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POM unit 5 > HIV > Flashcards

HIV Flashcards

1
Q

are youth afflicted by HIV

A

yes. 25% of new infections are between 13-24

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2
Q

what is HIV

A

infection with human immunodeficiency virus

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3
Q

what is AIDS

A

end-stage HIV infection

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4
Q

is HIV enveloped

A

yes

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5
Q

HIV genome

A

ssRNA

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6
Q

how does HIV replicate

A

via DNA intermediate

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7
Q

where did HIV come from

A

zoonoses from central and western africa. primate-to-human jumping events. simian is the immediate precursor.

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8
Q

how is HIV transmitted

A

sexual at genital or colonic mucosa. exposure to infected fluids such as blood. mother-to-infant. accidental occupational exposure.

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9
Q

how does HIV enter the cells?

A

initial interaction between gp120 and CD4, secondary interaction between gp120 and CCR5. the distal tips of gp41 are inserted into the membrane. gp41 undergoes a significant conformational change and pulls the virus and cellular membranes together, fusing them

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10
Q

steps of HIV replication

A

fusion > reverse transcriptase synthesizes RNA into DNA > integrase integrates the DNA into the host genome > replication and transcription occur after

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11
Q

why is HIV so successful

A

because of its remarkable variability. this results in phenotype diversity, immune escape, resistance to RT and protease inhibitors. there is underlying variation caused mutation, high rate of viral turnover, selection of viral variants.

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12
Q

what is the most common source of transmission

A

male homosexual contact

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13
Q

what are the factors that influence HIV spread

A

sexual behavior, male circumcision, demography and social context, gender, stigma and discrimination

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14
Q

stage 0 HIV

A

negative test within 180 of positive test

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15
Q

stage 1 HIV

A

CD4>500 %>26

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16
Q

stage 2 HIV

A

CD4 cells 200-499 %14-25

17
Q

stage 3 HIV

A

CD4 cells <14

18
Q

bacterial AIDS defining infections

A

multiple or recurrent bacterial infections, mycobacterium disseminated or extrapulmonary, salmonella species recurrent.

19
Q

fungal AIDS defining illnesses

A

candidiasis of esophagus or upper airway, coccidiomycoses disseminated or extrapulmonary, cryptosporidiosis chronic intestinal, histoplamosis disseminated or extrapulmonary, pneumocystis jirovecii pneumonia

20
Q

viral AIDS defining illness

A

CMV other than liver, spleen, nodes, CMV retinitis (with loss of vision), progressive multifocal leukoencephalopathy.

21
Q

parasitic AIDS defining illnesses

A

isosporiasis, chronic intestinal, toxoplasmosis of the brain

22
Q

AIDS defining cancers

A

invasive cervical cancers, karposi sarcoma, lymphoma (burkitt, immunoblastic, brain

23
Q

what is the clinical presentation of acute HIV infection

A

fever, weight loss, malaise, headache, neuropathy, pharyngitis, mouth sores, thrush, esophageal sores, myalgia, liver and spleen enlargment, LAD, skin rash, nausea and vomiting.

24
Q

symptoms of AIDS

A

meningitis, encephalitis, retinitis, pneumocystis pneumonia, TB, tumors, skin tumors, GI esophagitis, chronic diarrhea, tumors.

25
Q

what are the clinical suspicions for AIDS

A

high risk behavior or exposure, febrile illness, mononucleosis syndrome, aseptic meningitis, rash, mucocutaneous ulcers, diarrhea, LAD.

26
Q

IgM/IgG + p24 antigen time

A

15-24 days

27
Q

HIV RNA test

A

10-15 days

28
Q

HIV antigen tests?

A

they have variable sensitivities

29
Q

western blots?

A

35-50 days indeterminate, 45-60 positive

30
Q

what is in the differential for HIV

A

mononucleosis, toxoplasmosis, rubella, syphilis, hepatitis, gonococcal infection, lupus or other autoimmune diseases.

31
Q

what bacterial infections are suspected in HIV patients

A

recurrent pneumonias, tuberculosis ,

32
Q

what fungal infections are suspected in HIV patients

A

jirovecii, and other endemic fungus

33
Q

what viral and parasitic infections are suspected in HIV

A

rare.

34
Q

when there is cough and fever in HIV with CD4 count DDX

A

sinusitis, bronchitis, bacterial pneumonia, tuberculosis

35
Q

when there is cough and fever in HIV with no CD4 count DDX

A

PCP, disseminated fungal disease, CMV

36
Q

small bowel diarrhea

A

watery large volume, bloating, gas, cramping, weight loss.

37
Q

large bowel diarrhea

A

frequency, small volume, painful, weight loss uncommon

38
Q

anorectal diarrhea

A

history of receptive anal intercourse, severe tenesmus, dyschezia, urgency.

39
Q

what antiviral drugs can cause diarrhea

A

lopinavir, fosamprenavir, atazanavir

POM unit 5 (12 decks)

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