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Clin Med hematology > HIV / AIDS > Flashcards

HIV / AIDS Flashcards

(60 cards)

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1
Q

Which gender is more commonly effected by HIV

A

Men

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2
Q

Which ethnicity is more commonly effected by HIV

A

African American

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3
Q

What is the etiology of new HIV dx

A

Mostly male to male sexual contact

23% heterosexual contact

minimal IVDU

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4
Q

What mode of intercourse puts someone at highest risk for HIV

A

Receptive anal intercourse

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5
Q

Which forms of HIV are human pathogens

A

HIV 1
HIV 2

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6
Q

What are the symptoms of HIV

A

Often asymptomatic

*Can have acute retroviral syndrome

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7
Q

When will an acute retroviral syndrome present

A

3-6 weeks post infection and will last 1-2 weeks

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8
Q

What is occurring in the body during an acute retroviral syndrome

A

Rapid surge in viral load and a drop in CD4

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9
Q

What symptoms will someone with mild retroviral syndrome show

A

Vague
flu like

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10
Q

What symptoms will someone with severe retroviral syndrome show

A

Meningitis
encephalitis
thrombocytopenia

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11
Q

When are HIV screenings done

A

CDC recommends 1x screening for all patients 13-64

1x/year for high risk patients

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12
Q

What diagnostic tests are available for HIV testing

A

Nucleic acid tests
Antigen/antibody testing
Antibody only testing

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13
Q

What does the nucleic acid test show

A

HIV RNA

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14
Q

What does the antigen/ antibody HIV test show

A

Detects HIV p24 antigen and HIV IgM and IgG

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15
Q

What does the antibody only testing show for HIV

A

HIV IgM & IgG

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16
Q

When is nucleic acid most beneficial

A

Acute HIV or indeterminate test
*No HIV antibodies yet

Detectable 10 days post exposure

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17
Q

Which HIV test is considered a rapid test

A

HIV 1/2 antigen/antibody immunoassay

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18
Q

What can you start to receive HIV treatment if positive

A

> 18y/o
*regardless of CD4 count

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19
Q

Can pregnant women receive HIV treatment

A

Yes (Avoid TDF)

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20
Q

How soon do you initiate HIV treatment after infection

A

As immediately as possible

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21
Q

What baseline labs should be done before first HIV treatment

A

Viral load
HUV genotyping
CD4 count
BMP/CMP
Lipids
CBC
Glucose
Urinalysis
Pregnancy testing

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22
Q

What is the first line treatment for HIV

A

ART
(Anti-retroviral therapy)
*3 drug combo

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23
Q

What does the 3 drug combo include with ART

A

1InSTI + 2NRTIs

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24
Q

What is the second line treatment for HIV

A

2 NRTIs and 1 from a different class (PI/II/NNRTI)

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25
What are the main goals of HIV treatment
Virology suppression *CD4 should rise with the viral suppression
26
What is IRIS HIV treatment
Immune reconstitution inflammatory syndrome
27
When is IRIS treatment given for HIV
After the initiation of ART *Secondary to rapid increase in CD4
28
What must be ruled out before IRIS can be initiated
Worsening opportunistic infection... can make additive treatment higher risk
29
What are some reasons ART treatment can be adjusted
side effects toxicity simplify for regimen compliance virologic failure
30
How can HIV be prevented
cessation of IV drug use / needle sharing Safe sex practices Sex education ART as prevention
31
What are some harm reduction approaches for HIV prevention
Needle exchange programs appropriate cleansing of needles PrEP PEP
32
what is PrEP
Pre-exposure prophylaxis *prevention of HIV infection in HIV negative patients
33
Who can be given PrEP
Indicated for any high risk patient who requests it
34
What tests need to be done before administering PrEP
Negative HIV antibody creatinine Hep B/C STD test Pregnancy testing
35
How can PrEP be taken
Oral (Daily) IM (every 2 months)
36
How often does one need to be monitored with PrEP
every 3 months
37
what is PEP
post exposure prophylaxis *Prevention of HIV in negative patients after exposure to HIV (Includes potential exposure)
38
How soon must PEP be administered after exposure
within 72 hours
39
How long is PEP treatment
Orally for 28 days
40
What screening needs to be done before starting PEP
HIV rapid test Pregnancy test LFTs BUN /creatinine STI screen Hep B/C screen
41
After PEP how frequently does HIV need to be screened for and why
at 30 / 90 days to rule out seroconversion
42
What are some complications of HIV
CAD RA osteoporosis AIDS
43
What is the time period from the initial HIV infection and AIDS
roughly 10 years (without ARV treatment)
44
What properties must one have to be considered as having AIDS
CD4 count <200 cells OR AIDS defining infection / malignancy (Opportunistic infection)
45
What is (was) the most common opportunistic infection in AIDS patients
PCP Pneumocystitis jirovecii
46
What will be seen in someone with PCP
Diffuse or perihilar infiltrates on CXR *DX with sputum testing *TX: Bactrim x 21 days
47
How does Toxoplasmosis show up in AIDS patients
CNS infection -seizures / AMS - Ring enhancing lesion on CT -CD<100
48
How do you treat toxoplasmosis with AIDS patients
Pyrimethamine + Sulfadiazine
49
If an AIDS patient has a CD4 count of <50 what are you looking for
MAC Mycobacterium Avium Complex
50
How do you diagnose MAC in AIDS patients
Sputum culture
51
How do you treat MAC in AIDS patients
Clarithromycin (Azithromycin) + Ethambutol +Rifampin
52
If someone with AIDS have cryptococcal meningitis, what sx will they have
headache Fever
53
How do you diagnose cryptococcal meningitis in AIDS patients
CRAG (Serum cryptococcal antigen) +India ink strain CSF
54
How do you treat cryptococcal meningitis
IV lysosome Amp B + Flucytosine x2 weeks THEN Fluconazole 400mg x 8weeks THEN Fluconazole 200mg x 1 year
55
What is CMV retinitis in AIDS patients
Infection of the retina with cytomegalovirus Preivascular hemorrhages and white fluffy exudates **NOT cotton wool spots
56
What are AIDS opportunistic diseases
HIV related encephalopathy Invasive cervical cancer Kaposis Sarcoma Lymphomas PML Wasting syndrome
57
What is karposis sarcoma
Infection with kaposis sarcoma herpes virus (KSHV)
58
How does kaposis sarcoma look
Purplish macule / papule / nodules (CD4 <200)
59
How do you diagnose kaposis sarcoma
Biopsy
60
What is the tx for kaposis sarcoma
ART if not widespread *Add chemo if widespread

Clin Med hematology (6 decks)

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