluconazole = Diflucan)
Echinocandins (caspofungin, micafungin)

47
Q

What are Protozoan infections?

A

Toxoplasmosis, Cryptosporidosis, Cystoisosporiasis

48
Q

What protozoa causes toxoplasmosis?

A

Toxoplasma gondii

49
Q

How does toxoplasmosis gets reactivated?

A

when CD4 count drops

50
Q

What does Toxoplasmosis looks like?

A

CNS mass lesions in AIDS pts

51
Q

Toxoplasmosis usually arises when?

A

When CD4 count drop

52
Q

How is Toxoplasmosis transmitted?

A

contact with cat feces (pregnant woman should avoid little box)

53
Q

What is the coverage of Toxoplasmosis?

A

Pyrimethamine + Sulfadiazine; Bactrim

54
Q

What causes Cryptosporidiosis?

A

Protozoan GI pathogen

55
Q

What is the epidemiology of Cryptosporidiosis?

A

Chronic diarrhea in HIV patients

56
Q

How is Cryptosporidiosis transmitted?

A

Fecal-oral, waterborne

57
Q

What medications cover Cryptosporidiosis?

A

Nitazoxanide

58
Q

What is Cystoisosporiasis epidemiology?

A

Cause diarrheal disease in HIV pts

59
Q

How is Cystoisosporiasis transmitted?

A

fecal-oral, waterborne

60
Q

What is the coverage of Cystoisosporiasis?

A

Bactrim

61
Q

T/F; HIV pts can also develop malignant B cell cerebral lymphoma that often present tumors containing cancerous cells infected with Epstein-Barr virus (human herpesvirus 4)

A

True

ID (13 decks)

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