Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ICM - Infectious Disease > HIV > Flashcards

HIV Flashcards

(70 cards)

Start Studying
1
Q

What are all boring

A

Diabetic Feet

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

What are E Europe and Central Asia still on the rise

A

Heroin/IV drug use

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

Why did N America do so much better starting in 96

A

First release of Protease Inhibitors

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

HIV History.

A

Read the slide a time or two.

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

First good protease inhibitor

A

Indenovir

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

Dr. Myer made an anal joke.

A

lolz

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

Significance of the Release of HAART (the Protease Inhibitors) in 1996

A

60-80% reduction in mortality from AIDS in US

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

First signs of HIV showing up in the US population

A

1981 – Penumocystis pneumonia and Kaposi’s sarcoma show up in NYC and SF homosexuals

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

THe four H’s at risk groups

A

Homosexual
Heroin
Hemophiliac
Haitian

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

Transfusion related HIV began to diminish in 1985. Why?

A

Serologic Testing Developed

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

Where does HIV come from?

A

The Congo – ID’d as early as 1959

Most common strain from Africa to Haiti (66) to the US (69)

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

Why did HIV increase so much in the 70s?

A 
Increased Travel
Gay Sexual Revolution
Increased Blood Transfusions
Transfusing Factor VIII to hemophiliacs
Increased IVDA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
Estimated Transmission Rate. 
Transfusion with Contaminated Blood?
Needle Sharing?
Receptive Anal Intercourse?
Occupational Needle Stick?
A

90%

  1. 7%
  2. 5%
  3. 3%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CDC Testing Guidelines for HIV

A

Screen all healthy patients after notification unless they decline
Specific Informed consent unnecessary
High risk patients should be scheduled annually
Prevention counseling should not be required, but encouraged

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

Main Clinical Indications for Testing

A 
TB
Syphilis
Recurrent Shingles
Unexplained chronic constitutional symptoms
Unexplained Adenopathy
Unexplained Chronic Diarrhea/Wasting
Thrush
Opportunistic Diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common opportunistic diseases

A 
TB
Pneumo
Kaposi
Peri-anal warts
Thrush/Candidiasis
etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Testing for HIV. Who shows up first in blood?

A

HIV RNA in plasma (approx. 10 days)

Used for viral detection

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

Testing for HIV. Second blood level to rise.

A

HIV p24 Ag

Previously used viral detection method

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

Testing for HIV. Last level to rise

A

HIV Ab

Takes 20-30 days to become measurable

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

Common symptoms of Primary HIV

A 
Fever, Fatigue
Rash/Petechiae
Myalgia*
Pharyngitis
Night Sweats*
Weight Loss*
Oral/Genital ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Primary HIV Clinical Clues

A

Mucocutaneous ulcerations
Rash
** Abrupt onset
GI symptoms

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

Primary HIV Clinical Clues. What makes it less likely

A

Cough/URI

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

How do you test for HIV?

A

ELISA
Usually works within a month
99% accurate at 3 months

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

What do you do when you see a positive HIV response.

