INFECTIOUS DISEASES: HIV Flashcards Preview

Year 3 Medicine Block > INFECTIOUS DISEASES: HIV > Flashcards

Flashcards in INFECTIOUS DISEASES: HIV Deck (12)
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1
Q

Baseline investigations for patients newly diagnosed with HIV

A

Confirmatory HIV test

CD4 count

HIV viral load

HIV resistance profile

HLA B5701 status

Serology for syphilis, hep B (sAg, cAb,sAb), hep c,hep A

Toxoplasma IgG, measles IgG, varicella IgG, rubella IgG

FBC, U&Es, LFTs, bone profile, lipid profile

Schistosoma serology (if spent >1mnth in sub-Saharan Africa)

Wome should have annual cervical cytology

2
Q

Where is support provided for patient with HIV?

A

HIV clinical nurse, community support groups, psych support if needed

3
Q

What is post-exposure prophylaxis in HIV

A

Depends on the type of incidents- low risk may not need PEP

Combination of oral anti-reterovirals as soon as possible for 4 weeks

Serological testing at 12 weeks following completion of PEP

Reduces risk of transmission by 80%

4
Q

What is the HIV seroconversion reaction?

A

Symptomatic in 60-80% of patients

3-12 weeks after infection

The HIV has entered the body is now rapidly multiplying

5
Q

Features of seroconversion reaction?

A

Sore throat, lymphadenopathy, malaise, mylagia, arthralgia, diarrhoea, maculopapular rash, mouth ulcers

6
Q

Diagnosis of HIV?

A

Combination tests of HIV antibodies and P24 antigen

If positive, repeat to confirm the diagnosis

Viral load may also be measured- HIV RNA level

Testing for HIV in asymptomatic patients should be done at 4 weeks after possible exposure, if negative, offer a repeat test at 12 weeks

7
Q

What is anti-retroviral therapy?

A

Involves a combination of at least 3 drugs, usually 2 nucleoside reverse transcriptase inhibitors (NRTI) and either a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitors (NNRTI)

8
Q

As well as their normal ART treatment what else should patients with HIV and a low CD4+ count be on?

A

CD4< 200–> co-trimoxazole 480mg PO OD as primary prophylaxis against PCP

CD4<50 –> Azithromycin 1250mg PO once weekly protect against MAI, also be assessed by opthalmology with dilated fundoscopy to look for intra-ocular infections

9
Q

Nucleoside analogue reverse transcriptase inhibtors side effects?

A

Periperheral neuropathy

Tenofovir: renal impairment and osteroporosis

Zidovudine: anaemia, myopathy, black nails

Didanosine: pancreatitis

10
Q

non- Nucleoside analogue reverse transcriptase inhibtors side effects

A

P450 enzyme interactions

rashes

11
Q

Protease inhibtors side effects

A

Diabetes, hyperlipdaemia, buffalo hump, central obsesity, p450 enzyme inhibition

12
Q

What is Septic Arthritis ?

A

Infection of the joint and synovial fluid

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