REPRO 8 Flashcards

(47 cards)

1
Q

what does HIV cause

A

acquired immunodeficiency syndrome (AIDS)

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2
Q

what kind of virus is HIV and how does it transcribe itsself

A

RNA

reverse replication

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3
Q

HIV 2 is what

A

less virulent and less likely to cause AIDS

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4
Q

what does HIV do to the CD4 count leading to what

A

decreases it

increased susceptibility to viral, fungal, bacterial infections and infection induced cancers

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5
Q

normal CD4 count

when can you get oppertubnisitc infection

A

500-1600
<200 high risk
but 200-500 can still get

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6
Q

how foeti doe HIV replicate

A

every 6-12 weeks new gen

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7
Q

how does the infection establish itself

A

infection of mucosal CD4 langerhan cells and dendritic cells -> regional LNs inflectional established within 3 days. replication and dissemination

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8
Q

who is at higher risk of HIV

A

MSM

low seocioeconomis status

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9
Q

how many people present with symptoms after primary infection
how long after and what are the symptoms

A

80% 2-4 w after infection

fever, maculopapular rash, myalgia, pharyngitis, headache, aseptic meningits

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10
Q

v high risk of what in primary HIV infection

A

transmission

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11
Q

asymp HIV infection what is happening

what is there still a risk of

A

ongoing viral replication and CD 4 count depletion

ongoing transmission if remains undiagnosed

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12
Q

pneumocystis pneumonia caused by what
CD4 count what
symp

A

pneumocystis jiroveci
<200
dry cough, insidious onset, exercise desaturated

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13
Q

CXR of pneumocystis pneumonia

dx

A

intestinal infiltrates, retinodular marking, can be normal

BAL and immunofluorescence +/- PCR

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14
Q

treatment of pneumocystis pneumonia

proph

A

high dose co -trimox +/- steroid

low dose co trim

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15
Q

TB is what in HIV px
types
what is IRS

A

more common
symptomatic primary, reactivation, military, extra pulmonary, multi drug resistant
immune reconstruction syndrome - immune system is reactivated but is much more aggressive

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16
Q

cerebral toxoplasmosis CD4
ae
what can HIV cause

A

<150
toxoplasmosis gondii
cause reactivation of latent infection

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17
Q

symptoms of cerebral toxoplasmosis

A

multiple cerebral abscesses, chorioretinitis, headache, fever, focal neuro, seizures, reduced consciousness, increased ICP

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18
Q

MRI of cerebral toxoplasmosis

A

MRI ring enhancing lesions

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19
Q

cytomegalovirus caused by what
CD4
what can HIV cause

A

CMV
<50
reactivation of latent virus - retinitis, oesophagi’s, colitis

20
Q

symptoms of cytomegalovirus

A

decreased visual acuity, floaters, abdominal pain, diarrhoea, PR bleeding

21
Q

screening for cytomegalovirus

A

ophthalmic screening for all patients with cd4<50

22
Q

skin infections include what

A
recurrent herpes zoster
herpes simplex
HPV
pencillosis
histoplasmosis
23
Q

HIV associated neurocognitive symptoms CD4 count
cause
symp

A

any CD4 count - associated with increased immunosuppression

HIV1

reduced short term memory +/- motor dysfunction

24
Q

progressive multifocal leucoencephalopathy caused by what CD4
symptoms

A

JC virus - reactivation of latent virus
<100
rapid progression, personality change, focal neuro, seizures

25
neuropresentations of HIV related to what
related to viral replication distal sensory polyneuropathy, mononeuritis multiplex, vascular myelopathy, aseptic meningitis, GBS, viral meningitis - CMV, HSV, cryptococcal menignitis
26
haematological occur when | what
increased incidence with increased immunosuppression | malignancies, anaemia, thrombocytopenia
27
HIV associated wasting - slims disease cause
metabolic anorexia malabsorption/diarrhoea hypergonadism
28
Non OI symptoms of HIV
mucosal candidsis, sebbhoreic derm, diarrhoea, fatigue, worsening psoriasis, LD, STIs, hep B/C
29
karposki's sarcoma caused by what | CD4
HHV 8 | risk increased with increased immunodeficiency
30
karposkis symptoms more common in who rx
vascular tumour. cutaneous. mucosal. visceral - pulmonary, GI MSM HAART. local like systemic chemo for visceral
31
NHL caused by what | CD4 what
EBV | increased risk with increased immunodefic
32
NHL symp | rx
bone marrow involvement. extranodal disease. increased CNS involvement HAART
33
cervical cancer caused by what | what is done in HIV px
HPV | screening every year rather than every 3 years
34
sexual transmission of HIV in MSM MSW what increases the risk
51% 45% concurrent STIs, unreceptive sex, trauma, genital ulceration
35
parental transmission of HIV
IVDU, infected blood products, iatrogenic
36
maternal transmission of HIV - how 3 | whats the risk and whats the risk when the viral load is undetectable at delivery
inutero/transplacental. delivery. breast feeding | 1-2%. <0.1%
37
three main groups that are tested
high prevelance areas opt out high risk
38
who are the opt outs
GUM, TOP, drug dependancy, antenatal, conception screening
39
who are the high risk groups
MSM, female partner of bisexual man, drug infections, partners of HIV px, people from endemic areas
40
what is the antigen tested for in HIV
p24
41
rapid hiv testing - what is used when do results come whats the neg
fingerprick. saliva. within 20-30 mins expensive
42
treatment is what
HAART | two NRTI and either a protease inhibitor or a NNRTI
43
how to prevent drug resistance
compliant
44
prevention of HIV 4
treatment. condoms. STI screening and prophylaxis. post/pre exposure proph
45
wanna be pregnancy and HIV positive female | negative male
insemination and HAART
46
wanna be pregnant and HIV positive male and negative female
UPSI and HAART
47
prevention of maternal transmission when can woman delivery vaginally can she breastfeed what should be given to the neonate
HAART during pregnancy if viral load undetectable no 4 weeks of PEP