Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Reproduction > Human Immunodeficiency Virus > Flashcards

Human Immunodeficiency Virus Flashcards

(75 cards)

Start Studying
1
Q

what type of virus is HIV?

A

retrovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what syndrome does HIV cause?

A

AIDS by opportunistic infections and aids related cancers

*AIDS related conditions are the single highest predictor of mortality in HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how is AIDS preventable?

A

by early HIV diagnosis and treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the life expectancy of those with HIV?

A

near normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the two main types of HIV?

A

HIV2 = originated in west african sootey mangabey, very rare

HIV1 = originated in central/west african chimps, HIV1 group M is responsible for the pandemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is CD4?

A

glycoprotein found on surface of a range of cells including CD4+ cells, dendritic cells, macrophages and microglial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what receptors are the target site for HIV?

A

CD4+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the role of CD4+ Th lymphocytes?

A

recognition of MHC2 antigen-presenting cell
activation of B cells
activation of cytotoxic T cells (CD8+)
cytokine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what effect does HIV infection have on immune response?

A

sequestration of cells in lymphoid tissue (reduced circulating CD4+ cells)
reduced proliferation of CD4+
reduction of CD8+ activation
reduction in antibody class switching
chronic immune activation (microbial translocation)

*this causes susceptibility to viral infections, fungal infections, mycobacterial infections and infection induced cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

at which CD4 count do opportunistic infections present?

A

<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

HIV viral replication is rapid or slow?

A

rapid (new generation every 6-12 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does infection come about in HIV?

A

infection of mucosal CD4 cell (langerhans and dendritic cells)
transport to regional lymph nodes
infection established within 3 days (window of opportunity)
dissemination of virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if HIV is untreated, what is the average time until death?

A

9-11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what % of those with primary HIV present with symptoms and what are these symptoms?

A

80%

fever
rash (maculopapular)
myalgia 
pharyngitis 
headache / aseptic meningitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

on average, how long after infection will those with primary HIV infection get symptoms?

A

2-4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

primary HIV has a very low risk of transmission - true or false?

A

false - very high risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is asymptomatic HIV infection?

A

ongoing viral replication
ongoing CD4 count
ongoing immune activation
risk of onward transmission

*but, symptoms have stopped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is an opportunistic infection?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the most common opportunistic infection in HIV?

A

pneumocystis pneumonia (PCP)

*caused by pneumocystis jivroveci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how does PCP present?

A

insidious onset - SOB and dry cough

sensitive sign - exercise desaturation (treat based on this, not xray)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how is PCP diagnosed?

A

CXR - may be normal, interstitial infiltrates, reticulonodular markings

BAL and immunofluorescence +/- PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how is PCP treated?

A

high dose co-trimoxazole (+/- steroid)

prophylaxis - low dose co-trimoxazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

with tuberculosis, what types are more common in those with HIV+ than HIV- individuals?

A 
symptomatic primary infection
reactivation of latent TB
lymphadenopathies
miliary TB
extrapulmonary TB
multi-drug resistant TB
immune reconstitution syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what organisms causes cerebral toxoplasmosis?

