HIV + drugs Flashcards Preview

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Flashcards in HIV + drugs Deck (28):
1

diagnosis of HIV

screening: ELISA
high sensitivity (capture all positives)
confirm:
Western blot
high specificity (identify true positives)

2

viral load

PCR test that quantifies how many copies of HIV RNA in blood sample

3

use viral load: copies of HIV RNA in blood

diagnosis:
acute infection ("window period", 1-2 mo)
newborn of HIV+ mom was infected during peripartum
monitor effectiveness of drug therapy

4

ELISA and Western blot detect

antibodies to viral proteins: p24 + gp120
1-2 mo of HIV infection "window period"): asymptomatic + FN (low Ab levels) on ELISA + Western blot → use viral load
baby born to infected mother: FP (anti-gp120 crosses placenta) → determine if infected with viral load

5

AIDS diagnosis: immune system significantly affected by HIV

CD4 cell count

6

reason for cancer inHIV

immune system destroys neoplastic cells

7

interstitial infiltrates on CXR "ground-glass appearance on imaging"
CD4

pneumocystis jirovecii pneumonia (PCP)

8

mycobacterial pulmonary diseases in HIV+ patient

TB
mycobacterium avium intracellulare (MAC, MAI): CD4

9

pulmonary infections in HIV + patient

pneumocystis jirovecii pneumonia (PCP): CD4

10

neuro infections in HIV+ patient

cryptococcal meningitis
toxoplasmosis
1° CNS lymphoma
CMV retinintis
progressive multifocal luekoencephalolpathy (PML): reactivation of latent JC virus
AIDS dementia

11

AIDS patient with meningitis

cryptococcal meningitis

12

AIDS patient with ring-enhancing lesions on brain MRI

toxoplasmosis: MULTIPLE
1° CNS lymphoma: usually single

13

AIDS patient with CD4 count

CMV retinintis: cotton wool spots

14

"owl's eye" nuclear inclusions, cells enlarged

CMV

15

GI infection in HIV + patient

cryptosporidiosis

16

HIV + patient with chronic, watery diarrhea

cryptosporidiosis
self-limited in immunocompotent

17

oral infections in HIV+ patient

oral thrush or esophageal candidiasis: c. albicans
oral hairy luekoplakia
HSV: oral herpes
CMV: oral infections

18

HIV+ patient with fluffy, cottage-cheese lesions on tongue
CAN SCRAPE OFF

c. albicans

19

hairy lesion SIDES of tongue
caused by EBV infection in HIV patient
CAN'T SCRAPE OFF

oral hairy leukoplakia

20

malignancies in HIV + patient (caused by viral infections)

kaposi sarcoma (caused by HHV-8)
Non-hodgkin lymphoma (caused by EBV co-infection): 1° CNS lymphoma, large B cell lymphoma
squamous cell carcinoma of cervix/anus from MSM (caused by HPV 16 and 18)

21

HIV + patient with ↑ blood vessel production (purple)
lesions on skin, mucous membrane, lungs

kaposi sarcoma (HHV-8)

NOT bacillary angiomatosis (bacillary henselae: superficial vascular lesions that look like cherry hemangiomas)

22

prophylactic Abs when CD4

PCP prophylaxis: TMP-SMX
if sulfa allergy:
dapsone (don't use if G6PD deficiency)
aerosolized pentamidine

23

prophylactic Abs when CD4

prevent toxoplasmosis reactivation:
prophylaxis IF + IgG titer (previous infection): TMP-SMX
if sulfa allergy: dapsone + pentamidine + leucovorin

24

prophylactic Abs when CD4

MAC prophylaxis: azithromycin (1 dose/week)

25

prophylactic Abs when CD4

histoplasmosis prophylaxis IF in endemic area (MS river valley + Ohio river valley): itraconazole

26

HAART: highly active antiretroviral therapy

Know drugs in each category, MOA, common + life-threatening SEs

combo of at least 3 different drugs with different MOAs to prevent resistance

everyone HIV+ (regardless of CD4 count) should consider HAART
DEFINITELY if CD4

27

occupational exposure to HIV: post-exposure prophylaxis

3 drug regimen
continue for 4 weeks

28

treatment for pregnant women with HIV

zidovudine: if not on HAART during pregnancy and delivering
if already controlled on HAART during pregnancy: continue tx during delivery

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