Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCP: Infectious Diseases > HIV > Flashcards

HIV Flashcards

(64 cards)

Start Studying
1
Q

What are neurological complications of HIV?

A

Toxoplasmosis
Primary CNS lymphoma
Tuberculosis
Encephalitis
Cryptococcus
PML
AIDs dementia complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common neurological complication of HIV?

A

Toxoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are scan appearances of toxoplasmosis?

A

CT: usually single or multiple ring enhancing lesions, mass effect may be seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is cerebral toxoplasmosis treated?

A

sulfadiazine and pyrimethamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the second most common neurological complication of HIV?

A

Primary CNS lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is associated with CNS lymphonma?

A

Ebstein Barr virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the CT appearance of CNS lymphoma?

A

Homogenous enhancing lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

More likely to be toxoplasmosis or lymphoma?:
1, Multiple lesions
2. Ring or nodular enhacement
3. Thallium spect negative

A

Toxoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

More likely to be toxoplasmosis or lymphoma?:
1. Single lesion
2. Homogenous enhancement
3. Thallium spect positive

A

Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of encephalitis in HIV?

A

CMV
HIV
HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common neurological fungal infection in HIV?

A

Cryptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features of CNS cryptococcal infection in HIV?

A

CSF: high opening pressure, India ink test positive
CT: meningeal enhancement, cerebral oedema
meningitis is typical presentation but may occasionally cause a space occupying lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What infective agent undepins PML in HIV neurological infections?

A

JC virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of PML on CT scan?

A

Widespread demyelination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of AID dementia complex?

A

caused by HIV virus itself
symptoms: behavioural changes, motor impairment
CT: cortical and subcortical atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What severe respiratory complication can occur if CD4 < 200

A

PCP - although the organism is Pneumocystis jiroveci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of organism is PCP?

A

Fungal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the features if PCP?

A

Dyspnoea
Cough
Fever
Very few chest signs
Exercise induced dyspnoea

Extrapulmonary symptoms: 1-2%
- hepatosplenomegaly
- lymphadenopathy
- choroid lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the features of PCP on CXR?

A

Bilateral interstitial pulmonary infiltrates - although may also me normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How best to investigate and diagnose PCP?

A

Sputum often fails to show PCP

Bronchoalveolar lavage (BAL) often needed to demonstrate PCP (silver stain shows characteristic cysts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to treat PCP?

A

Co-trimoxazole

Steroids if hypoxic (if pO2 < 9.3kPa then steroids reduce risk of respiratory failure by 50% and death by a third)

IV Pentamidine in severe cases

Aerosolized pentamidine is an alternative treatment for Pneumocystis jiroveci pneumonia but is less effective with a risk of pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is the best time to start treatment for HIV?

A

Time of diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the CD4 count cut off for classified as AIDS?

A

<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the three types of antiretroviral therapy (ART)?

A

Combination of three:
- Nucleoside reverse transcriptase inhibitors (NRTI)
- Protease inhibitor (PI)
- Non-nucleoside reverse transcriptase inhibitor (NNRTI)