A

toxoplasma gondii

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are the symptoms of cerebral toxoplasmosis?
reactivation of latent infection causing multiple cerebral abscess (chorioretinitis) so it causes: ``` headache fever focal neurology seizures reduced consciousness raised ICP ```
26
what causes cytomegalovirus
reactivation of latent infection caused by retinitis, colitis and oesophagitis
27
how does CMV present?
reduced visual acuity floaters abdo pain, diarrhoea, PR bleeding *ophthalmic screening for all individuals CD4<50
28
what skin infections can be opportunistic infections in HIV?
herpes zoster - multidermatomal, recurrent herpes simplex - extensive, hypertrophic, aciclovir resistant HPV - extensive, recalcitrant, dysplastic (women have annual smears when they have HIV) other - penicilliosis and histoplasmosis
29
what organism causes HIV associated neurocognitive impairment?
HIV-1 (can be at any CD4 count)
30
how does HIV associated neurocognitive impairment present?
reduced short term memory | +/- motor dysfunction
31
what causes progressive multifocal leukoencephalopathy?
JC virus causing reactivation of latent infection *CD4 threshold <100
32
what are the symptoms of PML?
rapidly progressing focal neurology confusion personality change
33
other than HIV associated neurocognitive impairment and PML, what are other neurological presentations of HIV?
``` distal sensory polyneuropathy mononeuritis multiplex vacuolar myelopathy aseptic meningitis gullian-barre syndrome viral meningitis (CMV, HSV) cryptococcal meningitis neurosyphilis ```
34
what causes HIV-associated wasting (slims disease)?
metabolic (chronic immune activation) anorexia (multifactorial) malabsorption / diarrhoea hypogonadism (low testosterone)
35
what causes kaposi's sarcoma (vascular tumour)?
HHV8 *affected up to 40% pre-ART era
36
how does kaposi's sarcoma present?
cutaneous mucosal visceral - pulmonary GI
37
what is the treatment of kaposi's sarcoma?
HAART (for cutaneous) systemic chemotherapy (if visceral)
38
what causes non-hodgkins lymphoma?
EBV (everyone diagnosed with this screened for HIV)
39
how does non-hodgkins lymphoma present?
``` more advanced B symptoms bone marrow involvement extranodal disease increased CNV involvement ```
40
how is non-hodgkins lymphoma diagnosed and treated?
diagnosed - same for HIV- treatment - as for HIV- but add HAART
41
what AIDS related cancer can be caused by HPV?
cervical cancer *HIV testing should be offered to all complicated HPV disease
42
what other conditions can occur in HIV which are not opportunistic infections?
``` mucosal candidiasis seborrhoeic dermatitis diarrhoea fatigue worsening psoriasis lymphadenopathy parotitis epidemiology linked conditions - STIs, Hep B and C ```
43
what haematologic manifestations can be present in HIV?
anaemia (up to 90% thrombocytopenia (ITP) *caused by HIV, opportunistic infection, AIDS malignancies and HIV drugs
44
what factors increase the risk of sexual transmission of HIV?
anoreceptive sex trauma genital ulceration concurrent STI *between men (53%), men and women (42%)
45
other than sexual, what are other modes of transmission?
injection drug use infected blood products iatrogenic mother to child (in utero, delivery and breast-feeding)
46
what proportion of HIV+ infants will die before first birthday if untreated?
1 in 3
47
what is the total number of people living with HIV in the UK?
104,000 *7% undiagnosed
48
in order, what are the common risk groups of HIV?
MSM heterosexuals (age 15-44, particularly black africans) people who inject drugs (age 15-44)
49
what group are most likely to be undiagnosed?
heterosexual men (most likely to present late) *heterosexual women earlier as screened as part of antenatal process
50
who is HIV testing recommended to in high prevalence areas in UK (only lothian just now)?
all general medical admissions | all new patients registering at general practice
51
those attending what clinics are offered HIV testing due to higher prevalence in these groups?
termination of pregnancy services GUM clinics drug dependency services
52
those attending what clinics are offered HIV testing due to risks of it being undiagnosed?
antenatal services | assisted conception services
53
when HIV falls within the differential diagnoses, the patient should get a HIV test without a risk assessment - true or false?
true *eg worsening psoriasis
54
what should you do in terms of HIV testing if patient is incapacitated?
only test if in patients best interest consent from relative not required if safe, wait until patient regains capacity obtain support from HIV team if required
55
what markers of HIV are used by labs to detect infection?
``` antibody (takes 3 months) antigen (p24 = 14-28 days) viral RNA (viral genome, quick but expensive) ```
56
what is the window period for 4th generation HIV testing (antigen testing)?
4 weeks *negative at 4 weeks = highly likely to exclude HIV infection
57
what is the rapid HIV tests (POCT)?
``` fingerprick blood specimen or saliva, results in 20-30 mins 3rd gen (Ab only) or 4th (Ab/Ag) ``` *but, expensive and poor positive predictive value
58
what is the treatment for HIV?
anti-retroviral therapy
59
what are the different targets for anti-retroviral drugs?
``` reverse transcriptase integrase protease entry (fusion and CCR5 receptor) maturation ```
60
what was the first anti-HIV drug to be introduced?
zidovudine (nucleoside analogues reverse transcriptae inhibitors) *was found that dual NRTI therapy reduced mortality by 33%
61
what is highly active anti-retroviral therapy and what is its purpose?
a combination of 3 drugs from at least 2 drug classes to which the virus is susceptible purpose - reduce viral load to undetectable, restore immunocompetence, reduce morbidity and mortality
62
give an example of a single tablet co-formulation which can be used in HIV treatment?
tenofovir (NtRTI) emtricitabine (NRTI) efavirenz (NNTRI)
63
which ART drugs can cause GI side effects?
protease inhibitors
64
what ART drugs can cause dermatological side effects (rash, hypersensitivity, stevens-johnsons)?
abacavir | nevirapine
65
what ART drugs can cause CNS side effects (mood, psychosis)?
efavirenz
66
what ART drugs can cause renal toxicity (proximal renal tubulopathies)?
tenofovir | atazanavir
67
what ART drugs can cause bone side effects (osteomalacia)?
tenofovir
68
what ART drugs can cause CVS side effects (increased MI risk)?
abacavir lopinavir maraviroc
69
what ART drugs can cause anaemia?
zidovudine
70
what ART drugs can cause GI effects such as transaminitis and fulminant hepatitis?
nevirapine | most others
71
why do some drugs require pharmacological boosting (with potent liver enzyme inhibitors)?
because protease inhibitors are generally potent liver enzyme inhibitors but NNRTIs are generally potent liver enzyme inducers
72
what are the conception options for HIV+ male with HIV- female?
treatment as prevention +/- timed condomless sex ?HIV PrEP for female partner
73
what are the conception options for HIV+ female with HIV- male?
treatment as prevention +/- timed condomless sex ? self insemination ? HIV PrEP for male partner
74
how do you prevent mother to child transmission?
``` HAART during pregnancy vaginal delivery if undetected viral load caesarean if detected viral load 4/52 PEP for neonate exclusive formula feeding ``` *<1% risk of MTCT in UK, <0.1% if VL undetected at delivery
75
what is the reduction in HIV risk in countries with PrEP (pre exposure prophylaxis)?
close to 100% if taken daily *those with no PrEP (england, wales) have 6000 new HIV diagnoses every year for 10 years

Reproduction (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions