HIV

Question 1

Antiplatelet antibodies

Answer 1

ITP

Question 2

Bamboo spine on x-ray

Answer 2

Ankylosing spondylitis

Question 3

Webbing of neck, short stature

Answer 3

Turner syndrome

Question 4

Painful, raised lesions on finger pads

Fever

Answer 4

Osler’s nodes (infective endocarditis

Question 5

Dry eyes, dry mouth, arthritis

Answer 5

Sjogren Syndrome

Question 6

Posterior cervical adenopathy

Answer 6

EBV
Cat scratch disease
Otitis media

Question 7

Low serum ceruloplasmin

Answer 7

Wilson disease

Question 8

Coreceptors of HIV

Answer 8

CCR5
CXCR4

tropism - some viruses like to attach to certain coreceptors

Question 9

Cells with CCR5

Answer 9

Macrophages

Dendritic cells

Question 10

cells with CXCR4

Answer 10

CD4+ T cells

Question 11

structure genes

Answer 11

gag
env
pol

Question 12

gag

Answer 12

p24 capsid protein

p17 matrix protein

Question 13

env

Answer 13

gp120

gp41

Question 14

pol

Answer 14

Reverse transcriptase

Integrase

Question 15

diagnosis of AIDS

Answer 15

• CD4 < 200
• % of CD4 cells <14%
• Opportunistic infection (PCP)

Question 16

• Interstitial infiltrates on CXR

- CD4 count <200

Answer 16

PCP

Pneumocystis jirovecii pneumonia

Question 17

CD4 count <50

Answer 17

MAC / MAI

Mycobacterium avium complex

Question 18

• Systemic disease with hepatosplenomegaly, fever, cough in AIDS patient
• CD4 count <150
• Bird / Bat droppings
• Ohio and Mississippi river valleys

Answer 18

Histoplasma capsulatum

Question 19

AIDS patient with meningitis

Answer 19

Crytococcal meningitis

Question 20

AIDS patient with mutliple ring-enhancing lesions on brain MRI

Answer 20

Toxoplasmosis

Question 21

AIDS patient with solitary ring-enhancing lesions

Answer 21

Primary CNS lymphoma

Question 22

CD4 <50
Cotton-wool spots on retina
“Owl’s eye” nuclear inclusions
Tx?

Answer 22

CMV retinitis

Tx: ganciclovir

Question 23

Reactivation of latent JC virus

Answer 23

PML

Progressive Multifocal Leukoencephalopathy

Question 24

Chronic watery diarrhea

Significant wasting

Answer 24

Crytosporidiosis

Question 25

Oral Thrush vs. Oral hairy leukoplakia (EBV)

Answer 25

Oral thrush -- can scrape off

Question 26

Kaposi sarcoma | What number herpes?

Answer 26

HHV-8

Question 27

Malignancies associated with HIV

Answer 27

Usually viral - HHV-8 (Kaposi) - EBV (Lymphoma / NHL) - HPV (cervical, /vaginal carcinoma)

Question 28

abx ppx when CD4 <200

Answer 28

PCP - TMP-SMX - Dapsone (monitor G6PD) - Pentamidine (aerosolized)

Question 29

abx ppx when CD4 <100

Answer 29

Toxoplasmosis (if positive IgG) - TMP-SMX - Dapsone + Pentamidine + Leucovorin

Question 30

abx ppx when CD4 <50

Answer 30

MAC | - Azithromycin

Question 31

abx ppx when CD4 <150

Answer 31

Histoplasmosis | - Itraconazole

Question 32

Most common causes of DIC

Answer 32

``` "STOP Making Thrombi" S: sepsis T: trauma O: obstetric complications P: pancreatitis M: malignancy T: transfusion ```

Question 33

Most common cause of death in Lupus patients

Answer 33

Renal failure from lupus nephropathy

Question 34

- skin hyperpigementation - hypotension - weakness - malaise - anorexia - wt loss

Answer 34

Addison Disease autoimmune disease that attack adrenals, adrenal atrophy, decreased aldosterone and cortisol

Question 35

HAART treatment

Answer 35

Everyone w/ HIV regardless of CD4 Definitely in anyone w/ CD4 <350 or AIDS

Question 36

Ritonavir

Answer 36

Protease inhibitor (pol gene) MC side effect: GI intolerance "boost" other drugs by inhibit P450 Hyperglycemia Lipodystrophy (Cushing-like) Pancreatitis (not common)

Question 37

Atazanavir, Indinavir

Answer 37

Protease inhibitor (pol gene) GI Intolerance Nephrolithiasis (Indinavir, Atazanavir) Increased bilirubin (Atazanavir)

Question 38

``` Zidovudine Didanosine Lamivudine Abacavir Emtricitabine ``` Mechanism Major side effect

Answer 38

NRTI - nucleoside - Inhibit HIV reverse transcriptase - Nucleoside analogs - Competitive inhibitors - Must be phosphorylated or activated by thymidine kinase Lactic Acidosis (all NRTIs)

Question 39

Tenofovir

Answer 39

NtRTI - nucleoTide

Question 40

Zidovudine (AZT) indications and side effects

Answer 40

Newborns born to HIV (+) mothers Bone Marrow suppression (anemia, leukopenia)

Question 41

Occupational exposure

Answer 41

3 drug regimen, 4 weeks

Question 42

Didanosine indications and side effects

Answer 42

Pancreatits Peripheral neuropathy Hepatic steatosis

Question 43

Abacavir indications and side effects

Answer 43

Hypersensitivity reaction

Question 44

Nevirapine Delavirdine Efavirenz Rilpivirine mechanism

Answer 44

NNRTIs non-competitively inhibit reverse transcriptase Do NOT require phosphorylation to be active

Question 45

Fusion inhibitor Name, indications and side effects

Answer 45

Enfuvirtide - last effort after failure of other therapy - given by injection - expensive - injection site reactions - increased risk of bacterial pneumonia

Question 46

Integrase inhibitor

Answer 46

Raltegravir Elvitegravir Dolutegravir

Question 47

Raltegravir side effects

Answer 47

Nausea Rash Myopathy

Question 48

CCR5 antagonist

Answer 48

Maraviroc

Question 49

Maraviroc

Answer 49

Binds CCR5, inhibits gp120 conformational change so virus cannot bind host cell

Question 50

NNRTIs

Answer 50

Nevirapine Delavirdine Efavirenz Rilpivirine

Question 51

Given to pregnant women with HIV

Answer 51

Zidovudine given to pregnant women who are not on antiretroviral therapy during their pregnancy . Pregnant women already on control with ART stay with HAART.