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HIV Flashcards

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1
Q

Define localized infection

A

infections limited to small areas

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2
Q

define disseminated infection

A

infection that has spread to areas of the body beyond initial location

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3
Q

define systemic infection

A

infections that have spread throughout the body- often via blood

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4
Q

describe bacteria

A

bacteria are one celled organisms common throughout nature and within the body

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5
Q

how do bacteria cause disease in the body

A

entering the body and growing inside human cells

secreting toxins that damage cells

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6
Q

what are the shapes of bacteria?

A

cocci, bacilli, curved rods, vibrio, spirochetes

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7
Q

What is the structure of viruses

A

they are infectious particles consisting of RNA or DNA and a protein coat

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8
Q

What are protozoa

A

single-celled microorganisms that normally live in soil and water. Malaria

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9
Q

What are prions

A

infectious particles that contain abnormally shaped proteins
typically affect nervous system
Creutzfeldt-jakob disease

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10
Q

define emerging infections

A

an infectious disease that has recently increased in incidence or that threatens to increase in the immediate future

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11
Q

where do emerging infections originate

A

unknown sources, contact with animals, changes in known disease, biologic warfare

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12
Q

What are some examples of emerging infections

A

West nile virus, Ebola, H1N1, lyme disease, PUD, E.coli, HIV, Hepatitis

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13
Q

Examples of Reemerging infections

A

Diptheria, Pertussis, Plague, TB,

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14
Q

What is resistance

A

occurs when pathogenic organisms change in ways that decrease the ability of a drug to treat disease

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15
Q

How do microorganisms resist antimicrobial agents?

A

Mutation
Acquisition of new DNA or RNA
producing enzymes that destroy or inactivate drugs
changing drug target sites

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16
Q

Examples of emerging strains of antibiotic resistant organisms

A

Methicillin- Resistant S. Aureus (MRSA)
Vancomycin Resistant Enterococci (VRE)
Penicillin-resistant Streptococcus Pneumonia

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17
Q

How do health care providers contribute to the development of drug-resistant organisms

A

1- administering antibiotics for viral infections
2- succumbing to pressures from pt to prescribe unnecessary antibiotic
3- using inadequate drug regimens to treat infections
4- using broad-spectrum or combination agents that should be treated with first-line medications

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18
Q

How do patients contribute to resistant development

A

1- skipping doses
2-not taking antibiotics for the full duration
3- saving unused antibiotics

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19
Q

What are Health-care associated infections (HAI)

A

infections that are acquired as a result of exposure to a microorganism in a health care setting
- up to 10% of pt will get an HAI

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20
Q

how much HAIs are preventable

A

up to 1/3

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21
Q

What is the first line of defense against an HAI

A

hand washing, PPE

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22
Q

What is the most common HAI in the elderly population

A

UTIs especially in patients in nursing homes

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23
Q

Infections in older adults often present what?

A

atypical symptoms- behavior and cognitive- before normal symptoms (fever/pain) and laboratory findings

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24
Q

when should standard precautions be used?

