Test 1 Study Deck Flashcards

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1
Q

What does AIDS stand for?

A

Acquired Immune Deficiency Syndrome

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2
Q

What is the average time between contracting HIV and getting AIDS?

A

10 years

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3
Q

Why is HIV resistant to anti-virals

A

The replicates as it mutates

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4
Q

What is currently used to treat HIV?

A

Combination treatment (one pill once a day or an injection every 2 months)

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5
Q

When did HIV emerge?

A

1920s

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6
Q

When was AIDS discovered?

A

1981

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7
Q

When was HIV discovered?

A

1983/84

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8
Q

When was combination therapy introduced?

A

1995

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9
Q

How many people are currently living with HIV?

A

35 million

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10
Q

How many people in the U.S. live with HIV?

A

1 million

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11
Q

What percent of people in the U.S. take HIV drugs?

A

85%

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12
Q

What percent of people living with HIV are receiving anti-viral treatment?

A

75%

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13
Q

When was the first HIV patient cured?

A

2009

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14
Q

Numeracy

A

the ability to understand and work with numbers

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15
Q

What are the steps of the scientific method?

A

Observation/question, hypothesis, experiment, analyze data, report conclusions

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16
Q

Pathogenic

A

able to cause diease

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17
Q

Vector Borne Diseases

A

disease that results from an infection transmitted to humans and other animals by blood-feeing arthropods (mosquitoes)

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18
Q

Zoonosis

A

a human gets infected by a pathogen from an animal

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19
Q

Name the 5 stages of animal virus to human virus

A
  1. cross-species, spillover
  2. primary infection
  3. limited outbreaks
  4. longer outbreak
  5. pandemic
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20
Q

epizootic

A

animal virus that kills a different animal

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21
Q

spillover

A

the transmission of a pathogen from an animal to a human

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22
Q

When was the first paper about HIV published?

A

1981

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23
Q

What happened in 1960?

A

In the DRC, the lymph node was studied, RNA was extracted and doctors were able to line up the HIV genome

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24
Q

TMRCA

A

Time to the Most Recent Common Ancestor

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25
Q

What is the virus in primates that is very similar to HIV?

A

SIV

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26
Q

Why did HIV become a pandemic?

A

social and cultural factors, globalization and mobility, stigmatization and denial, lack of awareness and education

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27
Q

disease triumphalism

A

an overconfidence in humanity’s ability to conquer diseases

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28
Q

HIV Emergence

A

Initially a mysterious and poorly understood virus, crossed from primates to humans in central Africa

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29
Q

Lack of effective treatment (1980s-1990s)

A

no effective antiretroviral drugs available to treat HIV; no medical means to slow down the progression of this disease

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30
Q

high mortality rates

A

due to cancer and infection

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31
Q

stigma and discrimination

A

hindered early detection and treatment

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32
Q

vulnerable populations

A

gay/bi men, intravenous drug users, sex workers, women and people with hemophilia

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33
Q

global spread

A

first high risk then people of all demographics, the lack of effective prevention and treatment contributed to rapid transmission

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34
Q

public health response

A

inadequate resources allocated for HIV prevention and treatment, public awareness was limited

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35
Q

community activism

A

ACT UP

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36
Q

What does ACT UP stand for?

A

Aids Coalition to Unleash Power

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37
Q

What percent of people living with HIV are women?

A

60%

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38
Q

GRID

A

Gay Related Immune Defiency

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39
Q

Describe the stigmatized “gay lifestyle”

A

too much sex, animal nitrates/poppers, lifestyle mediated

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40
Q

Things that need to happen for virus to be transmissible

A

physiologic conditions (virus needs to be exposed to someone else in the same conditions because it can’t live outside the body) and a high amount of virus exchanging from infected to the newly infected

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41
Q

undetectable viral load = ?

A

untransmissible

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42
Q

Where is the virus found?

A

Blood, semen, breast milk, female vaginal fluid

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43
Q

vertical transmission

A

mother to child

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44
Q

When were bi/gay men banned from donating blood?

