HIV & pod patients

Question 1

what is the most common cause of AIDS in the world?

Answer 1

HIV-1

Question 2

which HIV strain is more related to the simian retro viruses?

Answer 2

HIV-2 (less common and less pathogenic mostly isolated in west africa)

Question 3

The immune defect of AIDS is seen in which cell type?

Answer 3

T4 lymphocytes

Question 4

What is the cellular receptor for HIV?

Answer 4

CD4 + surface moelcules

Question 5

What is the screening test? confirmatory test for HIV?

Answer 5

ELISA-screening test

Western blot- confirmatory test

Question 6

what does HIV PCR detect?

Answer 6

specific DNA and RNA sequences taht indicates presence of HIV in genetic structure

Question 7

what is the group 1 acute infection like?

Answer 7

acute mononucleosis like syndrome- characterized by fever, rash, malaise, and lymphadenoapthy

Question 8

what is group 2 asymptomatic infection like?

Answer 8

chronically infected, serology positive, virus culture positive, no clinical manifestations

Question 9

what is group 3 persistent generalized lymphadenopathy?

Answer 9

palpable enlarged lymph node (>1cm) at 2+ extrainguinal sites persisting for more than 3 months
*all test results positive

Question 10

What is the critical CD4 count?

Answer 10

below 350 cells/ml

Question 11

what diseases are associated with a critical CD4 count below 350 cells/ml?

Answer 11

Herpes simplex virus
tuberculosis
oral or vaginal thrush
Herpes zoster* 
Non-Hodgkin's lymphoma
Kaposi's sarcoma

Question 12

Which diseases are associated with a CD4 count below 200 cells/ml?

Answer 12

pneumocystis carinii
candida esophagitis
bacillary angiomatosis

Question 13

which diseases are associated with a CD4 count below 100 cells/ml?

Answer 13

(will see more of the neurological manifestations)

• cryptococcal meningitis
• AIDS dementia
• toxoplasmosis encephalitis
• wasting syndrome

Question 14

which diseases are associated with a CD4 count below 50 ml?

Answer 14

Mycobacterium avium

Cytomegalovirus

Question 15

what 2 main groups of HIV manifestations are seen in pod patients/

Answer 15

primary (neurotrophic)

secondary (lymphotrophic)

Question 16

What are the primary (neurotrophic) manifestations?

Answer 16

• encephalopathy: 90%
• meningitis: 10%
• myelopathy: 12%
• myopathy
• neuropathy: 10-50%

Question 17

What are the secondary (lymphotrophic) manifestations?

Answer 17

metabolic and toxic
neoplasms
opportunistic
vascular complications

Question 18

what is aka Aids Dementia complex?

Answer 18

encephalopathy

Question 19

what is distal symmetrical polyneuropathy?

Answer 19

affects sensory nerves first before motor nerves

*characterized by painful, burning feet

Question 20

What is maximal neurological dysfunction for Guillian Barr syndomre?

Answer 20

1 month (acute course)

Question 21

Which disease is associated with cytomegalovirus?

Answer 21

progressive lumbosacral polyradiculomyelopathy

Question 22

what are some early signs of progressive lumbosacral polyradiculomyelopathy?

Answer 22

urinary retention

sphincter dysfunction

Question 23

What is the tetrad of REiter’s syndrome?

Answer 23

urethritis
conjunctivitis
arthritis
mucocutaneous lesion

Question 24

what are the MSK manifestations of HIV ?

Answer 24

psoriatic arthritis
Reiter's
Myopathy
tenosynovitis
non-specific arthritis

Question 25

which MSK disease is this: patient has strength in the AM but it gradually decreases

Answer 25

myasthenia gravis

Question 26

which MSK disease is this: strength is weak in the AM but gradually increases as day goes on.

Answer 26

eaton-lambert syndrome

Question 27

eaton-lambert syndrome is associated with what cancers?

Answer 27

70% small or oat cell carcinoma

Question 28

What dermatological manifestaions are seen in HIV?

Answer 28

Kaposi's sarcoma
onychomycosis 
tinea pedis
psoriasis
eczema

Question 29

what is pseudothrombophlebitis due to?

Answer 29

Kaposi’s of the venous system

-presents similar to DVT