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Med Surg I > Wk 4 HIV Labs and Diagnostics > Flashcards

Wk 4 HIV Labs and Diagnostics Flashcards

1
Q

Who is considered for routine HIV screening?

A

Anyone ages 13-75

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2
Q

How often should someone considered high risk for contracting HIV be screened?

A

Yearly

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3
Q

Who is considered at high risk for contracting HIV? (5 groups)

A

1) Men who have sex with men
2) IV drug users
3) Persons who exchange sex for $/drugs
4) Sex partners of people who are infected with HIV, bisexual, or IV drug users
5) Persons who have sex with people who have unknown HIV status

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4
Q

What is required before doing an HIV screening?

A

Consent form that is voluntary and has had the chance to opt-out

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5
Q

What should you pay scrupulous attention to concerning HIV screening?

A

Confidentiality

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6
Q

What should you educate a patient on who is undergoing HIV screening?

A

Counseling to reduce the likelihood of exposure

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7
Q

What percentage of HIV-infected persons are aware of their status?

A

Only 85%

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8
Q

What is a concerning issue for HIV infected persons?

A

Adherence

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9
Q

What type of tests are the older generation HIV tests?

A

HIV antibody only

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10
Q

What are the fourth generation HIV tests?

A

Combination of antibody and antigen testing

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11
Q

What are 3 types of HIV older generation tests?

A

ELISA
HIV-1/HIV-2
Western Blot

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12
Q

What does the ELISA test stand for?

A

Enzyme linked immunosorbent assay

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13
Q

What is the Western Blot used for?

A

Confirmatory follow up testing

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14
Q

What is the advantage of the new generation HIV tests over the older generation HIV tests?

A

Because they test for both the antigen and antibodies, they can identify HIV infection earlier because antibodies have to be produced after the antigen replicates

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15
Q

What type of HIV test tests for the actual viral load level?

A

HIV RNA

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16
Q

What is the HIV-1/HIV-2 test?

A

Differentiation assay

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17
Q

Which test type has almost 100% specificity and sensitivity?

A

Combination, HIV antigen and antibody tests, 4th generation

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18
Q

What are the two categories of HIV RNA tests?

A

Qualitative and quantitative

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19
Q

What are qualitative HIV RNA tests used for?

A

Used as a screener to identify HIV-infected individuals

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20
Q

What is an example of a time where the qualitative HIV RNA test might be used?

A

Blood donors

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21
Q

What is a quantitative HIV RNA test used for?

A

It has the ability to count viral load, so it is used for management/monitor those who are infected or diagnose

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22
Q

How many days can the newer generation HIV test positive?

A

15-20 days

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23
Q

What are the 3 results a patient could get after doing an HIV test?

A

Positive
Negative
Indeterminate

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24
Q

What is the criteria for a patient to be HIV-positive?

A

Positive ELISA or combination assay followed by a positive confirmatory assay

25
Q

What is the criteria for a patient testing negative for HIV?

A

A negative screening ELISA or combination assay, do not need a follow up test

26
Q

What is the criteria for a patient testing indeterminate for HIV?

A

The first test is positive, but the follow up test is indeterminate or negative

27
Q

What is the window period, concerning HIV?

A

Time between potential exposure to HIV infection and the point when the test will give an accurate results

28
Q

During the HIV window period a patient is…

A

VERY infectious, but will still test negative

29
Q

What is the eclipse phase of HIV infection?

A

Point of exposure to point of increased viral load

30
Q

What is the window period phase of HIV infection?

A

Point of exposure to point of detectable antibodies

31
Q

When is the patient infectious during the phases of HIV infection?

A

They become infectious after the eclipse phase, with high viral load

32
Q

How long does it take to develop antibodies after being exposed to HIV?

A

Usually within 4 weeks, but almost all patients by week 12

33
Q

How is the progression of HIV monitored? (2 things to test for)

A

CD4 count

Viral load

34
Q

What number do you want the CD4 count to be?

A

Greater than 500

35
Q

What number do you want the viral load to be?

A

Less than 50 or non-detectable

36
Q

What is the best indicator for a healthy immune system?

A

CD4 count

37
Q

What is the normal CD4 cell count range?

A

800-1200

38
Q

CD4 count helps monitor the progression of __

A

AIDS

39
Q

CD4 count helps determine when it’s time for…

A

Prophylactic treatment and risk for opportunistic infections

40
Q

What is are the CD4 cells also called?

A

Copies

41
Q

What CD4 count is the HIV infected person vulnerable to opportunistic infections/rare cancers?

A

< 200

42
Q

How often is the CD4 count check in an HIV positive patient?

A

Every 3-4 months

43
Q

What is the best indicator of how active HIV is in a patient’s body?

A

Viral load testing

44
Q

If an HIV infected person remains untreated, the virus produces…

A

billions of new viral copies per day

45
Q

What is viral load?

A

Plasma HIV RNA

46
Q

What is plasma HIV RNA?

A

The viral load

47
Q

What does the viral load quantify?

A

Viral burden in plasma

48
Q

How often is viral load testing done in an HIV positive patient?

A

Every 3-4 months

49
Q

What else does the viral load test help monitor?

A

A patient’s response to ART

50
Q

The lowest level of detection __ with each test

A

differs

51
Q

What is the goal for viral load with HIV positive patients?

A

Keep it at an undetectable level

52
Q

How long is the clinical latency period of HIV?

A

Years

53
Q

What does undetectable viral load NOT mean?

A

It does not indicate absence or clearance of the virus from the body

54
Q

What is the recommendation for viral load testing?

A

Check twice at baseline before starting ART, and then every 3-4 months

55
Q

What are other labs worth monitoring in a patient with HIV? (5 tests)

A 
WBC
Platelets
H&H
LFTs
Resistance to ART drugs
56
Q

What two WBCs are especially important for monitoring HIV?

A

Lymphocytes and neutrophils

57
Q

What type of cell is a CD4 cell?

A

Lymphocyte

58
Q

Why are LFTs monitored for HIV patients?

A

Early detection of HCV or HBV confection is very important

Med Surg I (41 decks)

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