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COMAT - IM > HIV/TB > Flashcards

HIV/TB Flashcards

(55 cards)

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1
Q

Primary TB infectious usually is asymptomatic and then becomes latent. How do you evaluate for latent disease?

A

PPD +/- CXR

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2
Q

Whose PPD is (+) at > 5mm?

A

Those with close contacts that have TB

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3
Q

Whose PPD is (+) at > 10mm?

A

Healthcare workers
Homeless
Foreigners

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4
Q

Whose PPD is (+) at > 15mm?

A

Normal people with no risk factors

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5
Q

Once REactivation of latent TB occurs, the patient will be?

A

Symptomatic

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6
Q

What will be seen on CXR with TB?

A

Upper lobe cavitation

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7
Q

If you suspect TB but see fine nodular densities on CXR, that is likely?

A

Miliary TB

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8
Q

What is the treatment for Latent TB?

A

Isoniazid for 9 months

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9
Q

What is the treatment for Active TB?

A

RIPE for 2 months
RI for 4 months

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10
Q

RIPE

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

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11
Q

Side effect of Rifampin?

A

Turns body fluids orange

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12
Q

Side effects (2) of Isoniazid?

A

Peripheral neuropathy
Drug-induced hepatitis

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13
Q

What can you give to prevent peripheral neuropathy with Isoniazid?

A

B6

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14
Q

Side effect Pyrazinamide?

A

Hyperuricemia/Gout

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15
Q

Side effect of Ethambutol?

A

Eyes
– Optic neuritis
– Color vision changes

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16
Q

What is the treatment for active TB?

A

RIPE for 2 months
RI for 4 months

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17
Q

Describe how HIV infects CD4 cells?

A
  • Enters via CCR5/CXCR4
  • Reverse Transcriptase to turn RNA to DNA
  • DNA is replicated
  • Protease to exit cell
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18
Q

What is the mainstay of treatment for HIV?

A

2+1
= 2 Nucleotide Reverse Transcriptase (-)’ers
+ 1 Integrase/Protease (-)’er

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19
Q

What is used as prophylaxis against HIV?

A

2+1 for 4 weeks
(2NRTI + 1 Integrase/Protease Inhibitor)

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20
Q

If a mother with HIV is not on ART at delivery, what should be given to her and baby?

A

Zidovudine

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21
Q

How may an acute HIV infection present?

A

Flu-like illness or asymptomatic

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22
Q

During the Acute HIV phase, what test can be done to establish diagnosis?

A

HIV PCR to assess viral load
– antibodies not yet (+)

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23
Q

Once someone with HIV is past the acute illness, what tests can be done to assess?

Study These Flashcards
A
  • ELISA antibodies confirmed with Western blot
  • HIV viral load
  • CD4 count
24
Q

Once someone with HIV is past the acute illness, what tests can be done to assess?

Study These Flashcards
A
  • ELISA antibodies confirmed with Western Blot
  • HIV Viral load
  • CD4 count
25
CD4 count < _____ you should prophylactically treat against Pneumocystis Jirovecii
< 200
26
What is the prophylactic/treatment for Pneumocystis Jirovecii?
TMP-SMX OR Dapsone
27
What is the prophylactic/treatment for Pneumocystis Jirovecii?
TMP-SMX OR Dapsone
28
CD4 count < ____ you should prophylactically treat against Toxoplasmosis
< 100
29
What is the treatment for Toxoplasmosis infection?
Pyrimethamine Sulfadiazine Leucovorin
30
What is the prophylaxis for Toxoplasmosis?
TMP-SMX
31
CD4 < ____ you should prophylactically treat against Myocbacterium Avium Complex
< 50
32
What is the prophylactic treatment for Mycobacterium Avium Complex?
Azithromycin +/- Ethambutol
33
What lab finding may be seen with Mycobacterium Avium Complex infection?
HIGH Alk Phos
34
How will oropharyngeal candidiasis present?
White plaques on a red base of the tongue that can be scraped off
35
What are the treatment options for oral candidasis?
Nystatin suspension Oral Fluconazole
36
Where is Cryptococcus Neoformans found?
Pigeon droppings
37
What does Cryptococcus Neoformans commonly cause?
Meningitis
38
Signs of Cryptococcal Meningitis?
Fever Headache Elevated ICP AMS
39
What will be unique on LP if Cryptococcal Meningitis is to blame?
HIGH opening pressure!! -- Low glucose, High protein/WBC too
40
What is the best test to perform on CSF if worried about Cryptococcal Meningitis?
CSF antigen better than India Ink
41
What is the treatment for Cryptococcal Meningitis?
Amphotericin B + Flucytosine -- Followed by Fluconazole
42
Where is Histoplasmosis and Blastomycosis found?
Ohio/MI River Valleys
43
Histoplasmosis can present with a wide range of symptoms, what are 2 unique ones?
Palatal ulcers Pancytopenia
44
What findings are CXR are associated with Histoplasmosis?
Hilar LAD Nodular densities
45
How is Histoplasmosis diagnosed?
Urine histoplasma antigens
46
Treatment for Histoplasmosis?
Amphotericin B followed by Itraconazole -- Just Itraconazole if mild
47
Blastomycosis can have _____ involvement
Skin/Bone/Prostate
48
What will be seen on biopsy with Blastomycosis?
Broad budding yeast
49
Where is Coccidioidomycosis found?
Southwestern US
50
How is Coccidioidomoycosis diagnosed?
Bronchiolar lavage that shows an endospore containing many spherules
51
What test should be done to confirm Pneumocystis Jirovecii?
Silver stain of sputum
52
How will Pneumocystis Jirovecii look on silver stain?
Comma shaped spores in folded cysts
53
Bilateral ground glass appearance is seen with Pneumocystis Jirovecii. What lab finding can be present?
HIGH LDH
54
Bilateral ground glass appearance is seen with Pneumocystis Jirovecii. What lab finding can be present?
HIGH LDH
55
Histoplasmosis/Blastomycosis/Coccidioidomycosis present with wide symptoms. What are 2 unique features of Histoplasmosis?
Palatal ulcers Pancytopenia

COMAT - IM (17 decks)

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