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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
The CDC estimates that about how many ppl are infected w/ HIV each year?
50,000
26
The CDC estimates how many new cases were in the US in 2014?
44k
27
How many children worldwide are living with HIV?
2.6 million
28
How many people in the US are living with HIV?
1.2 million
29
What are the ways new HIV infections are transmitted, from most common to least common.
1. MSM, 63% 2. Heterosexual Sex 25% 3. Injuection/drug use 8% 4. MSM + IDU 3%
30
What are the top 3 races in the US who are dx with new HIV ??
1. African American 2. Whites 3. Hispanic/Latinos
31
At what years o age should routine screening be performed?
16-65 years
32
Awarness of HIV status decreased engagement of high risk sexual behavior by what %?
68%
33
What caused a decrease in HIV infections in the mid 90s?
Introduction of HAART medication | Highly active anti-viral therapy
34
If a patient has an HIV infection that goes untreated, how long will they live?
10 years
35
HIV attacks what 2 cells?
1. T-cells | 2. Macrophages
36
What % of HIV infected patients will be treated for an HIV-associated eye disorder during their illness?
70-80%
37
What are the 3 genes common to all retroviruses?
Gag Pol Env
38
Antibodies to these 2 proteins will be found in your blood when determining if HIV is present.
1. Capsid protein 24 | 2. Matrix protein 17
39
What is the host cell receptor for HIV?
CD4 receptor
40
What are the 2 cytokine receptors needed to help dock HIV besides GP 160?
CCR5 and CXVR4
41
If pregnant woman is infected with HIV, what drug will she take to prevent giving it to her baby?
AZT - Zidovudine
42
What is the % chance the newborn will get HIV if mother is treated and untreated with AZT?
Treated - 8% | Untreated- 25%
43
What is the risk of being infected by HIV after being stuck by a hollow bore needle from an HIV positive patient ?
0.3%
44
The chimpanzee version of HIV is what
SIV - Simian immunodficiency virus (a zoonotic disease)
45
This is when amicrobe jumps from a nonhuman to a human host. What do virologists call this?
Zoonoses | called Global viral forecasting
46
What is the most common HIV clade in North America? How is it spread?
- Clade B | - Anal sex
47
HIV-1 major strains are found mainly in what species?
Chimpanzees
48
HIV-2 major strains are mostly found in what species?
Sooty Mangabeys
49
HIlary Koprowsky possibly gave africans HIV by doing what?
Using chimpanzee kidneys to make polio oral vaccine (called CHAT)
50
HAART inhibits what 2 HIV enzymes? What does it do?
- inhibits Protease and Reverse Transcriptase | - decreases HIV virus in blood and increases CD4 T cells
51
This type of HAART drug inhibits RT by being incorporated into the newly synthesized viral DNA and preventing its eongation
Nucleoside (Nukes) and Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
52
This type of HAART inhibits RT directly by binding to the enzyme and interfering with its function
Non-Nucleoside Reverse Transcriptase Inhibitors (Non-Nukes)
53
HIV increases the risk of a MI by what %?
50%
54
What is the best HAART med for HIV patients?
Atripla - contains all the meds they need in one drug
55
When should a patient start HAART?
Immediately, at diagnosis
56
After 5 years of HAART and VL < 40, what % of adults have below normal CD4 tcells?
20%
57
What are the most common side effects of HARRT treatment?
1. diarrhea 2. nausea 3. vomiting 4. hyperglycemia/DM 5. Liver Toxicity
58
What % of patients stop HAART tx w/in the first year bc of side effects?
25%
59
What medication do patients take before having sexual intercourse with an HIV partner?
Truvada - combo of tenofovir & emtricitabine
60
What % of AIDs patients have ocular involvement??
75%
61
What's the most common of the ocular conditions found with HIV?
Severe dry eye; virus attacks the lacrimal gland
62
Syphillis can affect an HIV patient at what CD4 count?
