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Flashcards in HIV/AIDs and their infections Deck (15):
1

When is a good time to start therapy for HIV patients (4 reasons)

1. CD4 count

2

When you decide that you want to give HAART therapy for HIV patients, what is the HAART therapy

1.) Tenofovir + emtricitabine + efavirenz

3

The three classes of medications used for HIV are Nuc RTI's, Non-Nuc RTI's, and protease inhibitors. What are the side effects for each class

1.) Nucleoside reverse transcriptase - lactic acidosis
2.) Protease inhibitors - Hyperglycemia, hyperlipidemia
3.) Non-nucleoside reverse transcirptase - Drowsiness

More specifics in infectious diseases chapter

Indinivir = kidney stones
Zidovudine - anemia

4

What is the treatment criteria for HAART in needle stick injuries and pregnancy

Needle stick, exposure to mucosal surfaces of HIV positive blood, unprotected sexual contact: HAART for a month

Pregnancy: HAART no matter what trimester, don't need to change therapy if already on it

5

If someone has HIV, giving them prophylaxis depends on their CD4 counts. What opportunistic infections must you give prophylaxis for

PCP: If CD4 counts are below 200, and give them Bactrim, if a rash develops then switch to atovaquone or dapsone (unless G6PD deficiency)

Mycobacterium avium intracellulalre: IF CD4 counts below 50 - use azithromycin once daily

6

What are the opportunistic infections that someone with HIV can possibly get

1.) PCP
2.) Toxoplasmosis
3.) Cytomegalovirus
4.) Cryptococcus
5.) Progressive multifocal leukoencephalopathy

7

What are the symptoms of PCP, diagnostic studies, and treatment

Symptom: SOB, dry cough, hypoxia, and increased LDH

Diagnostics: CXR showing increased interstial markings initially, but best test is bronchoalveolar lavage

Treatment: IV bactrim, if rash switch to IV pentamidine (contrast with prophylaxis), atovaquone if mild, but never dapsone

If really severe with PO2

8

What are the symptoms, diagnosis studies, and treatment for toxoplasmosis

Symptoms: Headache, nausea, vomiting, focal neurological signs

Diagnosis: Head CT with contrast showing ring

Treatment: Pyrimethamine/sulfadiazine for 2 weeks. If it doesn't get smaller, need to do brain biopsy cause most likely lymphoma

9

Cytomegalovirus is another disease that happens with immunodeficiency. When should you suspect

If CD4 cells

10

Cryptococcus is another HIV disease that has a CD4 level that it happens at and gives meningitis signs. What are these, what are the best initial and accurate test, and the treatment

Symptoms: Photophobia, headache, fever when CD4

11

Progressive multifocal leukoencephalopathy is another disease characterized by HIV and a certain CD4 dependance. What are these, what is the best initial tests, and what is the treatment

Symptoms: Focal neurological signs (like toxoplasmsosis)

Diagnosis: Head CT or MRI

Therapy: None, treat with HAART, once CD4 counts go up this will resolve on own

12

Mycobacterium avium intracellulare is another condition that depends on CD4 counts. What counts are these, what are the symptoms, and diagnosis, and treatment

Symptoms: CD4 counts less than 50 with weight loss, fever, fatigue and invasion of bone marrow causing anemia

Diagnosis: Bone marrow more sensitive, liver biopsy best

Treatment: Clarithromycin and ethambutal. Prophylaxis with azithromycin

13

Lyme disease is a condition you get when you are camping/hiking and a target shaped rash. What is this rash called

Erythema migrans

14

What is the most common late manifestation of lyme disease, cardiac manifestation, and neurologic manifestation

1.) Most common late manifestation: Joint involvement
2.) Most common cardiac manifestation: AV conduction block/defect
3.) Neurologic manifestation: 7th cranial nerve palsy (bell's palsy)

15

What is the treatment for lyme disease

If rash, joint, or bell's palsy: Oral doxycycline or amoxicillin (if pregnant or less than 8 yo)

CNS/cardiac involvement: IV ceftriaxone