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Post. Seg 2 > P1: Inflammatory Conditions and Communicable Diseases > Flashcards

P1: Inflammatory Conditions and Communicable Diseases Flashcards

1
Q

What are the top 2 STDs in the country?

A
  1. Chlamydia

2. HPV

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2
Q

What part of the brain does the retina extend from?

A

Diencephalon

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3
Q

How much money is spent annually on STDs?

A

$16 billion

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4
Q

How many cases of STDs are reported annually in the US?

A

20 million

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5
Q

What % of the 20 million reported cases occur between the ages of 15-24.

A

50%

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6
Q

_ in _ teenage girls has an STD (>3 million cases)

A

1 in 4

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7
Q

Name the 7 STDs on the ocular-genital axis.

A
  1. Syphilis
  2. Chlamydia
  3. Pediculosis
  4. Gonorrhea
  5. HIV
  6. HSV
  7. Hepatitis B
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8
Q

What ocular disease is found in HIV/AIDs patients with a CD count of under 50?

A

Cytomegalovirus Retinitis

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9
Q

Cytomegalovirus Retinitis can cause what disease?

A

Encephalopathy

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10
Q

What’s a normal CD4 Tcell count?

A

> or equal to 1000

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11
Q

AIDs is dx in a patient when the CD4 count is what?

A

<200

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12
Q

What type of cancer was found in HIV patients, specifically homosexual men?

A

Kaposi Sarcoma

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13
Q

What type of opportunistic infection was first described in 1981 by the MMWR?

A

Pneumocystis Pneumonia

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14
Q

This research study was initiated to determine what the practitioner needs to know about HIV.

A

SOCA - Studies of Ocular Complications of AIDs

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15
Q

This research study is a subset of SOCA that examines the risk of complications over time and effects of long-term tx, visual function, quality of life and survival.

A

LSOCA - Longitudinal Study of Ocular Complications of AIDs

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16
Q

What are the 2 important clinical retroviruses?

A

HIV and HTLV-1 (Human T-cell Lymphotropic Virus)

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17
Q

Why is there no vaccine for HIV?

A

The genes that make up the glycoprotein compound are constantly altered

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18
Q

What are the 2 main glycoproteins of HIV? What is it called when they’re together?

A
  • GP 120
  • GP 41
  • together = GP 160
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19
Q

What is found inside the HIV retrovirus??

A

Reverse transcriptase
Integrase
Protease

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20
Q

What does HTLV-1 do?

A

Causes t-cells to proliferate uncontrollably

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21
Q

In the U.S., HIV is mainly spread through what 2 things?

A
  1. Sexual behaviors

2. Needle or syringe use

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22
Q

How many people are currently living with HIV around the world?

A

34 - 36 million

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23
Q

__ in ___ ppl living with HIV are unaware of their infection

A

1 in 8 ppl

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24
Q

In the US, what % of HIV cases are male and female?

A

80% are male

20% are female

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25
Q

The CDC estimates that about how many ppl are infected w/ HIV each year?

A

50,000

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26
Q

The CDC estimates how many new cases were in the US in 2014?

A

44k

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27
Q

How many children worldwide are living with HIV?

A

2.6 million

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28
Q

How many people in the US are living with HIV?

A

1.2 million

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29
Q

What are the ways new HIV infections are transmitted, from most common to least common.

A
  1. MSM, 63%
  2. Heterosexual Sex 25%
  3. Injuection/drug use 8%
  4. MSM + IDU 3%
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30
Q

What are the top 3 races in the US who are dx with new HIV ??

A
  1. African American
  2. Whites
  3. Hispanic/Latinos
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31
Q

At what years o age should routine screening be performed?

A

16-65 years

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32
Q

Awarness of HIV status decreased engagement of high risk sexual behavior by what %?

A

68%

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33
Q

What caused a decrease in HIV infections in the mid 90s?

A

Introduction of HAART medication

Highly active anti-viral therapy

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34
Q

If a patient has an HIV infection that goes untreated, how long will they live?