Any CD4 count
63
Mycobacteria/Tuberculosis affects an HIV patient at what CD4 count?
< 350
64
Cryptococcal Choroiditis affects an HIV patient at what CD4 count?
< 200
65
Penumocystis Carinii Choroiditis affects an HIV patient at what CD4 count?
< 200
66
Toxoplasmosis affects an HIV patient at what CD4 count?
< 200
67
Candida Chorioretinitis affects an HIV patient at what CD4 count? What's the tx?
< 200 | - Amphotericin B and Fluconazole
68
Histoplasmosis affects an HIV patient at what CD4 count?
< 100
69
CMV affects an HIV patient at what CD4 count?
< 50
70
What are the 4 opportunistic infections of the brain?
1. Cryptococcal Meningitis 2. HIV-related Encephalopathy 3. Progressive Multifocal Leukoencephalopathy (PML) 4. Toxoplasmosis
71
What are the two most common AIDS defining malignancies ?
1. Kaposi Sarcoma | 2. Lymphoma
72
What are the 3 common bacterial AIDS defining infections ?
1. Mycobacterium TB 2. Strep Pneumoniae 3. Salmonella
73
What are common viral AIDS defining infections ?
1. CMV 2. JC virus 3. EB virus 4. HSV 1/2 5. HHV 8
74
What are common fungal AIDS defining infections?
1. Candida 2. Cryptococcus 3. Histoplasma
75
What tests are used to dx HIV?
1. ELISA - initial sceening 2. WB - confirmatory 3. Genotyping 4. Tropism assay
76
If an HIV patient has a CD4 count > 250, when should they RTC?
1 year
77
If an HIV patient has a CD4 count 50-150, when should they RTC?
6 months
78
If an HIV patient has a CD4 count < 50, when should they RTC?
3 months
79
What is the definition of AIDs?
1. CD4 count < 200 | 2. Detection of opportunistic infection
80
How would you treat HIV retinopathy?
- no tx needed | - does not correlate w/ clinical severity of HIV
81
What ocular findings are present in HIV retinopathy?
1. CWS 2. Hemes 3. Microvascular disease
82
The fulminant form of CMV retinitis starts where?
- starts along arcades in posterior pole and goes to periphery
83
The indolent form of CMV retinitis starts where?
- can start in the periphery or posterior pole
84
What % of CMV retinitis pts will have a retinal detachment?
40%
85
Foscarnet is a tx for CMV that is administered how?
- through IV line
86
Ganciclovir is a tx for CMV that is administered how?
through IV line followed by capsules
87
Ganciclovir implants is a tx for CMV that is administered how?
Sx implanted directly into the eye
88
Cidoforvir is a tx for CMV that is administered how?
Through IV line
89
Valganciclovir is a tx for CMV that is administered how?
tablets
90
Fomirirsen is a tx for CMV that is administered how?
Intravitreal injection
91
What happens to a low CD4 count patient when they're put on HAART therapy? HOw do you treat it?
- Immune recovery retinitis | - cycloplege, or steroid injection
92
Acute retinal necrosis starts where?
Starts in periphery, goes circumferential and then goes toward posterior pole
93
What % of ARN patients get an exudative retinal detachment?
75%
94
What causes ARN?
- Varicella Zoster - HSV - Toxoplasmosis - CMV
95
How do you treat ARN?
- Acyclovir | - Ganciclovir
96
What is the tx for Toxoplasmosis?
- Pyrimethamine - Sulfadiazine - Folinic Acid - Steroids - Clindamycin - Bactrim
97
Acquired toxoplasmosis occurs where in the retina?
Mid-periphery
98
Tuberculosis mainly affects what area of the eye? Is a vitritis present
- Choroid via Choradal Tubercles | - no vitritis
99
What is the most common presentation of ocular TB?
Posterior Uveitis
100
What is the tx for ocular TB?
- Isoniazid - Rifampin - Pyrazinamide - Ethambutol

Post. Seg 2 (4 decks)

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