A

1983/84

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45
Q

When were bi/gay men allowed to donate blood again

A

late 2022/early 2023

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46
Q

flamaging

A

10-15 years faster of internal ageing

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47
Q

Triple combo Therapy discovered

A

1995

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48
Q

FDA approves AZT, the first medication for AIDS

A

March 19, 1987

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49
Q

the number of reported AIDS cases in the U.S. reaches 100,000

A

1989

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50
Q

Congress enacts the Ryan White Care Act, providing funding for community-based care/treatment

A

1990

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51
Q

AIDS becomes the leading cause of death for all Americans ages 25-44

A

1994

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52
Q

The FDA approves the first protease inhibitor, introducing combination therapy as treatment

A

1995

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53
Q

Number of AIDS cases in the US declines for the first time

A

1996

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54
Q

565,000 people have HIV since 1981

A

2007

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55
Q

The FDA approves use of TRUVADA for pre-exposure

A

2012

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56
Q

35.3 million people living with HIV

A

2013

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57
Q

2019

A

second person with HIV cured

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58
Q

Rock Hudson

A

One of the first celebrities to die of AIDS, well known actor. Friend of Ronald Reagan.

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59
Q

Vito Russo

A

Influential activist “Silence = Death”

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60
Q

Howard Temin

A

Scientist who discovered the enzyme that is critical in HIV lifecycle (UW-Madison) and Nobel Peace Prize

61
Q

stonewall riots

A

On June 28, 1969, the Stonewall Inn, a gay bar in New York’s Greenwich Village, was raided by police. But instead of responding with the routine compliance the NYPD expected, patrons and a growing crowd decided to fight back. The five days of rioting that ensued changed forever the face of gay and lesbian life.

62
Q

GSO

A

Gay Service Organization

63
Q

1986 Supreme Court

A

found sodomy laws were legal, homosexual behavior could be crimminalized, right to privacy did not extend to “homosexual behavior”

64
Q

ASO

A

AIDS Service Organization

65
Q

How did ACT UP draw attention to the AIDS/HIV crisis?

A

through dramatic and flamboyant actions, made themselves impossible to ignore (chained themselves to fire hydrants, shut down wall street)

66
Q

“Right to try”

A

ACT UP won accelerated access to drugs also known as accelerated access trials or “emergency use authorization”

67
Q

placebo controlled

A

everyone can respond differently to drugs

68
Q

GCP

A

Good community practice, patient representatives/advocacy get a seat at the table because of ACT UP

69
Q

virus

A

An obligate intracellular parasite. It needs to invade a living cell in order to copy itself. They cannot make more of itself until they “proactively” infect a cell.

70
Q

genome

A

genetic material, can we DNA or RNA, surrounding protein cell/capsid; keeps viral genome safe and helps latch onto cell/wiggle inside

70
Q

envelope

A

greasy overcoat, amde form stolen shards of the last cell they infected to spread, a virus has to find a cell

71
Q

What does the capsid bind with?

A

outer protein on host cell

72
Q

polymerase

A

generates numerous copies of the virus’s genes to produce capsid subunits and other viral proteins

73
Q

lysing

A

when new viruses break the shell of the host cell

74
Q

budding

A

viruses wrap themselves with a piece of the infected cell and slip through the cells outer membrane; host rarely survives

75
Q

What cells does HIV infect?

A

CD4 T Helper Cells

76
Q

CD4 Receptor

A

surface receptor that binds to virus

77
Q

What happens when the virus binds to CD4?

A

causes a conformational change and allows a second receptor to grab hold of CCR5

78
Q

CCR5

A

another surface protein, stands for chemokine coreceptor

79
Q

How does the virus get into the cell after connecting with CCR5 and CD4?

A

the virus pierces through the virus into the host cell, drawing the cell and viral membrane together

80
Q

What happens after the membranes are drawn together?

A

capsid is disolved, releasing viral enzymes and RNA

81
Q

What does reverse transcriptase do?

A

Reverse transcriptase takes the viral RNA and using host nucleotides converts RNA into a single strand of DNA; reverse transcriptase then goes on to create the second strand, the product is double stranded DNA

82
Q

What does integrase do?

A

integrase cuts host chromosome and inserts HIV in the host chromosome

83
Q

What does RNA polymerase do?

A

Makes mRNA

84
Q

What does mRNA do?

