HIV/AIDS and Opportunistic Infections Flashcards
(37 cards)
The risk for HIV increases with what feature to mucosa?
Inflamed or ulcerative mucosa
What geographical location bears the heaviest burden of HIV and AIDS worldwide?
Sub-Saharan Africa
What are some specific symptoms pointing towards HIV infection?
1) Hairy leukoplakia of tongue
2) Kaposi sarcoma
3) Cutaneous bacillary angiomatosis
4) LAD
Testing for HIV combines immunoassay for HIV Ab with a test for what antigen?
p24 Ag
A positive result on HIV-1/2 Ag/Ab combination assay is followed by testing of the sample with?
HIV-1/2 Ab differentiation immunoassay
Samples that are negative on Ab differentiation are tested with?
HIV-1 nucleic acid amplification test (NAAT)
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?
1) Acute HIV is diagnosed
2) It is a false-positive test
What is the most widely used marker to provide prognostic info and to guide therapy decisions?
Absolute CD4 Lymphocyte count
In regards to the CD4 lymphocyte count, what is more important than a single determination?
The trend
What is a patient more susceptible to when CD4 count is less than 200? (6)
1) Pneumocystis jiroveci pneumonia
2) Histoplasmosis
3) Kaposi Sarcoma
4) Extrapulmonary/miliary TB
5) Non-Hodgkin’s Lymphoma
6) CNS lymphoma
What is a patient more susceptible to when CD4 count is less than 100? (3)
1) Cryptococcosis
2) Esophageal candidiasis
3) Toxoplasmosis
What is a patient more susceptible to when CD4 count is less than 50? (3)
1) Mycobacterium-avium complex
2) Cytomegalovirus
3) Primary CNS lymphoma
What assesses the level of viral replication and provides useful prognostic info that is independent of the info provided by CD4 counts?
HIV viral load
What is the most common opportunistic infection associated with AIDS?
What does this infection typically cause?
1) Pneumocystis jiroveci
2) Hypoxemia
What is the cornerstone of diagnosis for Pneumocystis jiroveci pneumonia?
What is most commonly seen?
1) Chest radiograph
2) Diffused or perihilar infiltrates
What would give a definitive diagnosis for pneumocystis?
1) Wright-Giemsa stain
2) Direct fluorescent antibody (DFA) test
3) Bronchoalveolar lavage
What enzyme is elevated in Pneumocystis jiroveci pneumonia?
What is more sensitive and specific test compared to the one above?
1) Lactate dehydrogenase (LDH)
2) Serum beta-glucan test
What different diagnostic tools can make the diagnosis of pneumocystis pneumonia very unlikely with regards to carbon monoxide, CT imaging, and CD4 count?
1) Normal diffusing capacity of carbon monoxide (DLco)
2) CT scan of chest that shows no interstitial lung disease
3) CD4 count greater than 250 within 2 months prior to eval of respiratory symptoms
What can be seen on CXR in HIV infected patients with a history of Pneumocystis pneumonia?
Pneumothorax
What is the most common cause of pulmonary disease in HIV infected persons?
What do we know if they are recurrent?
Community acquired pneumonia
2) AIDS defining
What is the most common space-occupying lesion in HIV?
What is the second?
1) Toxoplasmosis
2) Primary CNS lymphoma
How would you characterize the lesion seen in toxoplasmosis on an unenhanced CT scan?
Multiple subcortical lesions most commonly at the basal ganglia
When does toxoplasmosis commonly occur in HIV patients?
CD4 count less than 100
In AIDS patients, toxoplasmosis is a common cause of?
Focal encephalitis
