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JL Reproduction and Sexual Health > Week 2 part 2 > Flashcards

Week 2 part 2 Flashcards

1
Q

What causes Acquired Immunodeficiency Syndrome AIDS?

A

HIV

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2
Q

What makes up AIDS?

A
  1. Opportunistic infections

2. AIDS related cances

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3
Q

What are the single highest predictor of mortality in HIV?

A

Aids related conditions

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4
Q

life ex[ectancy of HIV patinets?

A

Near normal

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5
Q

What type of virus is HIV?

A

Retrovirus

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6
Q

What type of HIV priginated from west african sootey mangabey (simian ID virus)?

A

HIV-2

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7
Q

What type of HIV 1 or 2 is less virulent?

A

Type 2

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8
Q

What HIV originated in central/west african chimpanzees and group M is responsible for starting global pandemic?

A

HIV-1

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9
Q

tARGET SITE for HIV?

A

CD4 receptors

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10
Q

What cells recognise MHC2 antigen presenting cell?

A

CD4 t lymphocytes

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11
Q

Name One major hallmark of HIV infection that promotes viral replication and drives CD4+ T cell depletion.

A

Chronic Immune Activation

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12
Q

Normal CD4 range?

A

500 to 1600

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13
Q

What CD4 count puts you at risk of opportunistic infections?

A

Less than 200

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14
Q

When does rapid replication of HIV occur?

A

Early and very late infection

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15
Q

When is a new generation of HIV replicated?

A

Every 6 to 12 hours

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16
Q

Within how many days is the HIV infection estasblished?

A

WIthin 3 days of entry

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17
Q

when does primary HIV infection present?

A

Onset 2-4 weeks after infection

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18
Q 
Fever
Rash (maculopapular)
Myalgia
Pharyngitis
Headache/aseptic meningitis
A

Primar yHIV

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19
Q

What type of HIV infection is occuring with ongoing viral replication, ongoing CD4 count depletion, ongoing immune activation?

A

Asymptomatic HIv infection

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20
Q

an infection caused by a pathogen that does not normally produce disease in a healthy individual. It uses the “opportunity” afforded by a weakened immune system to cause disease

A

Opportunistic infections (occur in late disease with high viral load)

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21
Q

Wjhat organism causes pneumocystis pneumonia HIV?

A

Pneumocystis jiroveci

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22
Q

What is CD4 threshold in pneumocystis pneumonia caused by HIV?

A

lESS THAN 200

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23
Q

What sign is present in pneumocystis pneumonia?

A

Exercise desaturation

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24
Q

: insidious onset
SOB
Dry cough
Patinet with HIV?

A

pNEUMOCYSTIS PNEUMONIA

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25
Q

How is HIV causing PCP diagnosed?

A

Bronchoalveolar lavage and immunofluorescence

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26
Q

Treatment of HIV causing PCP?

A

High dose co-trimoxazole +/- steroid

prophylaxis - low dose co-trimoxazole

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27
Q 
What are these more common in: Symptomatic primary infection
Reactivation of latent TB
Lymphadenopathies
Miliary TB
Extrapulmonary TB
Multi-drug resistant TB
Immune reconstitution syndrome
A

HIV posivie patients

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28
Q

In HIV what organism causes cerebral toxoplasmosis?

A

Toxoplasma gondii

CD4 threshold less than 150

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29
Q 
HIV patient
Multiple cerebral abscess
(Chorioretinitis)
Headache
Fever
Focal neurology
Seizures
Reduced consciousness
Raised intracranial pressure
A

Cerebral toxoplasmosis (ring enhancing lesions on MRI)

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30
Q

cmv causes cytomegalovirus in HIV - what CD4 threshold is needed?

A

Less than 50

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31
Q

Retinitis, colitis, oesophagitis

A

Cytomegalovirus (presents with reduced visual acuity, floaters, abdo pain, diarrhoea nad PR bleeds)

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32
Q

If an HIV patient is getting multidermatomal and recurrent rashes what might it be?>

A

Herpes zoster

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33
Q

What organism causes HIV-associated neurocognitive impairment

A

HIV-1

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34
Q

HIV patient with reduced short term memory and +/- motor dysfunction?