A

docks at ER to add proteins; encodes for various viral proteins by associating with ribosomes at the surface of the endoplasmic reticulum (ER); some proteins are produced directly into the ER, others are shuttled

85
Q

What does the golgi apparatus do?

A

It shuttles newly created viral proteins and embeds them in the cellular membrane

86
Q

What does protease do?

A

Protease breaks up the polypeptide chains into integrase, reverse transcriptase and a new protease

87
Q

Broad species trophism

A

disease can infect numerous species

88
Q

amino acids

A

give proteins their shape based on interactions and fold

89
Q

nucleic acids

A

instructions for making proteins in cells

90
Q

DNA

A

blueprint for genome, made of A,T,C,G

91
Q

What does mRNA convert T to?

A

U

92
Q

What is mRNA?

A

intermediate instruction that encodes amino acid sequences

93
Q

apoptosis

A

programmed cell death when creating dysfunctional cells/proteins

94
Q

necrosis

A

cell explodes and content are spewed to surrounding area

95
Q

quiestence

A

cell is alive but in hibernation

96
Q

cell signaling

A

causes the cell to shut down when it detects that something has gone wrong

97
Q

Of apoptosis and necorsis, which is controlled?

A

apoptosis

98
Q

What is the capsid?

A

It protects viral RNA

99
Q

What encodes for the capsid?

A

GAG

100
Q

why is protease the target of antiretrovirals?

A

because HIV protease and human protease are different shapes, so the antiretrovirals only attack the HIV

101
Q

What do DNASe, RNASE and NUCLEASE do?

A

The degrade DNA and RNA

102
Q

How many base pairs are in the human genome?

A

3 billion base pairs

103
Q

How many base pairs is the HIV genome?

A

10,000 nucleotides

104
Q

Why does HIV mutate so frequently?

A

Because HIV’s reverse transcriptase can not proofread

105
Q

6 steps of HIV reproduction

A
  1. attachment and entry
  2. reverse transcription
  3. integration
  4. gene expression and viral genomic RNA production
  5. budding
  6. maturation
106
Q

lymphatic network

A

detects any infections that arise in the body

107
Q

What kinds of cells are usually found in the lymph node?

A

b cells

108
Q

b cells

A

these scan the body for foreign material; each one (there are billions in the body) detects only one kind of foreign infection

109
Q

The surface of b cells

A

are covered with receptors that recognize one bacteria/viral protein

110
Q

triggering activation signal

A

b cells grab hold of invasive proteins which trigger an activation signal to travel into the cell

111
Q

what does a b cell do once activiated?

A

it migrates and begins to replicate; in a few days thousands of copies of the selected cell are made

112
Q

clonal selection

A

one cell is selected out of billions of b cells and identical clones of it have been created, therefore, the cell is clonally selected

113
Q

what do b cells produce

A

protein antibodies, and then they release them into the surrounding fluid

114
Q

where do antibodies circulate

A

the blood and into tissues

115
Q

how do antibodies trigger immune response

A

they bond to protein hairs on the foreign bacteria, flagging them for destruction by the immune system; other immune cells inject the antibody covered bacteria to destory and eliminate the infection

116
Q

what shape are antibodies

A

y-shaped proteins

117
Q

where do antibodies attach to viruses

A

on the outside of the virsus to block them from causing infection; this is called neutralizing

118
Q

Why do antibodies struggle to stop HIV?

A

HIV mutates every time it is replicated

119
Q

bNabs

A

broadly neutralizing antibodies

120
Q

vaccines vs. bnabs

A

vaccines tigger the creation of antibodies whereas when bnabs are injected into the blood, they are present immediately and go stop infection

121
Q

Ryan White

A

The Indiana teen got the virus from a blood transfusion as a treatment for hemophilia. He became a household name in 1985 when he fought to be readmitted to public school. His story drew worldwide attention, and he became a spokesman and public face of the disease. He gained attention from megastars like Elton John, who was in White’s hospital room when he died in April 1990. Shortly after, President George H.W. Bush signed the Ryan White CARE Act, which helps more than half of the people in the U.S. diagnosed with the disease.

