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SBL Week 4/5 > HIV/AIDS and Opportunistic Infections > Flashcards

HIV/AIDS and Opportunistic Infections Flashcards

1
Q

The risk for HIV increases with what feature to mucosa?

A

Inflamed or ulcerative mucosa

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2
Q

What geographical location bears the heaviest burden of HIV and AIDS worldwide?

A

Sub-Saharan Africa

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3
Q

What are some specific symptoms pointing towards HIV infection?

A

1) Hairy leukoplakia of tongue
2) Kaposi sarcoma
3) Cutaneous bacillary angiomatosis
4) LAD

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4
Q

Testing for HIV combines immunoassay for HIV Ab with a test for what antigen?

A

p24 Ag

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5
Q

A positive result on HIV-1/2 Ag/Ab combination assay is followed by testing of the sample with?

A

HIV-1/2 Ab differentiation immunoassay

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6
Q

Samples that are negative on Ab differentiation are tested with?

A

HIV-1 nucleic acid amplification test (NAAT)

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7
Q

If the NAAT result is positive with a negative Ab then?

If specimens are positive on initial combination assay and then are negative on Ab differentiation immunoassay and NAAT then?

A

1) Acute HIV is diagnosed

2) It is a false-positive test

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8
Q

What is the most widely used marker to provide prognostic info and to guide therapy decisions?

A

Absolute CD4 Lymphocyte count

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9
Q

In regards to the CD4 lymphocyte count, what is more important than a single determination?

A

The trend

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10
Q

What is a patient more susceptible to when CD4 count is less than 200? (6)

A

1) Pneumocystis jiroveci pneumonia
2) Histoplasmosis
3) Kaposi Sarcoma
4) Extrapulmonary/miliary TB
5) Non-Hodgkin’s Lymphoma
6) CNS lymphoma

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11
Q

What is a patient more susceptible to when CD4 count is less than 100? (3)

A

1) Cryptococcosis
2) Esophageal candidiasis
3) Toxoplasmosis

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12
Q

What is a patient more susceptible to when CD4 count is less than 50? (3)

A

1) Mycobacterium-avium complex
2) Cytomegalovirus
3) Primary CNS lymphoma

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13
Q

What assesses the level of viral replication and provides useful prognostic info that is independent of the info provided by CD4 counts?

A

HIV viral load

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14
Q

What is the most common opportunistic infection associated with AIDS?

What does this infection typically cause?

A

1) Pneumocystis jiroveci

2) Hypoxemia

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15
Q

What is the cornerstone of diagnosis for Pneumocystis jiroveci pneumonia?

What is most commonly seen?

A

1) Chest radiograph

2) Diffused or perihilar infiltrates

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16
Q

What would give a definitive diagnosis for pneumocystis?

A

1) Wright-Giemsa stain
2) Direct fluorescent antibody (DFA) test
3) Bronchoalveolar lavage

17
Q

What enzyme is elevated in Pneumocystis jiroveci pneumonia?

What is a more sensitive and specific test compared to the one above?

A

1) Lactate dehydrogenase (LDH)

2) Serum beta-glucan test

18
Q

What can be seen on CXR in HIV infected patients with a history of Pneumocystis pneumonia?

A

Pneumothorax

19
Q

What is the most common cause of pulmonary disease in HIV infected persons?

What do we know if they are recurrent?

A

1) Community acquired pneumonia

2) AIDS defining

20
Q

What is the most common space-occupying lesion in HIV?

What is the second?

A

1) Toxoplasmosis

2) Primary CNS lymphoma

21
Q

How would you characterize the lesion seen in toxoplasmosis on an unenhanced CT scan?

A

Multiple subcortical lesions most commonly at the basal ganglia

22
Q

When does toxoplasmosis commonly occur in HIV patients?

A

CD4 count less than 100

23
Q

In AIDS patients, toxoplasmosis is a common cause of?

A

Focal encephalitis

24
Q

What does MRI imaging typically shows when detecting toxoplasmosis?

A

Multiple ring enhancing lesions with surrounding areas of edema

25
Q

Primary CNS lymphoma is highly associated with?

How is it detected?

A

1) EBV

2) CSF PCR

26
Q

When does primary CNS Lymphoma commonly occur in HIV patients?

A

CD4 count less than 50

27
Q

What type of lesion do CNS lymphomas typically present with?

A

Single ring-enhancing lesion

28
Q

What is a common GI problem in HIV-infected patients?

A

Enterocolitis

29
Q

What is a major problem that in encountered with CMV?

A

Retinitis

30
Q

Kaposi Sarcoma is a low grade vascular tumor associated with?

A

Human herpesvirus-8

31
Q

Where do skin lesions from kaposi sarcoma most often appear?

A

1) LEs
2) Face (nose)
3) Oral mucosa
4) Genitalia

32
Q

Diagnosis of Kaposi Sarcoma can be confirmed by?

A

Bronchoscopy

33
Q

When does Pneumocystis jirovecii commonly occur in HIV patients?

What is a common co-infection?

A

1) CD4 count less than 200

2) Oropharyngeal candidiasis

34
Q

What is the treatment for pneumocystis jiroveci?

What is the dosage?

A

1) Trimethoprim-sulfamethoxazole (TMP-SMX)

2) 1 double strength (DS) tablet daily PO

35
Q

What immunizations are generally recommended for HIV patients?

A

1) Hepatitis B and A
2) Influenza virus
3) Streptococcus pneumonia
4) HPV

36
Q

What type of vaccines should be avoided in HIV patients?

A

Live vaccines

SBL Week 4/5 (7 decks)

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