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Flashcards in HIV Deck (70):
1

Define localized infection

infections limited to small areas

2

define disseminated infection

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

3

define systemic infection

infections that have spread throughout the body- often via blood

4

describe bacteria

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

5

how do bacteria cause disease in the body

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

6

what are the shapes of bacteria?

cocci, bacilli, curved rods, vibrio, spirochetes

7

What is the structure of viruses

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

8

What are protozoa

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

9

What are prions

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

10

define emerging infections

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

11

where do emerging infections originate

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

12

What are some examples of emerging infections

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

13

Examples of Reemerging infections

Diptheria, Pertussis, Plague, TB,

14

What is resistance

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

15

How do microorganisms resist antimicrobial agents?

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

16

Examples of emerging strains of antibiotic resistant organisms

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

17

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

18

How do patients contribute to resistant development

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

19

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

20

how much HAIs are preventable

up to 1/3

21

What is the first line of defense against an HAI

hand washing, PPE

22

What is the most common HAI in the elderly population

UTIs especially in patients in nursing homes

23

Infections in older adults often present what?

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

24

when should standard precautions be used?

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

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