HIV/AIDS and Opportunistic Infections Flashcards

(33 cards)

1
Q

Which route of transmission has the highest risk of transmission?

A

receptive anal intercourse 1:100 - 1:30

insertive vaginal intercourse is 1:10,000

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2
Q

A healthcare provider is working at a mission trip in Uganda. During the course of checking blood samples, they get stuck by a used needle. Which of the following best describes their transmission risk.

A. 1:100
B. 1:10,000
C. 1:2
D. 1:300

A

D. 1:300

things that change risk factors include depth of penetration, hollow bore needles, blood on needles, advanced stage of disease in source.

*remember to divide incidence in 2 with needle sharing in illicit drug use to 1:150

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3
Q

Without prophylactic prevention, what percentage of children born to HIV+ mothers will contract the disease

A

13-40%

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4
Q

Which two groups represent the most likely to be HIV positive?

A

African americans

Gay/Bixesual men

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5
Q

What is the mean time between infection with HIV and development of AIDS

A

10 years

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6
Q

Which diagnostic test, looks for the presence of HIV ab and the HIV p24 antigen?

A

combines immunoassay

improves ability to detect because p24 is present before Ab

99.6% specificity

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7
Q

If a person was negative for the HIV-1/2 Ab differentiation immunoassay, what test would you do to confirm the negative finding.

A

HIV-1 nucleic acid amplification test (NAAT)

if positive with negative ab test -> acute HIV

if initial positive on ab test, negative NAAT -> false positive.

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8
Q

What is the most widely used marker for HIV prognostic information?

A

absolute CD4 count

trend is more important than single determination

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9
Q

What are the limitations to consider when using CD4 count?

A

Diurnal variation
depression with intercurrent illness
intra-laboratory and interlaboratory variability

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10
Q

Which diseases are common with a CD4 count of >300

A

Pink Penises Hop On Very Fast (300 mph)

Pneumococcal pneumonia 
Pulmonary Tb
Herpes Zoster
Oral Candidiasis 
Vaginal Candidiasis 
Fatigue
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11
Q

Which diseases are common with a CD4 count of <300

A

Over The Worst Fucking Day

Oral Hairy Leukoplakia
Thrush 
Weight Loss
Fever 
Diarrhea
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12
Q

Which diseases are common with a CD4 count of <200

A

Please Dont Kap Every Non Catholic

Pneumocystis Jirovecii (PCP)
Disseminated histoplasmosis 
Kaposi Sarcoma 
Extrapulmonary/miliary TB
Non-Hodgkin's Lymphoma 
CNS Lymphoma
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13
Q

Which diseases are common with a CD4 count of <100

A

Cryptococcosis (cryptococcal meningitis)
Esophageal candidiasis
Toxoplasmosis

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14
Q

Which diseases are common with a CD4 count of <50

A

Mycobacterium-avium complex (MAC)
Cytomegalovirus
Primary CNS lymphoma

marked as important

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15
Q

How often should CD4 counts be monitored in patients taking antiretroviral treatment consistently

A

3-6 Months

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16
Q

True or false: CD4 count measures how actively HIV is replicating in the body

A

False:

this is measured by viral load. provides important prognostic info

17
Q

What are the AIDS defining illnesses?

A

Pneumocystis jirovecii
CMV infection
Coccidioidomycosis (disseminated or extrapulmonary)
Mycobacterium TB

These were the ones they emphasized but I would also know kaposi sarcoma.

18
Q

What is the most common opportunistic infection associated with AIDS

A

pneumocystis jirovecii

Fever, cough, shortness of breath
Hypoxemia.

19
Q

What techniques are used to obtain a definitive diagnosis of PJP

A

Wright-Giemsa stain or Direct Fluorescence antibody

Bronchoalveolar lavage (BAL)

20
Q

Describe the findings in Pneumocystis Pneumonia

A

elevated serum Lactate Dehydrogenase
serum beta glucan more sensitive and specific than LDH
if normal diffusion capacity of CO make pCP unlikely

21
Q

What is the most common cause of pulmonary disease in HIV+ pts

A

Community-acquired pneumonia

22
Q

What is the most common space occupying lesion in HIV+ pts

A

Toxoplasmosis

23
Q

What is the typical CD4 count and and symptoms associated with someone with a toxoplasmosis infection

A

CD4 <100

headache
fever
focal neuro deficits
altered mental status and seizures

24
Q

how does toxoplasmosis appear on unenhanced CT scan

A

multiple subcortical lesions with predilection in basal ganglia

25
on MRI you see the typical ring enhancing lesions associated with toxoplasmosis but you confirm 100% it isn't toxo. what other diseases should remain on your differential
CNS Lymphoma fungal infection cerebral TB
26
what is the second most common cause of space-occupying lesion in HIV
Primary CNS lymphoma
27
70-90% of patients with cryptococcal meningitis have a positive result of what?
serum CRAG (cryptococcal antigen)
28
Describe Primary CNS lymphoma
diffuse, large-cell B-cell malignancy high association with EBV usually occurs CD4 <50
29
Describe the problems associated with CMV in HIV pts
``` Retinitis* Colitis Esophageal ulceration Encephalitis Pneumonitis ```
30
Describe Kaposi Sarcoma
caused by HHV-8 skin lesions appear on LE, face, oral mucosa, and genitalia Pulmonary involvement can occur in HIV pts
31
Describe the situation that would warrant prophylaxis for PCP and what would that be
CD4+ <200 or Oropharyngeal candidiasis or prior PCP Trimethoprim-sulfamethoxazole (TMP-SMX) (Bactrim) - -1 DS tablet PO - - 1 SS tablet PO
32
What drugs are indicated in mycobacterium TB prophylaxis
Isoniazid 300 mg + Pyridoxine 25 mg PO or Isoniazid 900 mg PO 2X/week + Pyridoxine 25 mg PO QD
33
What type of vaccines should you avoid in patients with HIV
LIVE vaccines