HIV / AIDS

Question 1

What does ELISA (aka EIA) stand for and what does it test? How long does test take? What is the follow up test if results are positive?

Answer 1

Enzyme Linked Immunosorbent Assay
Tests for HIV antibodies
Rapid method takes 20 minutes
F/U with the Western blot for confirmation

Question 2

What is the window period?

Answer 2

The time period between infection and development of antibodies. U to 2 months.

Question 3

What lab assessments are done to evaluate the progression of HIV?

Answer 3

CD4+ T-cell count, Viral load

Question 4

What is seroconversion and what symptoms occur at this time?

Answer 4

When HIV specific antibodies develop. Often accompanied by a mononucleosis like syndrome (fever, swollen lymph glands, sore throat, HA, malaise, nausea, muscle/joint pain, diarrhea, diffuse rash)

Question 5

How is HIV transmitted?

Answer 5

Contact with infected blood, semen, vaginal secretions, and breast milk via sex, exposure to blood products, and perinatal during pregnancy, at delivery, or through breastfeeding

Question 6

How soon can HIV be transmitted to others after becoming infected?

Answer 6

Within a few days

Question 7

The risk of HIV infection due to needle stick is ______ for health care workers. The risk is higher with a ______ _______ wound.

Answer 7

low (0.3% - 0.4%)

deep puncture

Question 8

On average ____ % of infants born from HIV infected mothers are born with HIV. Fortunately with the use of _______ _______ the risk can be reduced to less than 2%.

Answer 8

25%

antiretroviral therapy

Question 9

What does retrovirus mean?

Answer 9

A virus that replicates in a backward manner going from RNA to DNA

Question 10

HIV cant replicate unless it is inside a living cell. How does HIV enter the cell?

Answer 10

HIV binds to specific CD4 and chemokine receptor sites on cell surface. Viral RNA enters cell and is transcribed to viral DNA using REVERSE TRANSCRIPTASE. Then viral DNA enters nucleus and uses INTEGRASE to splice itself into the genome. Viral DNA now directs cell to make new HIV.

Question 11

Initial infection of HIV results in ________ or a large amount of virus in the blood in which HIV replicates at a rapid and constant rate. How long can it take for S&S to appear during this period?

Answer 11

Viremia

10-12 years

Question 12

In early stages of HIV infection the immune response functions normally reducing viral loads. How?

Answer 12

B cells make HIV specific antibodies and T cells mount a cellular immune response to viruses trapped in lymph nodes

Question 13

The normal life span of a CD4 T cell is 100 days compared to ____ days of an HIV infected T cell.

Answer 13

2 days

Question 14

An immune system will remain healthy with more than _______ CD4 T cells. This is known as Early Chronic Infection.

Answer 14

500

Question 15

Immune problems start when CD4 T cell count drops below ______ cells/microliter. This is known as Intermediate Chronic Infection

Answer 15

500

Question 16

Severe immune problems develop when CD4 T cells drop below _______ cells/microliter. This is known as Late Chronic Infection.

Answer 16

200

Question 17

AIDS is diagnosed when an individual with HIV develops at least one of the following conditions? (5)

Answer 17

CD4 T-cell count drops below 200
Opportunistic infections
Opportunistic cancers
Wasting syndrome (loss of 10% IBM)
AIDS dementia complex

Question 18

What is the most common infection associated with HIV intermediate chronic infection?

Answer 18

Candidiasis or thrush

Question 19

What causes painless, white, raised lesions on the lateral aspect of the tongue that is an indicator of disease progression?

Answer 19

Oral hairy leukoplakia, an Epstein-Barr virus infection

Question 20

What lab abnormal lab values are common in HIV infected patients?

Answer 20

Decreased WBC, neutrophil, platelet

Question 21

Why is co-infection with hepatitis B or C is extremely important?

Answer 21

They have a more serious course in patients with HIV and it limits options for ART because of liver related morbidity and mortality

Question 22

What are the two resistance tests used to determine if a patient is resistant to the drugs used in ART?

Answer 22

Genotype assay - detects drug resistant viral mutations

Phenotype assay - measures the growth of HIV in various concentrations of antiretroviral drugs

Question 23

Collaborative care focuses on (7)

Answer 23

1. Monitoring progression and immune function
2. ART
3. Preventing opportunistic diseases
4. Detecting and treating opportunistic diseases
5. Managing symptoms
6. Prevent/Decrease complications of treatment
7. Prevention of further transmission of HIV

Question 24

The goals of HIV drug therapy are (3)

Answer 24

1. Decrease viral load (can reduce by 90-99% when taken consistently and correctly)
2. Maintain or raise CD4 T-cell counts
3. Delay onset of HIV related symptoms and opportunistic diseases

Question 25

_______ develops in most drugs when used alone. Combinations of ____ or more prescribed at full strength should be used. This works because _________ therapy can attack viral replication in several different ways keeping the viral load low and thus decreasing ________ that allow HIV to become resistant

Answer 25

Resistance
3
combination
mutations

Question 26

At least ___ clades (subtypes) of HIV exist around the world

Answer 26

9

Question 27

Assessing risk for HIV includes (4)

A positive response to any of these questions requires an in-depth exploration

Answer 27

1. Ever had blood transfusion/clotting factors?
2. Shared drug using equipment w others?
3. Sex w penis, vagina, rectum, mouth that came in contact w another person’s penis, vagina, rectum, mouth?
4. Ever had an STD?

Question 28

Nursing interventions include (8)

Answer 28

1. adhere to drug regimens
2. promote a healthy lifestyle
3. protect others from HIV
4. maintain/develop healthy relationships
5. maintain activities and productivity
6. explore spiritual issues
7. come to terms with disease, disability, death
8. cope with frequent symptoms and treatments

Question 29

Should exposure to HIV-infected fluids occur, _______ _______ with _______ ART can significantly decrease risk of infection

Answer 29

post-exposure prophylaxis

combination

Question 30

________ people in the US are not aware they are infected with HIV

Answer 30

250,000

Question 31

CDC has recommended that all people ages ____ to ____ be tested for HIV.

Answer 31

13 - 64

Question 32

Initial responses to the diagnosis of HIV include

Answer 32

anxiety, panic, fear, depression, denial, hopelessness, anger, guilt

Question 33

Metabolic disorders that include changes in body shape include

Answer 33

lipodystrophy, hyperlipidemia, insulin resistance and hyperglycemia, bone disease, lactic acidosis, cardiovascular disease