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1

What does HIV stand for?

Human immunodeficiency virus

2

If untreated, what does HIV infection cause?

AIDS

Acquired immunodeficiency syndrome

3

HIV infection is untreatable - true or false?

False

HIV is treatable and patients can go on to life an "almost-normal" life expectancy

4

What type of virus is HIV?

Retrovirus

5

Retroviruses have which type of genetic material?

RNA

6

How does a retrovirus replicate?

Converts its RNA to DNA using reverse transcriptase

Inserts its DNA into the DNA of the host cell

So when the host cell undergoes transcription and translation, it produces new viral RNA

Virus also takes over host metabolism to produce new coats

> Replication

7

Which receptor does HIV target?

CD4 receptors

8

Which immune cells have CD4 receptors?

TH lymphocytes

Macrophages

Dendritic cells

Microglia

9

Cells which ___ antigen to other immune cells tend to have CD4 receptors.

present

i.e antigen-presenting cells like macrophages and dendritic cells have CD4 receptors

10

Which molecules, found on CD4+ cells like macrophages and T helper lymphocytes, help these cells to present antigens to other immune cells?

MHC2

11

What does antigen presentation by CD4 cells cause?

Immune activation

B cells, cytotoxic T cells, cytokines

i.e your adaptive immune response

12

How does HIV infection reduce the adaptive immune response?

Affects antigen-presenting CD4+ cells, stopping the activation of the immune system in response to pathogens

13

HIV infection gammies the immune system.

What does this render the patient susceptible to?

Opportunistic infection

AIDS-related cancers

14

In untreated HIV infection, the count of CD4+ cells (increases / decreases).

CD4 cell count decreases

15

In untreated HIV infection, the viral load (increases / decreases).

viral load increases

16

CD4 count of less than ___ cells / mmconstitutes a risk of opportunistic infection.

< 200 cells / mm3

17

What syndromes do you develop in

a) Weeks 2 - 4

b) Years 9+

of HIV infection?

a) Acute HIV syndrome

b) AIDS

18

Without treatment, how long do

a) adults

b) babies

with HIV survive?

a) 10 years

b) 1 year

So it's important to identify and diagnose it early

19

Which system spreads HIV around the body?

Lymphatic system

20

Around 2 - 4 weeks after HIV infection, what do 80% of patients present with?

Acute HIV syndrome

21

What is the presentation of acute HIV syndrome?

Fever

Rash - maculopapular, similar to meningococcal rash

Myalgia

Pharyngitis

Headache

22

Is acute HIV syndrome a chronic condition?

No

Resolves after a week - opportunity to diagnose HIV passes

23

Are patients with acute HIV syndrome infectious?

Yes

V much so

24

If untreated, during which time period are HIV patients asymptomatic?

Week 4 Year 9+

25

During asymptomatic HIV infection, what happens to a patients

a) CD4 count

b) Viral load

c) infectivity?

a) CD4 count decreases

b) Viral load increases

c) Still infectious - can transmit via bodily fluids

26

What are two opportunistic respiratory infections which you need to know about re: HIV patients?

Pneumocystis pneumonia

Tuberculosis

27

What is the presentation of pneumocystis jirovecci infection?

SOB

Dry cough

28

What is the presentation of pulmonary tuberculosis?

Chronic productive cough +/- haemoptysis

Fever

Night sweats

29

What are the antibiotic treatments for

a) pneumocystis pneumonia

b) tuberculosis?

a) Co-trimoxazole +/- steroids

b) 2 RIPE 4 RI - 2 months rifampicin, isoniazid, pyrazinamide and ethambutol, then 2 months rifampicin and isoniazid

30

What infection, related to cervical cancer, are patients with HIV more susceptible?

HPV