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Flashcards in HIV: Pathophysiology Deck (33)
1

What type of virus is HIV and where did it originate

retrovirus
HIV 2- west African Sooty mangabey
HIV 1- central/west African chimpanzees

2

What immune cell is the target site for HIV

CD4 receptors found on immune cells particularly T helper cells, dendritic cells, macrophages and microglial cells

3

What effect does HIV have on the immune response

reduced circulating CD4 cells
Reduced proliferation of cd4 cells
reduced CD8 cell activation
reduction in antibody class switching
CHRONIC IMMUNE ACTIVATION

4

What are people with HIV more susceptible yo

viral infections
fungal infections
mycobacterial infections
infection induced cancer

5

what are the normal cd4 parameters

500-1600 cells/mm3

6

at what CD4 count is someone at risk of opportunistic infections

less than 200

7

what are the main phases of HIV infection

primary infection
asymptomatic infection
symptoms of AIDS

8

what is the average time between infection and death without treatment

9-11 yrs

9

what are the features of primary hiv infection

usually onsets 2-4 weeks after infection
flu like illness- rash, fever, myalgia, pharyngitis etc
high risk of transmission at this point

10

what are the features of asymptomatic infection

ongoing viral replication
ongoing cd4 count depletion
ongoing immune activation
risk of onward transmission of undiagnosed

11

what is an opportunistic infection

an infection caused by a pathogen that does not normally produce disease in a healthy indicidual

12

which organism causes pneumonia often in patients with HIV

pneumocystis jiroveci

13

what is the treatment of pneumocystis pneumonia

high does co-trimoxazole (give low dose for prophylaxis)
+/- steroid

14

What is cerebral toxoplasmosis

a parasitic infection resulting in multiple cerebral abscesses causing headache, fever, focal neurology, seizures, reduced consciousness and raised intracranial pressure

15

at what cd4 count can toxoplasmosis infection occur

less than 150

16

at what CD4 count can you get cytomegalovirus

less than 50

17

how can CMV present

preduced visuall acuity
floaters
abdo pain, PR bleeding

18

what skin infectiosn are common in HIV

herpes zoster
herpes simplex
HPV
pencilliosis
Histoplasmosis

19

what virus causes HIV associated neurocognatice impairement

HIV 1

20

what organism causes Progressive multifocal leukoencephelopathy and at what CD4 threshold

JC virus
less than 100

21

Name some AIDS related cancers

Kaposi's sarcoma (vascular tumour)
Non hodgkins lymphoma
cervical cancer

22

what virus causes kaposi's

human herpes virus 8

23

what organism can cause non hodgkins

EBV

24

what kind of things may a patient with symptomatic HIV present with

mucosal candidiasis
seborrhoeic dermatitis
diarrhoea
fatigue
psoriasis
lymphadenopathy
parotitis
STIs, hep B or C

25

what haematological conditions occur in those with HIV

anaemia
thrombocytopenia

26

how is HIV most commonly transmitted

sexual
51 percent (MSM)
49 percent between men and woman

27

what factors increase transmission risk

anoreceptive risk
trauma
genital ulceration
concurrent STI

28

name another mode of transmission

parenteral=
IVDU
infected blood products
iatrogenic
mother to child=
in utero
delivery
breast feeding

29

which group of people are most likely to present late with HIV

heterosexual men

30

how many people in the UK living with HIV are undiagnosed

1/4

31

when is universal (opt out) testing implimented

in high prevelance areas in the uK ie HIV rate is locally more than 0.2 percent of population

32

where is and opt out HIV test always offered in the UK

TOP services
GUM clinic
drug dependency services
antenatal services
assisted conception

33

what groups of people are deemed high risk and should be offered screening

MSM
female partners of bisexual men
IVDU
partners of people with HIV
adults/children/sexual partners from endemic areas
history of iatrogenic exposure