HIV, Syphilis and STDs Flashcards Preview

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Flashcards in HIV, Syphilis and STDs Deck (69)
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1

What is HIV itself?

Retrovirus that uses reverse transcriptase for reverse transcription (turning RNA into DNA) to integrate material into host cell DNA and new virus is produced

2

What is responsible for AIDS?

HIV-1

3

What does HIV target?

T cells (particularly CD4 T cells the helpers)
Also infects B lymphocytes and macrophages

4

What are lymphocytes?

WBCs that defend against protozoa, fungi, some bacteria and viruses

5

Routes of HIV transmission

Sexual transmission (infected body fluids)
Injection drug use
Occupational injury (needlestick)
Blood products
HIV mom to infant
(not just casual contact)
*receptive anal intercourse has highest risk of transmission

6

What is another name for primary HIV infection?

Acute HIV/ acute retroviral syndrome

7

What is acute HIV?

2-6 wks after exposure
Mono like or flu like illness (about 2 wks and resolves spontaneously)

8

Why is acute HIV missed?

Routine HIV Ab test is negative so miss it

9

Lab for acute HIV

HIV RNA (viral load( is measurable and usually extremely high >100,000

10

Common sxs of acute HIV

Fever, adenopathy, sore throat, rash and mucocutaneous ulcers, myalgia, arthralgia, HA, diarrhea, n/v

11

What does the rash look like in acute HIV?

Half of pts
Upper trunk, neck and face

12

Lab abnormalities in acute HIV

Elevated transaminases (LFTs)
Leukopenia
Anemia
Thrombocytopenia

13

When does clinical latency occur?

When immune system response to infection (acute illness resolves) and pt seroconverts!!! and becomes antibody positive
Viral load decreases to a set point
CD4 t cell count slowly declines

14

When do you see full symptomatic infection of HIV?

When immune system deteriorates:
-Lymphnodes and tissue damaged from burnt out
-Virus may mutate and become more pathogenic
-Body fails to keep up replacement of CD4
*viral load increases

15

All general sxs of HIV

Fever, night sweats, LAD, fatigue, arthralgias, weight loss, oral hairy leukoplakia or thrush, prolonged diarrhes, cervical dysplasia, skin disorders, Kaposis, ITP

16

Normal CD4 t cell count

500-1400 cell/mcL

17

What is the definition when HIV progresses to AIDS?

CD4 T cell count <200 cells/mcL
OR
HIV and 1 of 27 AIDS defining conditions (regardless of T cell count)

18

Types of AIDS defining conditions

PCP
Toxoplasmosis
MAC
CMV
Candidiasis
Kaposis sarcoma
Cervical cancer

19

What is pneumocystic jiroveci pneumonia?

Common opportunistic infection associated with AIDS
Caused by airborne fungus pneumocystis jiroveci
Reactivated dormant infection

20

Presentation of pneumocystic jiroveci pneumonia

Nonspecific: fever, cough, SOB
May have severe hypoxemia (usually younger 20-30)
CXR shows diffuse or perihilar infiltrates

21

How to diagnose pneumocystic jiroveci pneumonia

Sputum sample: see elevated LDH in most

22

Tx for pneumocystic jiroveci pneumonia

Bactrim and supportive

23

What does toxoplasmosis cause?

Encephalitis (most common intracranial lesion in HIV pts)

24

What causes toxoplasmosis?

Single celled parasite toxoplasma gondii

25

How to get toxoplasmosis

Ingestion of cat feces, contaminated rw food or utensils
Immuncompetent doesn't usually have pts

26

Presentation of toxoplasmosis in HIV pt

HA, focal neurological deficits, seizures, AMS
Maybe retinits or pneumonitis

27

Imaging for toxoplasmosis

Multiple contrast enhancing lesions on brain CT or MRI
Also seropositive for toxoplasmosis

28

Mycobacterium avium complex

May cause pulm infection when immunocompetent
Found in soil or dust inhaled

29

Presentation of MAC

Systemic disease in HIV
Night sweats, weight loss, abd pain, diarrhea, anemia

30

How to diagnose MAC

Sputum acid fast bacillus stain positive
Positive sputum and blood cultures