122
Q

Freddy Mercury

A

The flamboyant front man for the band Queen kept quiet about his HIV status until the day before his death from AIDS-related bronchial pneumonia in November 1991. In a final public statement, he wrote: “I felt it correct to keep this information private to date in order to protect the privacy of those around me. However, the time has now come for my friends and fans around the world to know the truth, and I hope that everyone will join with me, my doctors and all those worldwide in the fight against this terrible disease.”

123
Q

Rock Hudson

A

Hudson was nominated for an Oscar for his role in the 1956 film Giant, starring alongside Elizabeth Taylor and James Dean. But it was a series of romantic comedies with Doris Day that propelled him to heartthrob status in the late 1950s and early ’60s. He kept his sexuality a closely guarded secret throughout his career and in July 1984 became the first major public figure to announce he had AIDS. He died in October 1985.

123
Q

Liberace

A

The famed pianist was known for his over-the top performances, costumes, and piano-top candelabra. Liberace denied claims he was gay, suing both the London tabloid Daily Mirror in 1956 and his chauffeur and secretary, Scott Thorson, who sued for palimony in 1982. When he died in February 1987, his lawyer, manager, and publicist denied he had AIDS. The cause of death was listed as heart failure. But an autopsy showed he had AIDS and died from pneumonia.

124
Q

Magic Johnson

A

The basketball legend announced he was HIV-positive in October 1991. The news was a wake-up call to straight men who thought they weren’t at risk for the disease. Johnson retired from the L.A. Lakers but played in the 1992 NBA All-Star Game and helped the U.S. Olympic Team take the gold later that same year. Since then, he’s worked to educate people about HIV and AIDS.

125
Q

Arthur Ashe

A

The man who helped break the color barrier in professional tennis revealed he had AIDS in April 1992. He got HIV from a blood transfusion related to heart surgery. Once he went public, he spent the last months of his life raising awareness about HIV/AIDS and spoke about it on the floor of the United Nations. He died of complications from AIDS in February 1993.

126
Q

Gaétan Dugas

A

For many years, Gaétan Dugas was presumed patient zero in the U.S., originally termed patient O for “outside Southern California.” He was a flight attendant suspected of picking up HIV in Africa or Haiti and bringing it back to the U.S., transmitting it to dozens of men before his death.

127
Q

natural history of infection

A

time from inception to getting cured/death

128
Q

why was there a higher likelihood of getting HIV from a blood transfusion compared to sex?

A

In a blood transfusion or use of intravenous drugs, the virus does not have to pass through a physical barrier as it is injected straight into the blood stream

129
Q

What percent of hemophiliacs have HIV?

A

90%

130
Q

What is the rate of infection for heterosexual relationships for the mucosal barrier and for rectal contact?

A

mucosal -> 1/300
rectal -> 1/30

131
Q

two requirements for HIV transmission

A

how many viruses have the opportunity to get across the barrier?
how strong the barrier for the person who is newly exposed is?

132
Q

zero discordant couples

A

one has HIV, the other does not

132
Q

true or false: viral load is not constant throughout the course of infection

A

true

132
Q

when are HIV levels the highest?

A

during the first two weeks of infection because viruses are able to replicate endlessly

132
Q

Where are the majority of CD4 cells found?

A

the gut or in GALT

132
Q

GALT

A

Gut Associated Lymphode Tissue

132
Q

Why can HIV infect so quickly in GALT?

A

HIV can infect cells really quickly because of the concentration of CD4 cells in the gut

133
Q

How long does the viral life cycle take?

A

24 hours

134
Q

How long does it take for an infected cell to get to the gut?

A

7 days

135
Q

What percent of cells do HIV destroy after the first 3 weeks of infection?

A

over 90%

136
Q

Adaptive immunity

A

By infecting CD4+ T cells, HIV is able to replicate predominantly in activated T cells and paralyse one of the main components of adaptive immune system.

137
Q

What are the first two weeks of infection called?

A

acute or primary infection

137
Q

What stage comes after acute infection?

A

chronic infection

137
Q

Chronic infection

A

the virus comes down and stabilizes and its set point

137
Q

Rate of infection for acute infection period?

A

1/5 chances

138
Q

elite controllers

A

low viral setpoint