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Microbiology - Clinical Infectious Disaese > HIV > Flashcards

Flashcards in HIV Deck (40)
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1

What does the acute retroviral syndrome of HIV look like?

fever, fatigue, LAD, HA, pharyngitis, n/v/d, +/- aseptic meningitis.

2

How long after exposure does the acute retroviral syndrome present?

2-3 weeks s/p exposure.

3

Other HIV clues?

- young pt new b/l Bell's palsy
- young pt w unexplained thrombocytopenia + fatigue
- young pt unexplained weight loss >10%
- young pt w Thrush, zoster, kaposi

4

If known exposure to HIV?

AZT, lamivudine, and nelfinavir for 4 weeks

5

When to start HAART?

CD4 55,00
Preggos if viral load > 1000

6

What HIV med causes GI issues, leukepenia, macrocytic anemia?

Zidovudine

7

What HIV med causes HS rash, fever, n/v, muscle aches, SOB in 1st 6 weeks? What should you do?

Abacavir. D/C and never use again!

8

What HIV med causes nephrolithiasis and hyperbilirubinemia?

indinavir (protease inhibitor)

9

What HIV med causes sleepiness, confusion, psycho sx?

Efavirenz

10

HIV+ patient w/ DOE, dry cough, fever, chest pain

Think p. jirovecci pneumonia.

11

What CD4 count to be concerned w/ p. jirovecci ?

12

CXR for p. jirovecci shows?

bilat diffuse symmetric interstitial infiltrates.

13

Best test for p. jirovecci ? possible lab value finding?

After CXR, do bronchoscopy w/ BAL to visualize bug. May see elevated LDH.

14

1st line treatment for p. jirovecci pneumonia?:

trim-sulfa

15

2nd line treatment for p. jirovecci pneumonia?:

trim-dapsone, or primaquine-clinda, or pentamidine.

16

When to add steroids to p. jirovecci pneumonia treatment?

PaO2 35

17

When to add prophylaxis against p. jirovecci?

When CD4

18

Three causes of HIV diarrhea?

CMV, MAC, Cryptosporidium. CD4 count

19

Sx of CMV diarrhea?

Can be bloody

20

Dx of CMV diarrhea?

Colonoscopy/biopsy.

21

Treatment of CMV diarrhea?

gangiclovier (se: neutropenia), or foscarnet (se: renal tox).

22

Sx of MAC diarrhea?

Diarrhea, wasting, fevers, night sweats.

23

Tx of MAC diarrhea?

clarithromycin, ethambutol +/- rifampin. Prophylax w/ azithromycin weekly.

24

Sx of cryptosporidum diarrhea?

transmitted via dog poo, swimming pools. Water diarrhea w/ mucus, oocysts are acid fast.

25

HIV pt w/ neurologic sx and multiple ring enhancing lesions?

Toxoplasmosis.

26

Treatment of HIV toxo?

pyramethamine + sulfadiazine + folic acid for 6 weeks. If no imporvement after 1 week, consider biopsy.

27

HIV pt w/ neurologic sx and 1 ring enhancing lesions?

CNS lymphoma.

28

What virus is CNS lymphoma associated with?

EBV infection of b-cells.

29

Treatment of CNS lymphoma?

HAART.

30

If HIV+ patient has seizure w/ de ja vu aura and 500 RBCs in CSF? Treat?

HSV encephalitis (temporal lobe). acyclovir ASAP.