A

HIV-associated neurocognitive impairment

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35
Q

What organism causes Progressive multifocal leukoencephalopathy

A

JC virus

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36
Q

What is CD4 threshold for JC virus?

A

Less than 100

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37
Q

HIV patient with rapidly progressing focal neurology, confusion and personality change?

A

Progressive multifocal leukoencephalopathy

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38
Q

Slims disease

A

HIV associated wasting

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39
Q

What organism causes aids related canacer kaposis sarcoma?

A

Human herpes virus 8

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40
Q

Name a tumour that is vascular?

A

Kaposis sarcoma

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41
Q

How is kaposis sarcoma treated?

A

HAART

systmeic chemotherapy

42
Q

What aids related cancer does EBV cause?

A

Non-Hodgkins lymphoma

43
Q

B symptoms
Bone marrow involvement
Extranodal disease
increase CNS involvement

A

Non-hodgkins lymphona - aids related

44
Q

What virus causes aids related cancer cervical?

A

Human papilloma virus

45
Q

Name some non-OI symtpomatic HIV complaints

A 
Oral thrush
Seborrhoeic dematitis
Diarrhoea
Fatigue
Worsening psoriasis
lymphadenopathy
parotitis
Hep B,C
46
Q

Name two haematologic manifestations of HIV

A

Anaemia

Thrombocytopenia ITP

47
Q

nAME four factors increasing HIV transmission risk

A
  1. Anoreceptive sex
  2. Truama
  3. Genital ulceration
  4. Concurrent STI
48
Q

nAME 3 mother to child modes of transmission/

A

In utero/trans placental
Delivery
Breast feeding

49
Q

What risk group has the highest proportion of HIV in UK?

A

MSM

50
Q

Who should be tested for HIV

A

Universal testing in high prevalence areas
Opt out testing in clinical settings
Screening of high risk groups
Testing in presence of clinical indicators

51
Q

Which markers of HIV are used by labs to detect infection?

A

RNA viral genome
Capsulse protein p24 (antigen)
Envelope proteins gp120
Antibody

52
Q

When HIV seroconversion is taking place what is tested for?

A

Viralk load and p24 antigen

53
Q

When HIV is in chronic infection stage what is best tested for?

A

Antibody

54
Q

how long is window period (have infection but test negative) for antibody HIV testing?

A

3 months

55
Q

For fourth gen HIV tests (combined antibody and antigen p24) what is window period?

A

14-28 days

56
Q

What is a POCT

A

Rapid HIV test - results within 20-30 minutes

57
Q

What could be used to identify if an HIV infeciton occured within preceding 4-6 months?

A

RITA - recent infection testing algorithm

58
Q

what therapy is used for HIV treatment?

A

Anti-retroviral therapy ARV

59
Q

What is reverse transcriptase, integrase, protease, entry and maturation all targeted by?

A

HIV antiretroviral drugs

60
Q

What does highly active anti-retroviral therapy contain?

A

A combination of three drugs from at least 2 drug classes to which the virus is susceptible

61
Q

Name three HIV HAART drugs?

A
  1. Tenofovir
  2. Emtricitabine
  3. Efavirenz
62
Q

2 side effects of efavirenz

A

mood and psychosis

63
Q

Renal side effedcts of HAART

A

Proximal renal tubulopathies

64
Q

Bone side effects of HAART

A

Osteomalacia

65
Q

What drug drug interactions must be thought of for HIV

A

NNRTIs are generally potent liver enzyme inducers so be careful of OCP

66
Q

hOW DO you prevent mother to child transmission?

A

Vaginal delivery if undetected VL
HAART during pregnancy
PEP for neonate
Exclusive formula feeding

67
Q

wHEN should chlamydia and gonorrhoea be tested for?

A

2 weeks following exposure

68
Q

What is the incubation period of urethral infection in men for gonorrhoea?