A

Repeat the test

Still positive, WB to confirm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are you looking for on the western blot?
Three characteristic bands (positive with 2/3) | 1/3 indeterminate -- check the viral loads
26
Can a low CD4 be used as a confirmation of HIV?
No
27
Are rapid HIV tests available?
yes
28
What do you need to find in an HIV patient history? (8)
``` High Risk Behaviors Knowledge of HIV Emotional Response to Diagnosis Family/Social Situation Employment and Insurance Status Travel History Exposure to TB, STDs, Hepatitis Immunization Status ```
29
Labs you need to run on a newly diagnosed patient.
``` Complete Blood and Differential Count Liver Function Labs + Fasting Glucose CD4 count + Viral Load HIV Genotype Test Other disease checks ```
30
Labs you need to run on a newly diagnosed patient. Other diseases.
``` Syphilis Testing Toxo serology Anti- Hepatitis PPD Pap Smear +/- Anal pap smear Chlamydia+GC test G6PD quantitative testing ```
31
Why do the HIV genotype test?
By testing the genotype, you can assess specific genetic indication for which drugs may be most effective in killing off the virus
32
What is the main surrogate marker for HIV disease progression?
CD4 levels
33
Normal range for CD4
350-110 mm3
34
Normal decline in CD4/year without treatment?
75-100 mm3/year
35
Describe the natural history of untreated HIV
CD4 levels drop quite a bit while the virus levels shoot up. Clinical Latency at 10,000-20,000 Slow increase of Virus until the CD4 count drops below 200 Much more symptomatic below this level -- here you have worst symptoms and death
36
Prognostic indication of a high early viral load
Symptoms are worse for patients with early high levels of the virus. Knocks down the CD4s faster and indicates clinically that the meds will have a rough time.
37
Why is it important to track CD4 levels
Determines need for antiretroviral therapy Need for antimicrobial prophylaxis Assess Prognosis
38
How are viral loads measures?
PCR
39
Normal variability of HIV?
0.3 log (3-5 fold)
40
Why monitor viral load?
Monitor antiretroviral terhapy | Assess prognosis
41
Average HIV patient with a CD4 above 500
``` Asymptomatic Bacterial infections (pneumo, staph), TB, Shingles ```
42
Average HIV patient with CD4 200-500
Many still asymptomatic | Generalized adenopathy, thrush, Kaposi's
43
Average HIV patient with CD4 below 200
PCP, Toxoplasmosis, Cryptococcus
44
Average HIV patient with a CD4 below 50
CMV, Mycobacterium avium complex Increased risk of Lymphoma Highest Mortality
45
When do you start treating for HIV?
``` AIDS Defining Condition CD4 count below 500 Pregnancy if keeping baby Chronic co-infection with Hep B HIV-associated nephropathy ```
46
Targets of HIV drugs. NRTIs
``` Abacavir Didanosine *Emtricitabine *Lamivudine Stavudine *Tenofovir Zidovudine ```
47
How do you get resisitant HIV?
Failure to adhere to medications that can cause
48
How do integrase inhibitors work?
They prevent the incorporation of viral dsDNA from integrating into you DNA
49
What do protease inhibitors?
Prevent new RNA protegy from being able to assemble correctly in affected cells
50
What do infusion inhibitors do?
Exactly what it sounds like | Blocks virus from coming in
51
Name the fusion innhibitor
Enfuvirtide
52
Name the CCR5 Antagonist
Maravioc
53
How do meds usually work
Usually 3 drugs at a time, Virus can't make resistance to 3 at a time Often two NRTIs with an integrase inhibitor
54
Significance of SMART trial, ART-CC, NA-ACCORD
Shows lower risk for people who start above 350 | Even better above 500
55
Common NNRTI drugs
Delavirdine Efavirenz Etravine Nevirapine
56
What other non-infectious disease state should be watched for in HIV treatment?
HIV is an inflammatory disease
57
Preferred Initial Treatment for HIV. NNRTI based.
Not Recommended
58
Preferred Initial Treatment for HIV. PI based.
DRV/r + TCF/FTC
59
Preferred Initial Treatment for HIV. II based.
DTG or EVG/Cobi or Ral + TDF/FTC
60
Preferred Initial Treatment for HIB. Pregnant women.
LPV/r + ZDV/3TC
61
When should you initiate ART?
``` History of AIDS-defining Illness CD4 below 350 (sometime just blow 500) Pregnant Women HIV-associated nephropathy Hep B coinfection + HBV ```
62
Complications of HIV treatment
``` Lipodystrophy syndrome Lactic acidemia Premature osteopenia/porosis Avascular necrosis of hips Peripheral neuropathy ```
63
What is Lipodystrophy syndrome
Body morphologyy changes and metabolic complications (the big body little arms)
64
Symptoms of Lactic acidosis
``` Peripheral neuropathy pancreatitis Myopathy Steatosis Liver Failure ```
65
Who tends to get occupational exposures
Nurses and ancillary staff 24% say it happened this year Only 106 seroconversions worldwide reported
66
Which stick is most likely to infect. HBV? HCV? HIV?
HBV -- 30% HCV -- 3% HIV -- 0.3%
67
Why expose someone to ZDV immediately after a needle stick?
in this case, AZT was 81% protective against HIV | now they'd get blasted with 2-3 antiretrovirals
68
Examples of non-occupational HIV PEP scenarios
Sex/Sexual Assault | IDU
69
Who might you give PrEP to?
Patients uninfected with a high risk of infection
70
What is PrEP
you should really look that up Bryan

ICM - Infectious Disease (11 decks)

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