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4 MBCHB > REPRO 8 > Flashcards

REPRO 8 Flashcards

1
Q

what does HIV cause

A

acquired immunodeficiency syndrome (AIDS)

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2
Q

what kind of virus is HIV and how does it transcribe itsself

A

RNA

reverse replication

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3
Q

HIV 2 is what

A

less virulent and less likely to cause AIDS

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4
Q

what does HIV do to the CD4 count leading to what

A

decreases it

increased susceptibility to viral, fungal, bacterial infections and infection induced cancers

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5
Q

normal CD4 count

when can you get oppertubnisitc infection

A

500-1600
<200 high risk
but 200-500 can still get

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6
Q

how foeti doe HIV replicate

A

every 6-12 weeks new gen

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7
Q

how does the infection establish itself

A

infection of mucosal CD4 langerhan cells and dendritic cells -> regional LNs inflectional established within 3 days. replication and dissemination

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8
Q

who is at higher risk of HIV

A

MSM

low seocioeconomis status

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9
Q

how many people present with symptoms after primary infection
how long after and what are the symptoms

A

80% 2-4 w after infection

fever, maculopapular rash, myalgia, pharyngitis, headache, aseptic meningits

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10
Q

v high risk of what in primary HIV infection

A

transmission

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11
Q

asymp HIV infection what is happening

what is there still a risk of

A

ongoing viral replication and CD 4 count depletion

ongoing transmission if remains undiagnosed

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12
Q

pneumocystis pneumonia caused by what
CD4 count what
symp

A

pneumocystis jiroveci
<200
dry cough, insidious onset, exercise desaturated

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13
Q

CXR of pneumocystis pneumonia

dx

A

intestinal infiltrates, retinodular marking, can be normal

BAL and immunofluorescence +/- PCR

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14
Q

treatment of pneumocystis pneumonia

proph

A

high dose co -trimox +/- steroid

low dose co trim

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15
Q

TB is what in HIV px
types
what is IRS

A

more common
symptomatic primary, reactivation, military, extra pulmonary, multi drug resistant
immune reconstruction syndrome - immune system is reactivated but is much more aggressive

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16
Q

cerebral toxoplasmosis CD4
ae
what can HIV cause

A

<150
toxoplasmosis gondii
cause reactivation of latent infection

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17
Q

symptoms of cerebral toxoplasmosis

A

multiple cerebral abscesses, chorioretinitis, headache, fever, focal neuro, seizures, reduced consciousness, increased ICP

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18
Q

MRI of cerebral toxoplasmosis

A

MRI ring enhancing lesions

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19
Q

cytomegalovirus caused by what
CD4
what can HIV cause

A

CMV
<50
reactivation of latent virus - retinitis, oesophagi’s, colitis

20
Q

symptoms of cytomegalovirus

A

decreased visual acuity, floaters, abdominal pain, diarrhoea, PR bleeding

21
Q

screening for cytomegalovirus

A

ophthalmic screening for all patients with cd4<50

22
Q

skin infections include what

A 
recurrent herpes zoster
herpes simplex
HPV
pencillosis
histoplasmosis
23
Q

HIV associated neurocognitive symptoms CD4 count
cause
symp

A

any CD4 count - associated with increased immunosuppression

HIV1

reduced short term memory +/- motor dysfunction

24
Q

progressive multifocal leucoencephalopathy caused by what CD4
symptoms

A

JC virus - reactivation of latent virus
<100
rapid progression, personality change, focal neuro, seizures

25
Q

neuropresentations of HIV related to what

A

related to viral replication
distal sensory polyneuropathy, mononeuritis multiplex, vascular myelopathy, aseptic meningitis, GBS, viral meningitis - CMV, HSV, cryptococcal menignitis

26
Q

haematological occur when

what

A

increased incidence with increased immunosuppression

malignancies, anaemia, thrombocytopenia

27
Q

HIV associated wasting - slims disease cause

A

metabolic
anorexia
malabsorption/diarrhoea
hypergonadism

28
Q

Non OI symptoms of HIV

A

mucosal candidsis, sebbhoreic derm, diarrhoea, fatigue, worsening psoriasis, LD, STIs, hep B/C

29
Q

karposki’s sarcoma caused by what

CD4

A

HHV 8

risk increased with increased immunodeficiency

30
Q

karposkis symptoms
more common in who
rx

A

vascular tumour. cutaneous. mucosal. visceral - pulmonary, GI

MSM

HAART. local like systemic chemo for visceral

31
Q

NHL caused by what

CD4 what

A

EBV

increased risk with increased immunodefic

32
Q

NHL symp

rx

A

bone marrow involvement. extranodal disease. increased CNS involvement

HAART

33
Q

cervical cancer caused by what

what is done in HIV px

A

HPV

screening every year rather than every 3 years

34
Q

sexual transmission of HIV in MSM
MSW
what increases the risk

A

51%
45%
concurrent STIs, unreceptive sex, trauma, genital ulceration

35
Q

parental transmission of HIV

A

IVDU, infected blood products, iatrogenic

36
Q

maternal transmission of HIV - how 3

whats the risk and whats the risk when the viral load is undetectable at delivery

A

inutero/transplacental. delivery. breast feeding

1-2%. <0.1%

37
Q

three main groups that are tested

A

high prevelance areas
opt out
high risk

38
Q

who are the opt outs

A

GUM, TOP, drug dependancy, antenatal, conception screening

39
Q

who are the high risk groups

A

MSM, female partner of bisexual man, drug infections, partners of HIV px, people from endemic areas

40
Q

what is the antigen tested for in HIV

A

p24

41
Q

rapid hiv testing - what is used
when do results come
whats the neg

A

fingerprick. saliva.
within 20-30 mins
expensive

42
Q

treatment is what

A

HAART

two NRTI and either a protease inhibitor or a NNRTI

43
Q

how to prevent drug resistance

A

compliant

44
Q

prevention of HIV 4

A

treatment. condoms. STI screening and prophylaxis. post/pre exposure proph

45
Q

wanna be pregnancy and HIV positive female

negative male

A

insemination and HAART

46
Q

wanna be pregnant and HIV positive male and negative female

A

UPSI and HAART

47
Q

prevention of maternal transmission
when can woman delivery vaginally
can she breastfeed
what should be given to the neonate

A

HAART during pregnancy
if viral load undetectable
no
4 weeks of PEP

4 MBCHB (80 decks)

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