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121

What is the CD4 count for type C1, C2 and C3 HIV?

1 - >500
2 - 200-499
3 -

122

When does CD4 count cause immunodepression?

123

Investigations for HIV?

HLA-B 5701 status, lymphocyte subsets

ELISA in 6-8 weeks, western blot, immunofluorescence assay, nuclei acid testing

virology screen

serologic testing algorithm for recent HIV serovconversions (STARHS) to identify recent activation

viral p24 antigen, isolation of virus in culture, detect IgG antibodies to envelope components

124

What is screened in a virology screen for HIV?

HIV antibody, HIV viral load, HIV genotype, hepatitis serology, CMV antibody, syphilis screen

125

Treatment of HIV?

educate, transmission reduction, advice, contact tracing, psychological support

highly active antiretroviral therapy (HAART)
2xNRTI + 1xNNRTI or
2xNRTI + 1xPI or 1xII

(non nucloside reverse transcriptase inhibitor, nucleoside reverse transcriptase inhibitor, protease inhibitor, integrase inhibitor)

126

What are the co receptor sites in M and T tropic strains of HIV?

M = CCR5
T = CXCR4

127

Example of a protease inhibitor?

indinavir

128

Example of integrase inhibitor?

raltegravir

129

Complications of HIV?

increased risk of opportunistic infections e.g. toxoplasmosis, CMV. PJP, cryptococcal meningitis, aspergillosis

increased risk of malignancies e.g. Kaposis sarcoma, NHL, cervical, anal

AIDS (5-10yrs post)

130

Symptoms of AIDS?

candiasis of bronchi, trachea, lungs and oesophagus, lymphoma, pneumocytosis pneumonia, leucocenphalopathy, meningitis, CNS mass lesions, cervical cancer, TB

131

What is the treatment of HIV based on?

awareness, delivery, clinical services, cost, adherence, efficacy, co morbidities, side effects, 2ndline, combined formulants, paediatric formulants, ease of use

132

What is the difference between HIV-1 and -2?

they are closely related retroviruses, capable of reverse transcriptase and made up of 9 genes causing genetic variation

133

What are the 9 genes that code for the HIV genome?

Tat - viral replication and increased host transcription factor production
Rev - binds to RNA to allow export form nucleus and regulate RNA splicing
Nef - increase infectivity
Gag - encodes structural proteins
Pol - encodes enzymes
Env - encodes envelope proteins
Vif - host restriction factor to block replication and mediate degradation

134

Which three genes help encoding in HIV?

Gag, Pol, Env

135

What are the different types of tropic medicine?

neoplastic disease, chronic illness, blood dyscrasias, nutritional, envonoming

136

Examples of vector borne tropical diseases?

dengue, viruses, malaria, protozoa, trypanosomes, leishmaniasis, filaria, trachoma, bacteria, typhus, rickettsia, helminthiases

137

Examples of soil/water borne tropical diseases?

hookworm, ascaris, buruli ulcer

138

Examples of faecal oral tropical diseases?

amoebae, giardia, thyphoid, bacteria

139

Examples of sexual tropical diseases?

HIV and STIs

140

Examples of airborne tropical diseases?

measles, meningitis, pneumonias, TB

141

Symptoms of Dengue fever?

fever, headache, severe musculo skeletal pains (back break fever), fever temporarily drops, rash

142

How is Dengue fever transmitted?

aedes mosquito - in south america and central africa

143

Examples of arthropod borne viruses?

dengue fever, yellow fever, japanese encephalitis, west nile, o'nyong nyong, chikunggunya

144

Examples of human to human directly transmissable haemorrhagic viruses?

lassa fever, ebola, marburg, CCHF

have a high case fatality and need a high level barrier nursing of cases advised

145

What can sand flies (phlebotomus sp) cause, how does it present and what is the treatment?

causes a fever, biopsy shows amastigotes, shows the leishmania species, and treated with sodium stibogluconate

146

What is African Trypanosomiasis?

the sleep sickness, causing strange behaviour and hard to rouse

transmitted via the tryspansoma bruceii tsetse fly

it is a transient parasitaemia, with lymph gland invasion and chronic meningoencephalitis

147

Treatment of the African Trypanosomiasis?

IV suramin (urea derivative) and melarsoprol (trivalent arsenic compound), need CSF to diagnose if no symptoms

148

Symptoms of the Chagas disease?

initial lesion, oedema, transient toxaemia, long latent period, cardiomegaly, CCF, arrhythmia, megooesopghagus, megacolon, destructon of enteric nerve plexus

no treatment

149

Tropical infections with short (

arboviral infections (dengue), enteric bacterial infections, paratyphoid, plague, typhus, haemorrhagic fevers

150

Tropical infections with long (>21 day) incubation period?

viral hepatitis, TB, HIV, schistosomiasis, amoebic liver abscess, visceral leishmaniasis, filariasis