A

2-5 days

69
Q

For microscopy of gonorrhoea is urethral or endocervical more sensitive?

A

Urethral 90-95% sensitivity

70
Q

treatemtn of gonorrhoea?

A

IM ceftriaxone and oral azithromycin

71
Q

incubation of genital herpes

A

3-6 days

72
Q 
Blistering and ulceration of the external genitalia
Pain
External dysuria
Vaginal or urethral discharge
Local lymphadenopathy
Fever and myalgia (prodrome)
A

genital herpes

73
Q

is viral shedding higher in hsv1 or 2?

A

HSV 2

74
Q

PRIMAR YSYPHILS INCUBATION?

A

9 to 90 days mean of 21

75
Q

painless primary chancre?

A

Syphilis

76
Q

Incubation period is 6 wks to 6 months
Skin (macular, follicular or pustular rash on palms + soles)
Lesions of mucous membranes
Generalized Lymphadenopathy
Patchy Alopecia
Condylomata Lata (most highly infectious lesion in syphilis, exudes a serum teeming with treponemes)

A

Secondary syphilis

77
Q

What four conditions do not need partner notification?

A

Warts
Herpes
Vaginal thrush
Bacterial vaginosis

78
Q

Name the four structures of female body in the pelvic cavity?

A
  1. Ovaries
  2. Uterine tubes
  3. Uterus
  4. Superior part of vagina
79
Q

Name the 5 structures of female body in perineum?

A
  1. Inferior part of vagina
  2. Perineal muscles
  3. Bartholin’s glands
  4. Clitoris
  5. Labia
80
Q

In female body where does excess abnormal fluid within peritoneal cavity tend to collect?

A

Within pouch of douglas

81
Q

In females, how can fluid in the pouch of douglas be drained?

A

Needle passed through posterior fornix of the vagina

82
Q

What is formed from a double layer of peritoneum and helps maintain the uterus in its correct midline position?

A

Broad ligament

83
Q

What is contained in the broad ligament?

A

Uterine tubes and proximal part of round ligamnet

84
Q

What is an embryological remnant and attaches to the lateral aspect of uterus?

A

Round ligament

85
Q

What does round ligament pass through to attach to the superficial tissue of female perineum?

A

Deep inguinal ring

86
Q

What are the three layers of support for uterus?

A
  1. Uterosacral ligaments
  2. Endopelvic fascia
  3. Muscles of pelvic floor
87
Q

The most common position of uterus is when cervix tipped anteriorly relative to axis of vagina - what is the term for this?

A

Anteverted

88
Q

What is a retroflexed Uterus?

A

Uterus tipped posteriorly relative to axis of cervix

89
Q

What is sampled during a cervical smear?

A

Squamo columnar junction (transformation zone)

90
Q

What do fimbriae at end of uterine tubes open into?

A

Peritoneal cavity

91
Q

What are almond sized and shaped structures located more laterally in the pelvic cavity?

A

Ovaries

92
Q

In post-pubertal emales where is the monthly ovum released directly into?

A

Peritoneal cavity - to be picked up by fimbriae

93
Q

Where can ischial spines be palpated on vaginal digital exam?

A

4oclock and 8 o clock positions

94
Q

Shallow space between pelvic diaphragm and skin?

A

Perineum

95
Q

What merve su[pplies levator ani?

A

Nerve to levator ani - from S3,4,5

96
Q

wHAT SUPPLIES (nerve) perineal muscles?

A

Pudendal nerve

97
Q

What is the perineal body?

A

Bundle of collagenous and elastic tissue into which the perineal muscles attach
Important to pelvic floor strength
Can be disrupted during labour
Located just deep to skin

98
Q

What ribs does the bed of breast extend from?

A

ribs 2 to 6

and lateral border of sternum to mid axillary line

99
Q

Whjat do bed of breast lie on?

A

Deep fascia covering pec major and serratus anterior

100
Q

What lies between fascia and breast?

A

Retromammary space

JL Reproduction and Sexual Health (18 decks)

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