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Flashcards in Infectious Disease Deck (40)
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1

What is HIV and when was it first recognised?

Human immunodeficiency virus
1984

2

When has treatment for HIV been available since?

1996

3

How many people are living with HIV now worldwide?

37 million people

4

How many people are living with HIV in the UK now? How many are undiagnosed?

100 000
18000 undiagnosed

5

How many new diagnoses of HIV are made each year in the uk?

6000 a year, mainly 20-39 year olds

6

What is the mortality of HIV if diagnosed late when CD4 count is less than 100?

8% at 1 year

7

What is the mortality rate of HIV when diagnosed early, when CD4 count is more than 200?

0.5% mortality at 1 year

8

What is normal CD4+ T cell levels and what is it when opportunistic infections arise?

500+ normal

9

When should you be tested again for HIV if risk of exposure?

Test when exposed and 3 months after

10

Who should be routinely tested for HIV?

Men who have sex with men
IV drug users
Pregnant women
Anyone with another STI/partner has STI
From a country of high prevalence or partner from that country

11

Indicators for HIV testing?

Any opportunistic infection
Pneumonia
Blood disorders
Weight loss
Shingles
Lymphadenopathy

12

Name the 5 most common opportunistic infections

Seroconversion illness
Pneumocystis jirroveci pneumonia (PCP)
Toxoplasmosis gondii
Kaposi's sarcoma
Tuberculosis

13

What is seroconversion illness also called?

Acute HIV syndrome
Similar to glandular fever
Can drop CD4+ counts low enough to get infections

14

What is the commonest opportunistic infection in the UK?

Pneumocystis Jirroveci pneumonia

15

Signs and symptoms of PCP pneumonia? Treatment?

Subacute insidious onset of breathlessness, fever, cough
Progressive hypoxia
Treatment= co-trimoxazole +/- steroids

16

Toxoplasmosis gondii

Protozoan parasite
May be latent and reactivated when immunocompromised
Space occupying lesion in brain
Treated with sulfadiazine and pyrimethamine

17

Kaposi's sarcoma

AIDS associated cancer
Vascular tumour of spindle cells -> dark red pigmented lesions
Skin and viscera
Driven by co-infection with HHV-8

18

What is the most common complication of HIV worldwide?

TB

19

Who should be giver ART?

All people with HIV at any CD4+ count
-> prevents onward transmission, extends life and improve health

20

What is PrEP and who should be on it?

Pre-exposure prophylaxis
Anyone at substantial risk of HIV
(serodiscordant couples, sex workers, injecting drug users, men who have sex with men/transgender women, transgender people, prisoners)

21

What is a community acquired infection?

An infection contracted outside of a healthcare setting, or present

22

Why is it important to know if an infection is community or hospital acquired?

Different organisms and resistance patterns
Community cases are a potential marker for developing outbreaks

23

What is the most common community and hospital acquired cause for pneumonia?

Comm: Strep pneumonia
Hosp: Gram -ve E.coli/Klebsiella

24

What is the most common community and hospital acquired cause for meningitis?

Comm: Strep pneumonia
Hosp: Gram -ve E.Coli/Klebsiella

25

What is the most common community and hospital acquired cause for UTI?

Comm: E.coli
Hosp: E. coli

26

What are the main infective organisms for hospital acquired infections?

Gram -ve E.coli and Klebsiella
Pseudomonas
Staph aureus

27

What are the 2 main infective organisms for community acquired infections?

Strep pneumoniae
Haemophilus influenzae

28

Signs and symptoms of meningitis

Headache, neck stiffness, photophobia
CSF raised WCC and raised protein
Meningeal enhancement on CT
Sepsis?
Rash (in neisseria meningitis)

29

What is the most common cause of meningitis in the young versus old

Viral in young
meningococcal if older

30

Why is travel history useful in meningitis presentation?

Tick borne encephalitis
West nile virus
Lyme's disease