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Flashcards in HIV Deck (70):

Define localized infection

infections limited to small areas


define disseminated infection

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


define systemic infection

infections that have spread throughout the body- often via blood


describe bacteria

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


how do bacteria cause disease in the body

entering the body and growing inside human cells
secreting toxins that damage cells


what are the shapes of bacteria?

cocci, bacilli, curved rods, vibrio, spirochetes


What is the structure of viruses

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


What are protozoa

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


What are prions

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


define emerging infections

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


where do emerging infections originate

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


What are some examples of emerging infections

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


Examples of Reemerging infections

Diptheria, Pertussis, Plague, TB,


What is resistance

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


How do microorganisms resist antimicrobial agents?

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


Examples of emerging strains of antibiotic resistant organisms

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


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

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


How do patients contribute to resistant development

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


What are Health-care associated infections (HAI)

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


how much HAIs are preventable

up to 1/3


What is the first line of defense against an HAI

hand washing, PPE


What is the most common HAI in the elderly population

UTIs especially in patients in nursing homes


Infections in older adults often present what?

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


when should standard precautions be used?

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


What population is HIV more prevelent

men who have sex with men.


How is HIV transmitted?

sexual intercourse, exposure to HIV blood/blood products, perinatal transmission during pregnancy, delivery or breastfeeding


When can an HIV positive person transmit the virus

a few days after becoming infected until death


What are the variables that influence HIV transmission?

duration and frequency of contact with virus
volume, virulence and concentration of organism
host immune status


What is the most common way HIV is transmitted?

through unprotected sex


how has the greater risk of developing HIV during sex

the receiving partner- although the "inserting partner" is still at risk


Why is the receiving partner more at risk of developing HIV during sex

due to prolonged contact with infected fluid


how is HIV transmitted through contact with blood and blood products?

contaminated equipment- sharing equipment


What is the most common means of work-related HIV transmission?

puncture wounds- although the risk is till very low


How does the HIV virus enter normal cells?

The gp120 "knobs" on the virus attach to the specific CD4 and chemokine receptors


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


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


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


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


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


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


What cells does HIV predominately affect?

CD4+ T cells- which the T cells play an important role in the detection and defense against pathogens


What is the normal CD4+ count in a normal adult

800-1200 CD4+ T Cells/ microliter


what is the normal life span of a CD4+ T cell

100 days


What is the life span of a CD4+ T cell an an HIV person

2 days


When do opportunistic infections occur

when CD4+ count is below 500


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


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


When do acute HIV symptoms occur

within 2-4 weeks of initial infection and they last 1-3 weeks


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


what is the interval between initial HIV infection and AIDs

about 10 years


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


during the asymptomatic phase of HIV what are some symptoms that may appear?

fatigue, headache, low-grade fever, night sweats, persistent generalized lymphadenopathy


When does symptomatic infection occur in HIV

when the CD4+ T cell count drops to 200-500


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


what is the most common infection associated with the symptomatic phase of HIV infection

oropharyngeal candidasis- thrush
outbreaks of herpes
oral hairy leukoplakia


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


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


how is the progression of HIV monitored

CD4+ T cell counds and viral load


As HIV progresses what happens to the CD4+ T cell cound

the t cell number decreases


If the viral load is undetectable what does that mean?

that the viral load is lower than the test is able to report


Why are abnormal blood tests common in HIV infections

HIV, opportunistic disease, complications of therapy


why is anemia common in HIV patient

it is associated with the chronic disease process and an adverse effect of ART


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


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


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


How much can ART reduce viral load



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


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


Health Promotion of HIV

prevention of HIV
Decreasing risk related to sex
Decreasing risk of perinatal transmission
decreasing risks at work
HIV testing


Acute Intervention of HIV

initial response to diagnosis of HIV
antiretroviral therapy
delaying disease progression