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Flashcards in L69 Deck (25):
1

Define incidence vs prevalence

Prev = # people living with condition
- Increasing for HIV b/c better treatment
Incidence = # new infections per year
- Constant for HIV

2

Name the 5 body fluids that can transmit HIV.

Blood
Breast milk
Semen
Vaginal
Rectal fluids

3

What is the key factor driving infectiousness of a donor? How is this measured?

Viral load = amt of virus in the body
Measured by PCR

4

What are factors that increase your risk for transmission in an occupational setting?

1. Visible blood on needle
2. Needle from artery/vein
3. Hollow bore/large gauge needle
4. Deep injury
5. From pt w/ high viral load

5

What is the standard diagnostic method for pots over 18 mo old? What is it testing?

Serum PCR (immunoassay) for plasma viral RNA
- IgM
- IgG
- p24
Testing viral load

6

Name the order of HIV characteristics you see in pts.

Virus in blood - viral load

7

What would give you a false positive serum PCR?

HIV vaccine
Autoimmune disease

8

What is the eclipse period?

No signs of infection b/c localized
During first few days of infection

9

What is the window period? What is characteristic of this period for diagnostics?

Pt is infected with HIV
False negative test b/c no Abs yet

10

What is the seroconversion window?

Time to make Abs vs HIV

11

If the serum PCR is positive, what must you follow up with?

Western Blot to confirm
- Look for Abs against specific HIV antigens

12

How do you test infants for HIV?

PCR for pro-virus DNA
Abs not tested b/c inherited from mom

13

What is the cell profile of acute retroviral syndrome?

Increase serum HIV RNA
Decline CD4

14

What are the clinical symptoms of acute retroviral syndrome?

Fever
Lymphadenopathy
Pharyngitis
Rash
Myalgia/arthralgia
Aka you'd probably mistake this for mono or flu

15

What are the *big* AIDs defining illnesses?

Esophageal candida
Cryptococcosis
CMG
Kaposi sarcoma
PCP
PML (progressive multifocal leukoencephalopathy)
Toxoplasmosis

16

What are the other AIDs defining illnesses you should be aware of?

Candida of respiratory tract
Invasive cervical cancer
Cocci
Encephalopathy
Herpes
Histoplasmosis
Isosporiasis
Lymphoma
MAC
Recurrent pna
Salmonella
TB
Wasting

17

What are the serum characteristics of chronic HIV infection?

CD4
Dets when to start drug prophylaxis

18

Which 2 infections should you expect in pts with CD4 over 500?

Lymphadenopathy
Secondary syphilis

19

Which infections should you expect in pts with CD4 ct between 200-500?

TB
Oral candida
Shingles
Kaposi sarcoma

20

Which infections should you expect in AIDs pts (CD4

PCP
Toxoplasmosis
Crypto meningitis
CMV
JC virus --> PML

21

Is PCP prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

PCP:
1 & 2ary
CD4

22

Is toxoplasmosis prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Toxo:
1 & 2ary
CD4

23

Is crypto prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

Crypto:
2ary
CD4

24

Is MAC prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

MAC:
1ary
CD4

25

Is CMV prophylaxis 1ary or secondary? What CD ct do you start at? Drug.

CMV:
2ary
CD4