There are also:
- Entry inhibitors
- Integrase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do entry inhibitors work in HIV? Name two?
Maravoc - binds to CCR5, preventing an interaction with gp41 Enfuvirtide (binds to gp41, also known as a 'fusion inhibitor')
26
What is the general side effect of NRTI?
Peripheral neuropathy
27
List some NRTI's?
Zidovudine (AZT), Emtricitabine, Didanosine, Lamivudine, Stavudine, Zalcitabine, Tenofovir, Abacavir,
28
What is Zidovudine, and what are the side effects?
NRTI Anaemia Myopathy Black nails
29
What is Tenofovir and its side effects?
NRTI Renal impairment Ostesoporosis
30
What is Didanosine and its side effects?
NRTI Pancreatitis
31
Give examples of non-nucleoside transcriptase inhibitors?
Nevirapine, Efavirenz
32
What are side effects of non-nucleoside transcriptase inhibitors?
P450 interactions Rashes
33
Give examples of protease inhibitors in HIV?
Examples: indinavir, nelfinavir, ritonavir, saquinavir
34
Side effects of protease inhibitors?
Diabetes, hyperlipidaemia, buffalo hump, central obesity, P450 enzyme inhibition
35
What is Indinavir and its side effects?
Protease inhibitor Renal stones Asymptomatic bilirubinaemia
36
How do integrate inhibitors work ? Examples?
block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell examples: raltegravir, elvitegravir, dolutegravir
37
A pregnant woman with HIV. What is the preferred method of delivery?
Vaginal delivery is recommended if viral load is less than 50 copies/ml at 36 weeks, otherwise caesarian section is recommended
38
How should a neonate of a mother with HIV be managed?
Zidovudine if copies < 50 ART should be used. Therapy should be continued for 4-6 weeks.
39
What viruses causes kaposi sarcoma?
HHV-8 virus
40
What opportunistic infections are likely is CD4 count 200-500?
Oral thrush - Candida Shingles - Herpes zoster reactivate Hairy leukoplakia - EBV Kaposi sarcoma - EBV
41
What opportunistic infections are likely is CD4 count 100-200?
Cryptosporidosis Cerebral toxoplasmosis PML - JC virus PCP
42
What opportunistic infections are likely is CD4 count 50-100?
Aspergillosis Oesophageal candidiasis Cryptococcal Primary CNS lymphoma
43
What opportunistic infections are likely is CD4 count <50?
CMV retinitis Mycobacterium avium-intracellulare infection
44
What are the most common crytococcus species?
Cryptosporidium hominis Cryptosporidium parvum
45
What are the features of cryptococcus?
watery diarrhoea abdominal cramps fever in immunocompromised patients, the entire gastrointestinal tract may be affected resulting in complications such as sclerosing cholangitis and pancreatitis
46
How is cryptococcus diagnosed?
modified Ziehl-Neelsen stain (acid-fast stain) of the stool may reveal the characteristic red cysts of Cryptosporidium
47
What is the management of cryptococcus?
Largely supportive for immunocompetent patients nitazoxanide may be used for immunocompromised patients
48
What is more pathogenic: HIV1 or HIV 2?
HIV1
49
What factors increase the risk of transmitting HIV?
Mucosal ulceration High viral load Circumcision is protective
50
What makes the tuberculin skin test unreliable?
HIV - or immunosuppression
51
What is a common complication of PCP?
Pneumothorax
52
What is HIV seroconversion?
seroconversion is symptomatic in 60-80% glandular fever type illness 3-12 weeks after infection
53
What tests should be used to diagnosis HIV?
HIV PCR P24 antigen
54
What is the P24 antigen?
Component of HIV viral coat
55
What prophylaxis should CD4 < 200 be put on ? And why?
Co-Trimoxazole Prevention of PCP
56
What vaccinations cannot be used if HIV is <200 CD4?
Measles, Mumps, Rubella (MMR) Varicella Yellow Fever
57
What vaccinations are always contraindicated in HIV?
Cholera CVD103-HgR Influenza-intranasal Poliomyelitis-oral (OPV) Tuberculosis (BCG)
58
What is Monod's sign?
Monod's sign is similar to the air-crescent sign, which is a classic radiographic feature of air around a ball of fungus (in this case, an aspergilloma).
59
What stain is needed for PCP?
Silver stain
60
How do you treated cryptosporidosis?
Supportive in immunocompetent Nitazoxanide may be used for immunocompromised patients Rifaximin is also sometimes used for immunocompromised patients/patients with severe disease
61
What causes mycobacterium avian complex?
Mycobacterium avium Mycobacterium intracellulare
62
What is the treatment of mycobacterium avian complex?
Fever, sweats Abdominal: pain, diarrhoea Lung: dyspnoea, cough Anaemia Lymphadenopathy Hepatomegaly/deranged LFTs
63
What prophylaxis should HIV patients be on less at CD 100 for MAC?
Clarithromycin or azathioprine
64
What is the treatment of MAC active infection?
rifampicin + ethambutol + clarithromycin

MRCP: Infectious Diseases (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions