Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ID > HIV > Flashcards

HIV Flashcards

(59 cards)

Start Studying
1
Q

Diarrhoea in HIV, probably going to be…

A

Cryptosporidium
Red cysts in stools- do acid fast staining
Treatment supportive

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

What factors increase risk of transmission of HIV

A 
Gernital ulceration
High viral load
Not being circumcised in heterosexual transmission
HLA-B concordant couple
Not CCR5 D32 homozygote
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the main proteins of the virion

A

GP120 is the receptor surface protein
GP41 attaches GP120 to the cell membrane
P24 is core protein around the two ss of RNA

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

Binding process for HIV?

A 
CD4  binds GP120 
then
 there is coreceptor binding between GP120 and CCR5 or CXCR4
then 
fusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where are most of the CD4 cells killed?

A

The gut

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

What factors affect the rate of disease progression?

A

Coinfection with CMV accelerates
CCR5 using viruses progress faster initially
High HIV neutralising Ab titre slows
Extremes of age are worse
There are intracellular factors that supress replication eg TRIMSalpha, APOBEC3, SAMHDI

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

What are the five classes of ARV drugs?

A 
Nucleoside/tide RTI
Non nucleoside RTI
Protease inhibitors
Integrase inhibitors
Entry inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why do we screen for HLA B5701?

A

To predict occurrence of abacavir hypersensitivity syndrome

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

Abacavir

A

Nucleoside RTI

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

Zidovudine

A

Nucleoside RTI

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

Lamivudine

A

Nucleoside RTI

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

Emtricitabine

A

Nucleoside RTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tenofovir

A

Nucleotide RTI

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

Efairenz

A

NNRTI

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

Nevirapine

A

NNRTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rilpivirine

A

NNRTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Raltegravie

A

Integrase Inhibitor

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

Dolutegravir

A

Integrase inhibitor

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

Elvitegravir/cobicistat

A

Integrase inhibitor with p450 inhibitor

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

Lopinavir/Ritonavir

A

Protease inhibitor/P450 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Maraviroc

A

Entry inhibitor- CCR5 inhibitor

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

Virologic supression

A

RNA below detection limit of assay

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

Virologic failure

A

either incomplete virological response : 24 weeks on ART and RNA over 200

or

virologic rebound: repeated detection of HIV RNA over 200 on several occasions after viral supression

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

Immunologic failure

Study These Flashcards
A

CD4 drops below baseline on therapy
or
CD4 increase less than 25-50 cells in 12 months

Switching drugs does not work

25
clinical failure
HIV related event after three months on therapy, excluding immune reconstitution
26
When is it safe to switch drugs over
When viral load undetectable, free to switch one or two
27
When do you do HIV genotype testing
Whilst person is taking the failing regimen or has been off for under 4 weeks. Usually need viral load over 1000 Pregnant New diagnosis, even if not planning to start ART
28
Tenofovir toxicities (3)
Fanconi syndrome Reduce GFR even without fanconi Reduced BMD (rare, can still provoke lipoatrophy)
29
Abacavir toxicities (3)
3-5% will have an allergic reaction that strongly associated with HLAB5701- may happen any time but often in first 6 weeks of treatment. GI sx, malaise, rash, cough, leukopaenia Some trials say increase risk MIs but inconsistent Can still see lipoatrophy but rare
30
Efavirenz toxicities
40% CNS- vivid dreams, sleep change, headache Rash Teratogenic Induces AND inhibits
31
Nevirapine toxicities
Rash 5-10% usually mild but can be SJS | Enzyme inducer
32
Atazanapine toxicities
Hyperbilirubinaemia | Kidney stones
33
Which statin should you use in HIV?
Pravastatin has the least P450 interaction but is not very strong Atorvastatin and Rosuvastatin are suggested but can reach very high levels with protease inhibitors Avoid simvastatin and lovastatin as -->RHABDO If TGs are the issue, give gemfibrozil
34
Which protease inhibitors are the best in terms of lipid profile?
Darunavir and Atazanavir
35
What is the problem with Nevirapine and methadone?
Induces P450 so can cause methadone withdrawl if started
36
Which agents have minimal/minor P450 activity?
Raltegrivir and Dolutegravir have minor P450 activity
37
Inhaled steroids and HIV treatment?
Inhaled fluticasone (not beclamethasone) can cause cushings, AVN, osteoporosis in setting of P450 3A4 inhibition
38
In general, protease inhibitors do what with drug metabolism?
CYP 3A4 inhibitors PIs (in order of potency: ritonavir, indinavir, nelfinavir, amprenavir, atazanavir, saquinavir)
39
Which ART drugs are CYP 3A4 inducers?
efavirenz | nevirapine,
40
CD4 count 200-500 : what infections are you worried about?
HSV Pneumococcal pneumonia Oral candida TB
41
CD4 50-200 : what infections are you worried about?
PCP plus cancers plus brain things ``` PCP CNS toxoplasmosis cryptococcus K's sarcoma NHL Primary CNS lymphoma ```
42
Under 50 CD4 cells: what infections are you worried about?
disseminated MAC CMV retinitis Cryptosporidiosis
43
What are the strong indications to start ART?
``` history of aids defining illness CD4 under 500 Any CD4 and pregnancy Any CD4 and HBV needing treatment HIV associated nephropathy ```
44
What is immune restoration disease?
Worsening symptoms of previously diagnosed opportunistic infection (paradoxical IRD), or new opportunistic infection (unmasking IRD). Due to enhanced immune recognition of intercurrent pathogens/antigens
45
If someone presents with an opportunistic infection and not on ART...when to start?
Treat OI and start ART 2-4 weeks later in general TO PREVENT OVERLAP TOXICITY TB and cell count over 50- do not start for 4-8 weeks TO MINIMISE IRIS TB and CD4 under 50- 2-4 weeks TB tx TO MINIMISE AIDS PROGRESSION AND DEATH
46
Treatment for cerebral toxoplasmosis?
Sulfadiazine and pyrimethamine
47
Zidovudine toxicities? (3)
MYOPATHY black nails anaemia
48
Early after HIV probably caught, what can you test?
p24 Ag
49
What proportion of people with abacavir hypersensitivity have HLA B5701 compared with people who can tolerate abacavir?
78% vs 2%
50
Which ART gives you nephrolithiasis?
Indinavir
51
How does a Jarich-Herxheimer reaction occur?
Release of endotoxins with first dose of abx- within a few hours see rash, fever, tachy
52
what happens with HIV affecting cells in infectionq
impaired production CD34 progenitor cells in BM reduce proliferation thymocytes-->reduced naive CD4 direct infection memory CD4 but low frequency depletion of mucosal CD4 by infection of dendritic, macrophages, CCR5 positive and negative cells hihg levels of immune activation that increase proliferation and death of both CD4 and 8 cells T cells are retained in the LN
53
How does aspergillus cause cancer!?
aflatoxins produced which are assoc with high rates of p53 mutation and HCC
54
What does zidovudine myelopathy look like
proximal muscle weakness and tenderness
55
CMV vs HIV myelopathy
CMV get CSF PCR and neutrophilic pleocytosis HIV myelop looks similar but CSF ok- degen posterior and lateral spinal cord tracts HIV dementia- fine motor, urine incontinence
56
Which drug causes pancreatitis?
Didanosine
57
Nevirapine feared side effect?
SJS
58
Lipoatrophy worst
NRTIs thymidine analogue -zidovudine and stavudine
59
How do you judge successful treatment of syphilis?
RPR and VDRL falls 4 fold in 6-12 months =cure treat contacts within last 3 months empirically as serology might not be positive yet

ID (14 decks)

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