A

10 years

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35
Q

HIV attacks what 2 cells?

A
  1. T-cells

2. Macrophages

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36
Q

What % of HIV infected patients will be treated for an HIV-associated eye disorder during their illness?

A

70-80%

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37
Q

What are the 3 genes common to all retroviruses?

A

Gag
Pol
Env

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38
Q

Antibodies to these 2 proteins will be found in your blood when determining if HIV is present.

A
  1. Capsid protein 24

2. Matrix protein 17

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39
Q

What is the host cell receptor for HIV?

A

CD4 receptor

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40
Q

What are the 2 cytokine receptors needed to help dock HIV besides GP 160?

A

CCR5 and CXVR4

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41
Q

If pregnant woman is infected with HIV, what drug will she take to prevent giving it to her baby?

A

AZT - Zidovudine

42
Q

What is the % chance the newborn will get HIV if mother is treated and untreated with AZT?

A

Treated - 8%

Untreated- 25%

43
Q

What is the risk of being infected by HIV after
being stuck by a hollow bore needle from an
HIV positive patient ?

A

0.3%

44
Q

The chimpanzee version of HIV is what

A

SIV - Simian immunodficiency virus (a zoonotic disease)

45
Q

This is when amicrobe jumps from a nonhuman to a human host. What do virologists call this?

A

Zoonoses

called Global viral forecasting

46
Q

What is the most common HIV clade in North America? How is it spread?

A
  • Clade B

- Anal sex

47
Q

HIV-1 major strains are found mainly in what species?

A

Chimpanzees

48
Q

HIV-2 major strains are mostly found in what species?

A

Sooty Mangabeys

49
Q

HIlary Koprowsky possibly gave africans HIV by doing what?

A

Using chimpanzee kidneys to make polio oral vaccine (called CHAT)

50
Q

HAART inhibits what 2 HIV enzymes? What does it do?

A
  • inhibits Protease and Reverse Transcriptase

- decreases HIV virus in blood and increases CD4 T cells

51
Q

This type of HAART drug inhibits RT by being incorporated into the newly synthesized viral DNA and preventing its eongation

A

Nucleoside (Nukes) and Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

52
Q

This type of HAART inhibits RT directly by binding to the enzyme and interfering with its function

A

Non-Nucleoside Reverse Transcriptase Inhibitors (Non-Nukes)

53
Q

HIV increases the risk of a MI by what %?

A

50%

54
Q

What is the best HAART med for HIV patients?

A

Atripla - contains all the meds they need in one drug

55
Q

When should a patient start HAART?

A

Immediately, at diagnosis

56
Q

After 5 years of HAART and VL < 40, what % of adults have below normal CD4 tcells?

A

20%

57
Q

What are the most common side effects of HARRT treatment?

A
  1. diarrhea
  2. nausea
  3. vomiting
  4. hyperglycemia/DM
  5. Liver Toxicity
58
Q

What % of patients stop HAART tx w/in the first year bc of side effects?

A

25%

59
Q

What medication do patients take before having sexual intercourse with an HIV partner?

A

Truvada - combo of tenofovir & emtricitabine

60
Q

What % of AIDs patients have ocular involvement??

A

75%

61
Q

What’s the most common of the ocular conditions found with HIV?

A

Severe dry eye; virus attacks the lacrimal gland

62
Q

Syphillis can affect an HIV patient at what CD4 count?

A

Any CD4 count

63
Q

Mycobacteria/Tuberculosis affects an HIV patient at what CD4 count?

A

< 350

64
Q

Cryptococcal Choroiditis affects an HIV patient at what CD4 count?

A

< 200

65
Q

Penumocystis Carinii Choroiditis affects an HIV patient at what CD4 count?

A

< 200

66
Q

Toxoplasmosis affects an HIV patient at what CD4 count?

A

< 200

67
Q

Candida Chorioretinitis affects an HIV patient at what CD4 count? What’s the tx?

