Week 5

Question 1

Who gets screened for the HIV (4 groups)

Answer 1

All pregger chicks
All pts between 13 and 64
All pts with TB, STD
“High Risk” pts annually

Question 2

When does the viral load of HIV initially peak

Answer 2

6-8 weeks after infection

Question 3

How long are HIV patients asymptomatic after initial infection

Answer 3

Up to 12 years

Question 4

What test is used for rapid HIV testing/screening?

Answer 4

ELISA

Question 5

Sensitivity / Specificity of HIV ELISA

Answer 5

Highly Sensitive (very few false negatives)
Not super specific (possible false positives)

Question 6

What test is used for confirmatory testing of HIV?

Answer 6

Western Blot

Question 7

Benefit of western blot for HIV

Answer 7

High specificity (very few false positives)

Question 8

What is the initial peak in viral load after HIV infection called

Answer 8

Acute Retroviral Syndrome

Question 9

When does acute retroviral syndrome typically start

Answer 9

2-4 weeks after infection

Question 10

Symptoms of acute retroviral syndrome

Answer 10

flu-like illness for 3-14 days

Question 11

Difficulty of diagnosis in acute retroviral syndrome

Answer 11

Antibody tests (like ELISA) will be negative

Question 12

Patients are ________ infectious during acute retroviral syndrome

Answer 12

super duper

Question 13

Are tops or bottoms more likely to contract HIV? What about bottoming from the top? What about power-bottoming? What about canoodling the Congolese chicken? What about sharing IUD’s? What about docking?

Answer 13

Bottoms

Question 14

3 highest-risk practices for HIV transmission

Answer 14

receptive anal intercourse (0.3-3%)
IDU needle sharing (0.67%)
Maternal-infant (24%)

Question 15

What CD4 count should you wait for to start ARV therapy?

Answer 15

You shouldn’t wait, waiting is bad, dummy

Question 16

40-85% of women who give birth to an HIV positive child. . .

Answer 16

Didn’t know they had HIV

Question 17

HAART during pregnancy brings risk of vertical transmission of HIV from ______ to ______

Answer 17

25% (40% if breastfeeding) to less than 1%

Question 18

How long should a patient receive post exposure prophylaxis for HIV

Answer 18

28 days

Question 19

Reasons for HIV post exposure prophylaxis

Answer 19

needle stick, splash, bite, unprotected sex, sexual assault, condom breakage, IVDA

Question 20

What body fluids are NOT infectious for HIV

Answer 20

peepee
drool
sweat
tears
snot
spit
pukes
poops

Question 21

HIV post exposure prophylaxis should be started within how long after exposure

Answer 21

under 72 hours

Question 22

major clinical clues for HIV infection (5)

Answer 22

fatigue
weight loss
leukopenia
anemia
polyclonal hypergammaglobulinemia

Question 23

CD4 count below _____ puts patients at high risk for opportunistic infection

Answer 23

200

Question 24

List some exotoxins (5)

Answer 24

Diphtheria toxin
Pertussis toxin
Shiga toxin
Botulinum toxin
Tetanus toxin

Question 25

Give an example of an endotoxin

Answer 25

LPS in gram negative bacteria

Question 26

Staph aureus toxins with a role in nec fasc

Answer 26

Leukocidin, Exfoliatin B

Question 27

Strep pyo toxins with a role in nec fasc

Answer 27

Streptolysin O Strep pyrogenic exotoxin e Strep pyrogenic exotoxin B

Question 28

Strep toxic shock syndrome diagnostic criteria (7-9)

Answer 28

``` GABHS isolated Renal / Rash Platelets ARDS Bleeding / BP Hepatic Soft tissue necrosis ``` (Mnemonic GRouP A Beta Hemolytic Strep)

Question 29

Strep toxic shock syndrome treatment

Answer 29

``` Debride Pcn IV Clinda IV maybe IVIG (can transition to oral abx when afebrile, clean cultures, and stable) ```

Question 30

Staph toxic shock diagnostic criteria

Answer 30

``` Fever greater than 38.9 Rash Desquamation Hypotension Multiorgan (more than 3: muscles, kidneys, livers, bloods, brains, mucus membranes) ``` (Mnemonic FaRD HaM, or whatever, fuck you)

Question 31

Staph toxic shock treatment

Answer 31

IVIG anti-staphys supportive care

Question 32

Diphtheria incubation period

Answer 32

2-4 days

Question 33

Diphtheria fever?

Answer 33

low grade or none

Question 34

Diphtheria snot

Answer 34

erosive (upper lip ulcers)

Question 35

Diphtheria neck

Answer 35

"bull neck"

Question 36

Diphtheria mouth

Answer 36

Nasty ass exudate in oropharynx, white to grey

Question 37

Diphtheria organs

Answer 37

Toxin fucks up the CNS, kidneys and heart all bad

Question 38

Diphtheria treatment

Answer 38

antitoxin and penicillin

Question 39

If you delay diphtheria antitoxin by 4 days

Answer 39

you just made your patient 20x more likely to die, dummy

Question 40

Who does pertussis kill most

Answer 40

4-10 week olds

Question 41

Pertussis treatment

Answer 41

Azith for 5 days, not very effective if started after cough begins

Question 42

Tetanus is _______

Answer 42

Hell

Question 43

What's the terrible name for the facial expression common in tetanus

Answer 43

Risus sardonicus (sarcastic smile)

Question 44

Tetanus treatment

Answer 44

tetanus immunoglobulin | IV pc for 10-14 days or metronidazole

Question 45

How do infants get botulism

Answer 45

dirt and honey

Question 46

how do children and adults get botulism

Answer 46

injuries and home-canned shit and food

Question 47

botulism clinical syndrome

Answer 47

descending symmetrical paralysis, (cranial nerves in foodborne and wound)

Question 48

What is the title for a host in which parasites can bang?

Answer 48

definitive host

Question 49

What is the title for a host in which parasites don't bang, but develop into a new stage

Answer 49

Intermediate host

Question 50

What is the title for a host that can get infected with parasites, but is not necessary for the parasites

Answer 50

incidental host