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Flashcards in HIV Deck (27)
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0
Q

Acute HIV syndrome affect what portion of first-time infected? Characterized by?

A

30% of patients. Mononucleosis like illness with fever, headaches (aseptic meningitis), shotty lymphadenopathy, pharyngitis, and macular rash

1
Q

Patient with HIV presents with dry cough. Diagnosis? Helpful lab test?

A

PCP; Elevated LDH

2
Q

At CD4 levels less than 500 patients are susceptible to which infections?

A

Pneumonia, TB, vaginal candidiasis, HZV and HSV

3
Q

At CD4 levels less than 200, patients can develop?

A

PCP, toxoplasmosis, histoplasmosis, Cryptococcus, Cryptosporidium

4
Q

At CD4 levels less than 50, patients susceptible to?

A

MAI, CMV, CNS lymphoma, esophagitis

5
Q

Most common opportunistic infection affecting AIDS patients? Presents with? can lead to?

A

PCP. Dry cough. Can lead to respiratory compromise or spontaneous pneumothorax (from rupture of blebs)

6
Q

Definitive diagnosis of PCP with what stain?

A

Giemsa or Silver stain

7
Q

Serum marker used as an indirect marker for PCP? Level? May also be elevated in?

A

Elevated LDH. Patients with LDH less than 220 are very unlikely to have PCP. Also seen in Histoplasmosis or lymphoma.

8
Q

PCP unlikely to be cause of infection if?

A
  1. LDL level less than 220

2. CD4 count more than 250

9
Q

PCP positive patients with arterial PO2 less than 70 or Aa gradient more than 35 should be treated with?

A

Prednisone in conjunction with TMP-SMX

10
Q

Patchy infiltrates and pleural based infiltrates can be seen with?

A

TB and Cryptococcus

11
Q

Patients allergic to sulfa can be treated for PCP with?

If G6PD deficiency?

A

Pentamidine + clindamycin with primaquine

Pentamidine

12
Q

Cavitary lesions can be seen with?

A

TB, PCP, Coccidioides

13
Q

Most common causes of pneumonia in AIDS patients are?

A

Same organisms that cause pneumonia immunocompetent patients

14
Q

Think community-acquired pneumonia if?

A

Acute onset of fever and productive cough, with the pulmonary infiltrate

15
Q

Patient with an indolent or chronic history of cough and weight-loss - think?

A

TB

16
Q

Most common CNS mass lesion in AIDS patients? Tx? If lesions do not regress after two weeks of treatment, likely diagnosis? Test?

A

Toxoplasmosis. Sulfadiazine with pyrimethamine. CNS lymphoma. Stereotactic brain biopsy.

17
Q

This is present in more than 90% of cases of patients with CNS lymphoma?

A

Epstein-Barr virus

18
Q

Screen for Cryptococcus? If Cryptococcus, CNS findings?

A

Serum cryptococcal antigen or LP. Normal white blood cells but elevated intracranial pressure.

19
Q

Treatment cryptococcal meningitis?

A

Amphotericin B plus flucytosine followed by chronic suppression with oral fluconazole

20
Q

Signs of CMV infection?

A
  1. Persistent fever and constitutional symptoms
  2. Retinitis that can lead to blindness
  3. Esophagitis that can cause odynophagia
  4. Necrotizing adrenalitis that can cause adrenal insufficiency
21
Q

Treatment for CMV?

A

Ganciclovur, foscarnet, cidofovir

22
Q

Patient with low CD4+T count presents with persistent fevers, weight-loss, abdominal pain, or diarrhea. Cause? Tx?

A

MAI. Clarithromycin and ethambutol and rifabutin.

23
Q

Appropriate prophylaxis when CD4 count less than 200? Less than 100? Less than 50?

A

Double strength tablets of TMP SMX 3x week. Increase TMP SMX. Clarithromycin daily or azithromycin weekly

24
Q

HAART therapy?

A

Backbone - two nucleoside analog reverse transcriptase inhibitors

Base - Non-nucleoside analogue reverse transcript inhibitor or a protease inhibitor

25
Q

Immune reconstitution syndrome?

A

Improvement in the immune system can cause worsening of symptoms 1 to 2 weeks after starting HAART.

26
Q

PNA ppx in HIV pts?

A

Bactrim if CD4<50 (for atypicals)

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