A

when in contact with, blood, body fluids, nonintact skin, mucous membranes

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25
What population is HIV more prevelent
men who have sex with men.
26
How is HIV transmitted?
sexual intercourse, exposure to HIV blood/blood products, perinatal transmission during pregnancy, delivery or breastfeeding
27
When can an HIV positive person transmit the virus
a few days after becoming infected until death
28
What are the variables that influence HIV transmission?
duration and frequency of contact with virus volume, virulence and concentration of organism host immune status
29
What is the most common way HIV is transmitted?
through unprotected sex
30
how has the greater risk of developing HIV during sex
the receiving partner- although the "inserting partner" is still at risk
31
Why is the receiving partner more at risk of developing HIV during sex
due to prolonged contact with infected fluid
32
how is HIV transmitted through contact with blood and blood products?
contaminated equipment- sharing equipment | transfusions
33
What is the most common means of work-related HIV transmission?
puncture wounds- although the risk is till very low
34
How does the HIV virus enter normal cells?
The gp120 "knobs" on the virus attach to the specific CD4 and chemokine receptors
35
Once in the cell (usually CD4 T cells) what does the HIV virus do?
viral RNA enters the cell where it is transcribed with the help of a reverse transcriptase into a single strand of viral DNA
36
What happens next to the single strand of viral DNA?
it copies it self becoming a double strand of viral DNA and enters the cell's nucleus with the help of the enzyme integrase
37
Once the double stranded viral strand of HIV is in the nucleus what happens?
The DNA splices itself into the human genome becoming a permanent part of the genetic structure which causes all daughter DNA to have the same DNA and make new HIV
38
What does the initial HIV infection result in
viremia- large amounts of virus in the blood for a couple of weeks followed by low levels of HIV
39
what is a major consequence of the rapid replication of HIV
errors can occur in the copying process, causing mutations that can contribute to resistance to ART and limit treatment options
40
in the initial stages of the HIV infection, how do B cells and T cells respond?
They function normally B cells make HIV specific antibodies which reduce viral load T cells mount a cellular response to viruses trapped in lymph nodes
41
What cells does HIV predominately affect?
CD4+ T cells- which the T cells play an important role in the detection and defense against pathogens
42
What is the normal CD4+ count in a normal adult
800-1200 CD4+ T Cells/ microliter
43
what is the normal life span of a CD4+ T cell
100 days
44
What is the life span of a CD4+ T cell an an HIV person
2 days
45
When do opportunistic infections occur
when CD4+ count is below 500
46
What is the pattern that untreated HIV infections follow
1- disease progression is highly individualized 2 treatment can significantly alter this pattern 3- an individual's prognosis is unpredictable
47
Symptoms of the Acute infection of HIV
similar to a mononucleousis syndrome fever, swollen lymph glands, sore throat, headache, malaise, nausea, muscle and , diarrhea, rash accompanies seroconversion- development of antibodies
48
When do acute HIV symptoms occur
within 2-4 weeks of initial infection and they last 1-3 weeks
49
During acute infection what is the viral load at?
the viral load is typically high and CD4+ T cells are low but this quickly returns to normal or baseline
50
what is the interval between initial HIV infection and AIDs
about 10 years
51
During the asymptomatic infection phase of HIV what is the viral load
the viral load is low and the CD4+ T cell level remains above 500
52
during the asymptomatic phase of HIV what are some symptoms that may appear?
fatigue, headache, low-grade fever, night sweats, persistent generalized lymphadenopathy
53
When does symptomatic infection occur in HIV
when the CD4+ T cell count drops to 200-500
54
What are the symptoms of HIV in the symptomatic infection stage
persistent fever, frequent drenching night sweats, chronic diarrhea, recurrent headaches, and fatigue, localized infections, lymphdenopathy, nervous system manifestations
55
what is the most common infection associated with the symptomatic phase of HIV infection
oropharyngeal candidasis- thrush shingles outbreaks of herpes oral hairy leukoplakia
56
What is the diagnostic criteria for AIDS
``` CD4+ T cells below 200 Opportunistic Infection Opportunistic Cancer - invasive cervical cancer, kaposis sarcoma, burkitt's lymphoma, immunoblastic lymphoma, primary lymphoma of the brain Wasting syndrome AIDS dementia complex ```
57
How do you diagnose HIV infection
testing the blood for HIV antibodies or antigen in the blood- typically detects HIV specific antibodies typically take several weeks
58
how is the progression of HIV monitored
CD4+ T cell counds and viral load
59
As HIV progresses what happens to the CD4+ T cell cound
the t cell number decreases
60
If the viral load is undetectable what does that mean?
that the viral load is lower than the test is able to report
61
Why are abnormal blood tests common in HIV infections
HIV, opportunistic disease, complications of therapy
62
why is anemia common in HIV patient
it is associated with the chronic disease process and an adverse effect of ART
63
What are the two types of resistance tests that can determine if a patient is resistant to drugs used for ART
Genotype Assay- detects drug resistant viral mutations | Phenotype Assay- measures growth of HIV in various concentrations of ART
64
what is the focus of collaborative care in HIV infected Patients
1- monitoring HIV disease progression and immune function 2- initiating and monitoring ART 3- preventing the development of opportunistic disease 4- detecting and treating opportunistic disease 5- managing symptoms 6- preventing or decreasing complications of treatment 7- preventing further transmission of HIV
65
What is the goal of drug therapy in HIV infection
1- decrease the viral load 2- maintain or increase CD4+ T cell counts 3- prevent HIV-related symptoms and opportunistic disease 4- delay disease progression 5- prevent HIV transmission
66
How much can ART reduce viral load
90-99%
67
What is the advantage of using multiple ART?
is that the combination therapy can inhibit viral replication in several ways making it more difficult for the virus to recover and decreasing the likelihood of drug resistance
68
what is truvada
truvada is the first drug approved to reduce the risk of HIV in uninfected individuals who are at high risk of HIV
69
Health Promotion of HIV
``` prevention of HIV Decreasing risk related to sex Decreasing risk of perinatal transmission decreasing risks at work HIV testing ```
70
Acute Intervention of HIV
initial response to diagnosis of HIV antiretroviral therapy delaying disease progression

Nursing 337 (9 decks)

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