Infectious Disease #2 Flashcards
(74 cards)
HIV Screening Recommendations:
All adults ages 18-64 (once in lifetime)
+ risk factors (yearly)
Pregnant women (once)
Pregnant women- high risk (2nd test in 3rd trimester)
Newborns (if mother is HIV + or high risk)
*30% transmission from breast feeding **
HIV risk factors?
Homosexual males Bisexual males Women with at-risk male partner Women with multiple male partners IV drug abusers Blood transfusions (high risk areas) Infants of HIV + mothers or high-risk
Early detection is key for?
Antiretroviral therapy
Appropriate immunizations
Prophylactic antibiotics
HIV screening tests?
HIV-1 p24 antigen HIV-1 antibody HIV-2 antibody HIV-1/2 antibody HIV-1/2 Ab/Ag Rapid HIV-1/2 Ab
HIV confirmation tests?
WB HIV-1 Ab WB HIV-2 Ab Immunoblot-HIV-2 Ab IFA HIV-1 Ab HIV RNA NAAT (qualitative testing)
HIV rapid tests?
Urine or saliva
*low risk that wants a screening **
Which HIV test detects the viral protein p24 in blood?
p24 direct serologic antigen assay
In the p24 test, how early is the infection detectable? and it is detectable before antibody ______________?
16 days after infection
seroconversion
- you cant detect HIV for up to three months b/c we have not ABS to it yet because it is hiding in the CD4 cells **
4th generation enzyme-linked immunoassay target of detection and days to positivity?
IgM and IgG Abx and p24 antigen
15-20 days
HIV _________ test uses PCR to replicate a very small amount of HIV RNA to a detectable amount
HIV viral load test
HIV diagnostic testing algorithm?
4th gen. HIV-1/2 immunoassay
then,
type the HIVm( is it 1 or 2)
then,
RNA testing
Determines “amount” of HIV in serum?
HIV RNA (quantitative)
HIV RNA aids in?
Marker for prognosis
Disease progression
Response to treatment
Indication for treatment
Indicates course of disease more accurately than any other test
HIV RNA is extremely sensitive to < __ copies/ml
50
HIV RNA determines baseline viral load with _ measurements - weeks apart?
2 measurements
2-4 weeks apart
What are HIV Resistance Assays?
Assess viral strains (genotyping)
Useful in selecting therapies
Useful if patient is failing therapy
Aspergillosis organism?
Aspergillus fumigatus
- affects lungs sinuses and can go into the brain = it is inhaled
- *
- most of us have an immunity towards it already but AIDS and chemo patients and people with liver and organs transplant patients can become colonized with this.
- *
Aspergillosis Tests?
PCR form tissue biopsy
Galactomannan
Fungal Ab
ELISA detecting molecule in cell wall of the fungus for Aspergillosis testing?
Galactomannan
beta-D-glucan?
fungal ABS for fungal Ab test
What Aspergillosis test is not highly reliable, not specific and can use blood and CSF samples?
Fungal Ab test
- “not good first line, or we do this first” it depends on the patient severe or not severe?**
- a lot of these patients get thrombocytopenia so careful not to make them bleed if your are doing a biopsy if they have the condition **
Candidiasis is a ________ dx?
clinical
what do you see on a KOH prep with Candidiasis?
yeast and spores - hyphae
Candidiasis ?
Clinical diagnosis KOH prep - yeast and spores ( hyphae) Vaginal pathogens probe (microscopy) Blood culture revealing fungemia Beta-D-glucan testing
diabetics and chemo patients