A

< 200

- Amphotericin B and Fluconazole

68
Q

Histoplasmosis affects an HIV patient at what CD4 count?

A

< 100

69
Q

CMV affects an HIV patient at what CD4 count?

A

< 50

70
Q

What are the 4 opportunistic infections of the brain?

A
  1. Cryptococcal Meningitis
  2. HIV-related Encephalopathy
  3. Progressive Multifocal Leukoencephalopathy (PML)
  4. Toxoplasmosis
71
Q

What are the two most common AIDS defining malignancies ?

A
  1. Kaposi Sarcoma

2. Lymphoma

72
Q

What are the 3 common bacterial AIDS defining infections ?

A
  1. Mycobacterium TB
  2. Strep Pneumoniae
  3. Salmonella
73
Q

What are common viral AIDS defining infections ?

A
  1. CMV
  2. JC virus
  3. EB virus
  4. HSV 1/2
  5. HHV 8
74
Q

What are common fungal AIDS defining infections?

A
  1. Candida
  2. Cryptococcus
  3. Histoplasma
75
Q

What tests are used to dx HIV?

A
  1. ELISA - initial sceening
  2. WB - confirmatory
  3. Genotyping
  4. Tropism assay
76
Q

If an HIV patient has a CD4 count > 250, when should they RTC?

A

1 year

77
Q

If an HIV patient has a CD4 count 50-150, when should they RTC?

A

6 months

78
Q

If an HIV patient has a CD4 count < 50, when should they RTC?

A

3 months

79
Q

What is the definition of AIDs?

A
  1. CD4 count < 200

2. Detection of opportunistic infection

80
Q

How would you treat HIV retinopathy?

A
  • no tx needed

- does not correlate w/ clinical severity of HIV

81
Q

What ocular findings are present in HIV retinopathy?

A
  1. CWS
  2. Hemes
  3. Microvascular disease
82
Q

The fulminant form of CMV retinitis starts where?

A
  • starts along arcades in posterior pole and goes to periphery
83
Q

The indolent form of CMV retinitis starts where?

A
  • can start in the periphery or posterior pole
84
Q

What % of CMV retinitis pts will have a retinal detachment?

A

40%

85
Q

Foscarnet is a tx for CMV that is administered how?

A
  • through IV line
86
Q

Ganciclovir is a tx for CMV that is administered how?

A

through IV line followed by capsules

87
Q

Ganciclovir implants is a tx for CMV that is administered how?

A

Sx implanted directly into the eye

88
Q

Cidoforvir is a tx for CMV that is administered how?

A

Through IV line

89
Q

Valganciclovir is a tx for CMV that is administered how?

A

tablets

90
Q

Fomirirsen is a tx for CMV that is administered how?

A

Intravitreal injection

91
Q

What happens to a low CD4 count patient when they’re put on HAART therapy? HOw do you treat it?

A
  • Immune recovery retinitis

- cycloplege, or steroid injection

92
Q

Acute retinal necrosis starts where?

A

Starts in periphery, goes circumferential and then goes toward posterior pole

93
Q

What % of ARN patients get an exudative retinal detachment?

A

75%

94
Q

What causes ARN?

A
  • Varicella Zoster
  • HSV
  • Toxoplasmosis
  • CMV
95
Q

How do you treat ARN?

A
  • Acyclovir

- Ganciclovir

96
Q

What is the tx for Toxoplasmosis?

A
  • Pyrimethamine
  • Sulfadiazine
  • Folinic Acid
  • Steroids
  • Clindamycin
  • Bactrim
97
Q

Acquired toxoplasmosis occurs where in the retina?

A

Mid-periphery

98
Q

Tuberculosis mainly affects what area of the eye? Is a vitritis present

A
  • Choroid via Choradal Tubercles

- no vitritis

99
Q

What is the most common presentation of ocular TB?

A

Posterior Uveitis

100
Q

What is the tx for ocular TB?

A
  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol

Post. Seg 2 (4 decks)

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