HIV

Question 1

This HIV protein binds cell surface proteins CD4 and CCR5

Answer 1

p120

Question 2

What is protein p120?

Answer 2

Protein on HIV that binds cell surface proteins CD4 and CCR5
Both proteins needed for infection to occur

Question 3

People with this homozygous mutation are resistant to HIV infection

Answer 3

CCR5
Both CD4 and CCR5 are needed for infection to occur

Question 4

What is the result of HIV infection of a quiescent T cell?

Answer 4

Latent infection
Viral RNA remains linear and cytoplasmic

Question 5

What is the result of HIV infection of an activated proliferating T cell?

Answer 5

Cell death
Viral RNA integrates into host genome

Question 6

Type of T cell that Proliferating infected cell sheds virus and is killed

Answer 6

Th cells

Question 7

2 cells that are not killed by HIV infection, but serve as reservoirs of infection (important when Th count is very low)

Answer 7

Macrophage and Dendritic cell

Question 8

Probable initial infected cell at mucosal inoculation

Answer 8

Dendritic cell

Question 9

Cell that Brings infection to other tissue sites (microglia, etc)

Answer 9

Macrophage

Question 10

Cell that Brings HIV infection to lymph nodes and more CD4+ T cells

Answer 10

Dendritic cell

Question 11

This begins 3-6 weeks after HIV infection and lasts 2-4 weeks

Answer 11

Acute retroviral syndrome

Question 12

How do you get loss of barrier function at mucosal sites and microbial invasion often with diarrhea in acute retroviral syndrome?

Answer 12

Infection and death of memory T cells at mucosal site

Question 13

How do you get generalized lymphadenopathy and viremia in acute retroviral syndrome?

Answer 13

Dendritic cells bring HIV to lymph nodes

Question 14

Acute retroviral syndrome is characterized by generalized ______ and _______

Answer 14

Lymphadenopathy and Viremia

Question 15

When does seroconversion (making Abs; humoral response) occur in acute retroviral syndrome?

Answer 15

3-7 weeks

Question 16

Fever, sore throat, fatigue, rash, and lymphadenopathy are symptoms of this

Answer 16

Acute retroviral syndrome

Question 17

What affect does the cell-mediated response have on viremia?

Answer 17

Decreased

Question 18

When does the cell-mediated response (and subsequent decreased viremia) occur in acute retroviral syndrome?

Answer 18

12 weeks

Question 19

Does the humoral response or cell-mediated response occur 3-7 weeks in acute retroviral syndrome?

Answer 19

Humoral (seroconversion)

Question 20

Does the humoral response or cell-mediated response occur 12 weeks in Acute retroviral syndrome?

Answer 20

Cell mediated (decrease viremia)

Question 21

Seroconversion takes 3-7 weeks after infection, and these are detectable a little earlier

Answer 21

Viral particles or p24 capsid protein

Question 22

Long period of stable viremia and gradual decreased CD4+ T cells

Answer 22

Latency period

Question 23

CD4 count trend in latency period

Answer 23

Gradually decreases

Question 24

Viral load count trend in latency period

Answer 24

Gradually increases

Question 25

Period where HIV is replicating in spleens, lymph nodes

Answer 25

Latency period

Question 26

Symptoms of HIV during the latency period

Answer 26

Usually asymptomatic May have minor opportunistic infections (Candida, Tb, Herpes) Occasionally have autoimmune thrombocytopenia

Question 27

Level of viremia reaches plateau with onset of this

Answer 27

Cell mediated response

Question 28

This level predicts the time course to AIDS

Answer 28

Level of viremia that reaches plateau with CMI onset

Question 29

This count is assessment of current immune deficiency

Answer 29

CD4 count

Question 30

Viremia level of >36k predicts 62% chance of this at 5 years

Answer 30

AIDS

Question 31

Viremia level of <4k predicts 5% chance of this at 5 years

Answer 31

AIDS

Question 32

Viremia level of this predicts 62% chance of AIDS at 5 years

Answer 32

>36k

Question 33

Viremia level of this predicts 5% chance of AIDS at 5 years

Answer 33

<4k

Question 34

When does AIDS occur?

Answer 34

Generally 5-10 years after initial infection

Question 35

AIDS is defined by a CD4 count of this

Answer 35

<200 cells/ul

Question 36

AIDS is defined by either of these

Answer 36

CD4 count <200 cells/ul OR AIDS defining illnesses

Question 37

This is Often preceded by constitutional SSx, generalized LAD, fever

Answer 37

AIDS

Question 38

Viral load count trend in AIDS

Answer 38

Dramatically increases slope

Question 39

CD4 count trend in AIDS

Answer 39

Loss accelerates

Question 40

6 AIDS defining illnesses

Answer 40

Viral Pneumocystic pneumonia Mycobacteria Recurrent bacterial pneumonia Fungal infections Neoplasms

Question 41

AIDS defining illness: What cell dysfunction causes bacterial pneumonia?

Answer 41

B cell and neutrophil dysfunction

Question 42

AIDS defining illness: In bacterial pneumonia, what type of bacteria are patients most vulnerable to?

