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med n surg S2 > paeds - HIV > Flashcards

paeds - HIV Flashcards

1
Q

words to use

A
  • HIV disease not infection (infection stigma of being contagious, threat, unclean)

people living with HIV not HIV infected ppl (ppl w/ HIV emphasises humanity)

perinatal/ vertical transmission not mother-to-child

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2
Q

how do children acquire HIV

A
  • Vertical Transmission
  • Accounts for > 95% of cases
  • ‘Horizontal’ transmission
  • Unexplained
  • Blood transfusion transmission
  • Sexual abuse
  • Wet nursing
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3
Q

% pregnant women in SA are HIV +

A

31%

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4
Q

transmission - mother to child / vertical / perinatal

A
  • 1 in 4 babies born HIV+ (25%) if no intervention offered
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5
Q

transmission types in children

A
  • intrapartum 60%
  • breastfeeding 30%
  • in utero 10%
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6
Q

HAART transmission %

A

from 20-40% to 2%

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7
Q

stages of grief cycle & emotions

A

SAD DAE (day)

guilt
fear
depression

  1. shock & denial
  2. anger
  3. depression and detachment
  4. dialogue & arguing
  5. acceptance
  6. empowerment
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8
Q

HIV/ AIDS staging for infants and children

A

stage 1 (HIV) -> stage 4 (AIDS)

stage 1 - asymptomatic
stage 2 - mild disease
stage 3 - advanced
stage 4 - severe

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9
Q

HIV/ AIDS staging for infants and children - stage 1

A
  1. Asymptomatic – i.e displays NO symptoms
  2. PGL - Persistent generalized lymphadenopathy
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10
Q

HIV/ AIDS staging for infants and children - stage 2

A

In 2s = HH PP RR L

  • Hepatosplenomegaly
  • Herpes zoster / shingles (blistered rash)
  • Papular pruritic eruptions
  • Parotid enlargement
  • Recurrent oral ulcerations
  • Recurrent or chronic URTI
  • Lineal Gingival Erythema (LGE) angular chelitis

seen in OPD/GP

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11
Q

HIV/ AIDS staging for infants and children - stage 3

A

3rd stage: 4P Minus One CHaiN

  • Pulmonary TB
  • persistent diarrhoea Unexplained (14 days or more)
  • persistent fever Unexplained, for longer than 1month)
  • pneumonia Severe recurrent presumed bacterial
  • malnutrition Unexplained moderate
  • Oral candidiasis (outside neonatal period )
  • Chronic HIV associated lung disease
  • haematologic abnormalities Unexplained - anaemia, neutropenia or thrombocytopenia for more than 1 month
  • Necrotising ulcerative gingivitis/periodontitis

admitted to wards

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12
Q

HIV/ AIDS staging for infants and children - stage 4

A

WEEP CCCRacK Here

  • Wasting Unexplained severe
  • Extrapulmonary cryptococcosis including meningitis
  • Extrapulmonary tuberculosis
  • PCP
  • Chronic Cryptosporidiosis
  • Chronic Herpes simplex infection
  • Cytomegalovirus (CMV) infection
  • Recurrent severe presumed bacterial infections (excl. pneumonia)
  • Kaposi’s sarcoma
  • HIV encephalopathy
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13
Q

HIV direct effect on CNS

A

HIV encephalopathy

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14
Q

HIV indirect effect on CNS

A

TO VIDeo

secondary to illnesses and therefore delayed development

  • Tumours
  • Opportunistic infections (OIs)
  • Vasculitides
  • IRIS –immune reconstitution syndrome
  • Drug related phenomena (like with Efavirenz)
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15
Q

unrelated to HIV effects on CNS

A
  • birth related brain injury
  • foetal alcohol syndrome
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16
Q

HIV encephalopathy diagnosis

A

B SAACC R

long term disability
* birth hx
* Slow achievement or loss of milestones or loss of intellectual ability
* Acquired microcephaly
* Acquired symmetrical motor deficits in an alert child - increased tone, pathologic reflexes, ataxia, gait disturbances, paresis
* CSF is normal or has non-specific findings
* CT scan shows diffuse brain atrophy
* Rule out CNS infections/conditions

17
Q

HIV encephalopathy Rx

A

HAART+multidisciplinary team approach

Later management – spasticity, tendon procedures, Botox

18
Q

role of primary healthcare workers

A
  • Promotive – as HCWs need to empower through knowledge dissemination
  • recognize HIV signs and symptoms
  • Preventive – specific HIV preventive strategies
  • HIV can be prevented
  • Rehabilitative – to avoid long term complications
  • Understand the complications & mx
  • Curative – part of MDT providing care and
    treatment
  • counsel patients and their families
19
Q

severe pneumonia & recurrent how to help

A
  • support in ICU
  • sputum collection
  • HEP
  • rx
20
Q

why to treat neurodevelopment disability

A
  • prevent complications

med n surg S2 (18 decks)

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