Porth Chapter 16 Flashcards

1
Q

Characteristics of AIDS

A

Profound immunosuppression ​

Associated opportunistic infections​

Malignancies​

Wasting​

Central nervous system degeneration

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2
Q

AIDS Epidemic and Transmission of HIV

A

Caused by HIV​

Occurs worldwide​

There is no cure.​

Transmitted through blood, semen, vaginal fluids, and breast milk​

Not spread by casual contact or insects​

Is infectious, even if the person is asymptomatic

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3
Q

Cells Affected by the HIV

A

A subset of lymphocytes called CD4+ T lymphocytes (also known as T-helper cells or CD4+ T cells)​

Macrophages​

Dendritic cells

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4
Q

Functions of the CD4+ T Cells

A

Necessary for normal immune function​

Recognizes foreign antigens ​

Helps activate antibody-producing B lymphocytes​

Orchestrates cell-mediated immunity​

Influences the phagocytic function of monocytes and macrophages

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5
Q

Life Cycle of the HIV-1

A

Attachment of the HIV to CD4+ receptor​

Internalization and uncoating of the virus with viral RNA and reverse transcriptase​

Reverse transcription, which produces a mirror image of the viral RNA and double-standard DNA molecule​

Integration of viral DNA into host DNA using the integrase enzyme
Transcription of the inserted viral DNA to produce viral messenger RNA​

Translation of viral messenger RNA to create viral polyprotein​

Cleavage of viral polyprotein into individual viral proteins that make up the new virus​

Assembly and release of the new virus from the host cell

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6
Q

Three Phases of HIV Infection

A

Primary infection phase​

Chronic asymptomatic or latency phase​

Overt AIDS phase

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7
Q

CDC HIV/AIDS Classification System

A

The clinical importance of the CD4+ cell count in the categorization of HIV-related clinical conditions ​

Category 1: >500 cells/μL​

Category 2: 200 to 499 cells/μL​

Category 3: <200 cells/μL

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8
Q

Unique Opportunity for Treatment in the Primary Infection Phase

A

Reduce the number of long-living HIV-infected cells (e.g., CD4+ memory cells)​

Protect the functioning of HIV-infected CD4+ T cells and cytotoxic T cells​

Help maintain a homogeneous viral population that will be better controlled by antiretroviral therapy and the immune system

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9
Q

Typical progressors

A

60% to 70% acquire AIDS 10 to 11 years after infection​

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10
Q

Rapid progressors

A

10% to 20% progress rapidly and acquire AIDS in less than 5 years ​

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11
Q

Slow progressors

A

5% to 15% are slow progressors, who do not progress to AIDS for more than 15 years​

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12
Q

Long-term nonprogressors

A

1% have been infected for at least 8 years, are antiretroviral naive, have high CD4+ cell counts, and have usually very low viral loads ​

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13
Q

Consequences of CD4+ Death

A

Opportunistic infections​

Malignant tumors​

Nervous system manifestations​

The wasting syndrome​

Metabolic disorders

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14
Q

Bacterial Opportunistic Infections

A

Bacterial pneumonia, TB, Salmonella bacteremia, Mycobacterium avium–intracellulare complex (MAC)

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15
Q

Fungal Opportunistic Infections

A

Candidiasis, coccidiomycosis, cryptococcosis, and histoplasmosis

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16
Q

Protozoal Opportunistic Infections

A

Cryptosporidiosis, isosporiasis, pneumocystiasis, and toxoplasmosis

17
Q

Viral Infections

A

Cytomegalovirus (CMV), herpes, and progressive multifocal leukoencephalopathy (PML)

18
Q

Most Common Opportunistic Infections Affecting AIDS in the United States

A

Pneumocystis carinii pneumonia (PCP)​

CMV​

Oropharyngeal or esophageal candidiasis (thrush)​

Infections caused by MAC

19
Q

Signs and Symptoms of Acute HIV Infection

A

Fever​

Fatigue​

Rash​

Headache​

Lymphadenopathy​

Pharyngitis
Arthralgia​

Myalgia​

Night sweats​

Gastrointestinal problems​

Aseptic meningitis​

Oral or genital ulcers

20
Q

Respiratory Manifestations Associated with AIDS

A

PCP​

Pulmonary tuberculosis (TB)​

CMV, MAC​

Toxoplasma gondii​

Cryptococcus neoformans​

Streptococcus pneumoniae​

Haemophilus influenzae​

Legionella pneumophila​

Kaposi sarcoma

21
Q

Diseases of the Gastrointestinal Tract Associated with AIDS

A

Diarrhea or gastroenteritis​

Cryptosporidium parvum​

Esophagitis​

Esophageal candidiasis (thrush)​

CMV infection​

Herpes simplex virus infection

22
Q

Nervous System Manifestations Associated with AIDS

A

AIDS dementia complex (ADC)​

Toxoplasmosis​

PML​

These disorders can affect the peripheral or central nervous system (CNS).

23
Q

Cancers and Malignancies Associated with AIDS

A

Kaposi sarcoma​

Non-Hodgkin lymphoma​

Noninvasive cervical carcinoma

24
Q

Wasting Syndromes

A

Factors that contribute to wasting ​

Anorexia​

Endocrine dysfunction​

Malabsorption​

Cytokine dysregulation​

Characteristics​

Involuntary weight loss of at least 10% of baseline body weight, presence of diarrhea, more than two stools per day, chronic weakness, and fever

25
Q

Metabolic and Morphologic Disorders Associated with HIV/AIDS

A

Lipodystrophy and mitochondrial disorders​

Hypercholesterolemia​

Hypertriglyceridemia​

Insulin resistance​

Impaired glucose tolerance

26
Q

Transmission of HIV and Prevention

A

Transmission​

Intravenous drug use​

Risky/unsafe sexual behavior​

Prevention​

Personalized risk assessment ​

Prevention plan​

Education ​

Behavioral intervention

27
Q

Diagnostic Methods Used for HIV Infection

A

Laboratory methods to determine infection ​

HIV antibody test​

Western blot test​

OraSure test​

Polymerase chain reaction (PCR)​

Clinical methods to evaluate the progression of the disease

28
Q

Treatment for HIV Following Diagnosis

A

Baseline evaluation​

Complete history​

Physical examination ​

Baseline laboratory tests​

Routine follow-up care

29
Q

Criteria for Therapeutic Interventions for HIV/AIDS

A

Determined by the level of disease activity based on​

the viral load​

the degree of immunodeficiency based on the CD4+ cell count​

the appearance of specific opportunistic infections

30
Q

HIV Antiretroviral Medications

A

Nucleoside reverse transcriptase inhibitors​

Nucleotide analog reverse transcriptase inhibitors​

Nonnucleoside reverse transcriptase inhibitors​

Protease inhibitors​

Fusion inhibitors

31
Q

Psychosocial Issues Associated With HIV/AIDS

A

The dramatic impact of this illness is compounded by complex reactions on the part of the person with HIV or AIDS; his or her partner, friends, and family; members of the health care team; and the community.​

Hidden lifestyle impact on support persons​

Depression ​

Anxiety disorders ​

Alcohol ​

Drug problems

32
Q

HIV Infection in Pregnancy, Infants, Children

A

HIV can be passed from mother to infant.​

During labor and delivery​

Through breast-feeding​

Diagnosis of HIV infection in children born to HIV-infected mothers is complicated by the presence of maternal HIV antibody, which crosses the placenta to the fetus.​

The course of HIV infection is different for children than adults.