Answer 42

Encapsulated bacteria (due to poor opsonization) Includes pneumococcus, haemophilus, staph aureus

Question 43

AIDS defining illness: Occurs early, incidence 10-20x Due to B cell and neutrophil dysfunction

Answer 43

Bacterial pneumonia

Question 44

AIDS defining illness: Occurs anytime, usually early (CD4 ~ 325) Restricted to lungs if CD4 count relatively high (Pneumonia, Cavitary disease, Hilar lymph nodes) Disseminated disease if CD4 count low (Bone marrow, adrenals, etc)

Answer 44

Tuberculosis

Question 45

AIDS defining illness: Tuberculosis trend if CD4 count is relatively high

Answer 45

Restricted to lungs Pneumonia, cavitary disease, hilar lymph nodes

Question 46

AIDS defining illness: Tuberculosis if CD4 count is low

Answer 46

Disseminated disease Bone marrow, adrenals, etc

Question 47

AIDS defining illness: Kaposi Sarcoma is always associated with this

Answer 47

HHV8 (human herpes virus) infection

Question 48

HHV8 (human herpes virus) infection is always associated with this AIDS defining illness

Answer 48

Kaposi Sarcoma

Question 49

Blue-violaceous-brown maculopapular skin lesions are characteristic of this AIDS defining illness

Answer 49

Kaposi Sarcoma

Question 50

AIDS defining illness: When does bacterial pneumonia occur?

Answer 50

Early Incidence 10-20x

Question 51

AIDS defining illness: When does tuberculosis occur?

Answer 51

Anytime, usually early (CD4 ~ 325)

Question 52

AIDS defining illness: When does Kaposi Sarcoma occur?

Answer 52

Anytime

Question 53

AIDS defining illness: When does lymphoma occur?

Answer 53

CD4 < 200

Question 54

AIDS defining illness: Lymphoma is associated with this coinfection

Answer 54

EBV

Question 55

AIDS defining illness that is associated with EBV coinfection

Answer 55

Lymphoma

Question 56

Lymphoma is typically this cell lineage

Answer 56

B cell

Question 57

AIDS defining illness: Lymphoma is frequently located

Answer 57

Extra-nodal

Question 58

AIDS defining illness: 2 common types of lymphoma

Answer 58

Burkitt lymphoma Diffuse large B-cell lymphoma

Question 59

AIDS defining illness: When does Pneumocystis occur?

Answer 59

CD4 < 200 Begin prophylaxis

Question 60

AIDS defining illness: Pneumocystis is caused by this

Answer 60

Unicellular fungal organism

Question 61

AIDS defining illness characterized by: Non-productive cough, Fever, and bilateral fluffy infiltrates (not always present with low CD4)

Answer 61

Pneumocystis

Question 62

AIDS defining illness: Involves bilateral fluffy infiltrates (not always present with low CD4)

Answer 62

Pneumocystis

Question 63

AIDS defining illness: Unicellular fungal organism causes this

Answer 63

Pneumocystis

Question 64

AIDS defining illness: When does Cryptococcus infection occur?

Answer 64

CD4 < 100

Question 65

AIDS defining illness: 2 forms of Cryptococcus

Answer 65

Pneumonia or disseminated forms

Question 66

AIDS defining illness: Encapsulated yeast; visible with mucicarmine or India ink preparations

Answer 66

Cryptococcus

Question 67

AIDS defining illness: Cryptococcus is visible with either of these 2 preparations

Answer 67

Mucicarmine or India Ink preparations

Question 68

AIDS defining illness: When does taxoplasmosis occur?

Answer 68

CD4 < 200

Question 69

AIDS defining illness: CNS disease producing abscesses "Ring enhancing lesions" as seen on brain scans

Answer 69

Toxoplasmosis

Question 70

AIDS defining illness: "Ring enhancing lesions" as seen on brain scans

Answer 70

Toxoplasmosis

Question 71

AIDS defining illness: Toxoplasmosis involves these seen on brain scans

Answer 71

Ring enhancing lesions

Question 72

AIDS defining illness: What is taxoplasmosis?

Answer 72

CNS disease producing abscesses

Question 73

AIDS defining illness: When does Mycobacterium avium-intracellulare occur?

Answer 73

CD4 < 50

Question 74

AIDS defining illness: Fever, weight loss, night sweats Initial pulmonary infection Disseminated form

Answer 74

Mycobacterium avium-intracellulare

Question 75

AIDS defining illness: When does cytomegalovirus infection occur?

Answer 75

CD4 < 50

Question 76

AIDS defining illness: 3 characteristics of cytomegalovirus infection

Answer 76

Retinitis (painless vision loss, floaters) Colitis (diarrhea) Esophagitis (odynophagia, dysphagia)

Question 77

AIDS defining illness: Characterized by retinitis, colitis, esophagitis

Answer 77

Cytomegalovirus

Question 78

AIDS defining illness: Neoplasms are often associated with this

Answer 78

Viral associated (Cervical or anal squamous cell carcinoma, Non-Hodgkin lymphoma, Hodgkin lymphoma, Kaposi sarcoma)

Question 79

2 tests for initial HIV diagnosis

Answer 79

Antibody test p24 antigen test

Question 80

3 confirmatory tests for HIV diagnosis

Answer 80

HIV antibody specific assay HIV viral RNA Ab- with RNA+ : recent infection (window period; blood test not positive yet)