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Opportunistic illnesses Flashcards

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1
Q

What type of infections usually create more complications with HIV infections?

A

Opportunistic illnesses (OIs)

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2
Q

How are OIs suppressed?

A

with antimicrobial prophylaxis regimens in HIV and other immunocompromised patients

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3
Q

What is CD4 cell levels in AIDS?

A

<200/uL

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4
Q

T/F; A patient with >500/ul CD4 cells is generally not at a risk for an AIDS-defining OI

A

True

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5
Q

What pathogen causes primary or reinfection of latent infection TB?

A

M. Tuberculosis

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6
Q

What effect does Rifamycins have on CYP450?

A

Inducers

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7
Q

What does Rifamycin do to ART drugs?

A

decrease the plasma levels of ART drugs

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8
Q

What drugs replace rifampin in HIV patients; and why?

A

Rifabutin and Rifepentine; due to weaker CYP450 inducers

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9
Q

What Pathogen disseminates MAC in AIDS?

A

M. Avium

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10
Q

What does M. Intracellulare causes?

A

Pulmonary disease

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11
Q

What is the coverage of MAC infections?

A

Clarithromycin or Azithromycin + anti- TB drugs

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12
Q

T/F; Cytomegalovirus usually is activated in as a latent infection (Subacute) in AIDs pts?

A

True

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13
Q

When does CMV disease arises?

A

when CD4 count drops

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14
Q

How is CMV manifested?

A

Retinitis: Lesions occur near or on the retina; It causes irreversible blindness

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15
Q

What Medications cover CMV?

A

Ganciclovir, Valganciclovir, Foscarnet, Cidofovir

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16
Q

What pathogen reactivation cause Progressive Multifocal Leukoencephalopathy?

A

Papovavirus JC (JCV)

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17
Q

What organ is infected by JCV?

A

Gi tract and it remains latent

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18
Q

What is the pathogenesis of PML?

A

Virus reactivated in HIV pts

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19
Q

JCV destroys what part of body?

A

White matter of the brain

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20
Q

What pathogen causes Kaposi Sarcoma?

A

Human herpesvirus 8 (HHV8)

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21
Q

What immune cell is infected by HHV8?

A

infects B-cells

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22
Q

what is pathogenesis of of Kaposi’s Sarcoma?

A

Promote B-cells growth and prevent apoptosis

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23
Q

What effect does Kaposi’s Sarcoma have on skin cells?

A

cells from benign tumors (Skin cancer)

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24
Q

What causes Pneumocystis Pneumonia?

A

Pneumocystis Jirovecii pneumonia (PCP)

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25
Is Pneumocytis pneumniea active in healthy patient, Why?
No, Suppressed by immune system via CD4 cells in healthy persons
26
When does PCP in AIDS patients arises?
when immune system can no longer contain of latent organisms
27
What is pathogenesis of PCP?
P. Jirovecii is a yeast-like fungi. the fungi are able to colonize and grow causing damage to alveoli
28
How is PCP manifested?
reactivated latent infections in the lungs give rise to pneumonia (Fluid in the lungs)
29
What is the coverage of PCP?
Bactrim and trimetrexate; Pentamidine and atovaquone
30
How do Bactrim and Trimetrexate work?
Bactrim and trimetrexate (used with leucovorin to reduce drug toxicity) inhibit folic acid synthesis in P. jirovecii.
31
How do Pentamidine and atovaquone work?
inhibit electron transport (respiration = ATP synthesis) in P. jirovecii
32
What is Cryptococcosis?
Cryptococcus neoformans is an opportunistic yeast
33
Cryptococcosis occurs primarily in what patients?
in HIV pts
34
How is Cryptococcosis transmitted?
by aerosol inhalation
35
What is the pathogenesis of Cryptococcosis
Yeast spores germinate in alveoli. In AIDS pts, the CD4+ T-cells deficiency allows the disease to disseminate into the bloodstream and CNS
36
What is the manifestation of of Cryptococcosis?
Occurs as meningoencephalitis in AIDS pts. Causes pulmonary (Pneumonia) and Cryptococcal CNS disease
37
What is Cryptococcal CNS disease?
Usually disseminates from lungs; Most common cryptococcosis presentation and it causes CNS lesions
38
What is the coverage of Cryptiococcosis?
Amphotericin B, Flucytosine, Fluconazole
39
How does Amphotericin B work? (Cryptococcosis)
causes leaks in ergosterol-rich fungal membranes; ADR = Nephrotoxic
40
How does Flucytosine work? (Cryptococcosis)
given with amphotericin B; disrupts nucleic acid synthesis; ADR = Bone marrow suppression
41
How does Fluconazole work? (Cryptococrossing)
Inhibits ergosterol synthesis; CYP3A4 inhibitor
42
what is the most frequent OI occurring in nearly all AIDS pts that are not on anti fungal prophylaxis?
Candidiasis
43
What is Candida?
commensal yeast of skin, genitals, and GI tract
44
Describe the Pathogenesis of Candidiasis?
Candidiasis occurs when CD4 cells are depleted and candida can colonize mucocutaneous surface
45
How is Candidiasis manifests?
Oropharyngeal and esophageal candidiasis
46
What is the coverage for Candidiasis?
Azole antifungals (Fluconazole = Diflucan) Echinocandins (caspofungin, micafungin)
47
What are Protozoan infections?
Toxoplasmosis, Cryptosporidosis, Cystoisosporiasis
48
What protozoa causes toxoplasmosis?
Toxoplasma gondii
49
How does toxoplasmosis gets reactivated?
when CD4 count drops
50
What does Toxoplasmosis looks like?
CNS mass lesions in AIDS pts
51
Toxoplasmosis usually arises when?
When CD4 count drop
52
How is Toxoplasmosis transmitted?
contact with cat feces (pregnant woman should avoid little box)
53
What is the coverage of Toxoplasmosis?
Pyrimethamine + Sulfadiazine; Bactrim
54
What causes Cryptosporidiosis?
Protozoan GI pathogen
55
What is the epidemiology of Cryptosporidiosis?
Chronic diarrhea in HIV patients
56
How is Cryptosporidiosis transmitted?
Fecal-oral, waterborne
57
What medications cover Cryptosporidiosis?
Nitazoxanide
58
What is Cystoisosporiasis epidemiology?
Cause diarrheal disease in HIV pts
59
How is Cystoisosporiasis transmitted?
fecal-oral, waterborne
60
What is the coverage of Cystoisosporiasis?
Bactrim
61
T/F; HIV pts can also develop malignant B cell cerebral lymphoma that often present tumors containing cancerous cells infected with Epstein-Barr virus (human herpesvirus 4)
True

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