Flashcards in Exam 2 HIV Deck (37):
Primary HIV infection occurs when?
2-6 wks post exposure
flu-like sxs x 2 wks w/ spontaneous resolution
Primary HIV infection Lab results? (6)
HIV Ab U negative
HIV RNA (viral load) U very high
LFT = ↑transam
Primary HIV infection Retroviral Syndrome presentation? (6)
RASH (up trunk, neck, face)
Initial immune response resolves acute phase ->
Seroconversion w/i 3 mo of infection ->
Viral load ↓ to setpoint ->
Slowly ↑ again (HIV stays active in lymph nodes) ->
CD4 T-cell count slowly ↓ ->
Pt asympt or LAD for ~10YRS
Symptomatic infection process? (5)
Immune system deteriorates:
-Lymph burns out
-Virus becomes more pathogenic
-Body can't maintain CD4 cell replacement
-HIV RNA load ↑
-CD4 count ↓ even more
HIV sxs? (5 initial)
Oral Hairy Leukoplakia (from EBV)
Chronic fungal infect
CD4 T cell count < 200
or 1 of 27 Defining Conditions
Pneumocystis Jiroveci PNA: Type of microbe?
Seen w/ CD4 counts of?
p. jiroveci, airborne fungus
CD4 < 200
Pneumocystis Jiroveci PNA presentation?
Fever, cough, SOB
P severe hypoxemia
CXR = diffuse or perihilar infiltrates
Pneumocystis Jiroveci PNA labs?
Sputum sample = ↑ LDH
Toxoplasmosis: Type of microbe?
t. gondii, parasite
CD4 < 200
Raw meat or cat poop
Toxoplasmosis presentation? (6)
Focal neuro deficits
Serum cx = toxoplasmosis
Brain CT/MRI = multiple lesions
Mycobacterium Avium Complex (MAC): Microbe?
mycobacterium avium or intracellulare
CD4 < 50
Inhaled/ingested from soil/dust
Systemic dz in advanced AIDS
MAC labs? (3)
Sputum Acid-Fast Bacillus Stain = +
Sputum cx = +
Blood cx = +
Cytomegalovirus Retinitis: Microbe?
blood, sexual, perinatal
Cytomegalovirus Retinitis is most C what?
Retinal infection in AIDS
Cytomegalovirus Retinitis presentation?
Perivascular hemorr, cotton wool exudates
Cytomegalovirus Retinitis labs?
Sero = + for Cytomegalovirus
Esophageal or Vaginal Candidiasis
common fungal infections
Kaposi's Sarcoma is?
Seen w/ what CD4 count?
Any CD4 count
Kaposi's Sarcoma presentation?
Multi-focal, widespread lesions
HIV screening: tests? (3)
for screening, not detectible until seroconversion (4-12wks post)
saliva or blood,
+ result req's confirmation
HIV screening: Who? (4)
All pts 13 - 64 yo
All TB pts
Every STD pt
Initial HIV W/U includes what? (8)
Get baselines of what? (5)
Confirm HIV Ab
HIV RNA viral load
Genotypic resistance prior to ART
TB PPD test
IgG (for P reactived infections)
HIV tx for which pts?
Which CD4 counts see best results supporting tx guidelines?
ALL HIV-infected (P wait for infants)
CD4 < 350
AntiRetroviral Therapy (ART) includes?
3 drug from 2 different classes
1) Non-nucleoside reverse transcriptase inhib
2) Nucleoside reverse transcriptase inhib
3) Protease inhib
4) Integrase inhib
ART benefits? (5)
1) Prevent progression of immune destruction
2) Restore immunity
3) Delay HIV infection
4) Improve life expectancy
5) ↓ transmission
ART risks? (5)
1) Drug reactions
2) CROSS RESISTANCE
3) Transmission of drug-resistant virus
4) Long-term toxicity
5) Unknown duration of effectiveness
HIV monitoring includes? (3)
1) CD4 count Q 3-6 mo
2) Viral load Q 3-6 mo
3) Med toxicities (CBC, CMP, lipids)
HIV transmission to infants happens how? (3)
HIV transmission prevention in preggos? (3)
C-section if HIV RNA > 1000
HIV occupational post-exposure prophy considerations? (3)
1) Test source for + HIV
2) Type of body fluid blood vs low risk fluids
3) Adverse effects of prophy meds
HIV occupational post-exposure prophy initiation?
Tx includes? (3)
2 med regimine x 4 wks
Monitor for s/e Q 2 wks
Monitor for HIV 3 wks, 3 mo, 6 mo