S3L4: HIV/AIDS Flashcards by MindMed Official | Brainscape

Q

modified T/F on Human Immunodeficiency Virus (HIV)

A retrovirus that attacks CD4 T Lymphocytes

May be transmitted sexually, via blood transfusions, sharing intravenous needles, and from mother to child

A

TT

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Q

match the ff stages of HIV

HIV wasting syndrome
Esophageal thrush
> 1 mo. : Herpes simplex ulceration
Lymphoma
Kaposi sarcoma
Invasive cervical cancer

A. Stage 1: Asymptomatic
B. Stage 2: Mild disease
C. Stage 3: Moderate disease
D. Stage 4: severe disease (AIDS)

A

ALL D

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Q

match the ff stages of HIV

wt. loss >10%
Oral thrush/hairy
Leukoplakia
> 1 mo.: Diarrhea, unexplained fever, severe bacterial & muscle infection, pneumonia
Pulmonary TB,
TB lymphadenopathy

A. Stage 1: Asymptomatic
B. Stage 2: Mild disease
C. Stage 3: Moderate disease
D. Stage 4: severe disease (AIDS)

A

ALL C

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Q

match the ff stages of HIV

Acute necrotizing ulcerative gingivitis
wt. loss > 5-10%
no sx
persistent generalized lymphadenopathy
sore/cracks around the lip
seborrhea

A. Stage 1: Asymptomatic
B. Stage 2: Mild disease
C. Stage 3: Moderate disease
D. Stage 4: severe disease (AIDS)

A

C
B
A
A
B
B

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Q

match the ff stages of HIV

prurigo
herpes zoster
recurrent URTI/mouth ulcer
Pneumocystic pneumonia
Extrapulmonary TB

A. Stage 1: Asymptomatic
B. Stage 2: Mild disease
C. Stage 3: Moderate disease
D. Stage 4: severe disease (AIDS)

A

B
B
B
D
D

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Q

match the ff stages of HIV

cryptococcal meningitis
toxoplasma brain abscess
visceral leishmaniasis
HIV encephalopathy

A. Stage 1: Asymptomatic
B. Stage 2: Mild disease
C. Stage 3: Moderate disease
D. Stage 4: severe disease (AIDS)

A

ALL D

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Q

the ff are true about HIV, Except:

A. Once CD4 counts become too low, host immune defences cannot fight against opportunistic infections and malignancies

B. CD4 count >200 = AIDS diagnosis

C. Treatment of AIDS is focused on opportunistic infection treatment and decreasing the HIV viral load through
antiretroviral therapy

D. Most HIV+ patients develop AIDS after 10 years if left untreated

E. Undetectable means Untransmissible

A

B. CD4 count <200 = AIDS diagnosis

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Q

which of the ff are true about Human Immunodeficiency Virus (HIV)

A. Around 39 million people have died from HIV infection

B. Currently around 36.7 million living with HIV

C. There has been AIDS-defining efforts in the areas of education, prevention and research to decrease transmission and treat the virus.

D. All of the above

A

D

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Q

The ff are Risk factors for HIV, EXCEPT

A. Male sex with male (MSM)
B. unsafe sexual practices
C. use of intravenous drugs
D. vertical transmission
E. blood transfusions
F. None of the above

A

F

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Q

modified T/F

HIV is transmitted by use of non-sterile syringes & tools, pregnancy & breastfeeding, blood transfusion, organ transplant, unprotected sex

HIV is not transmitted from food, drink & utensils, insect bites, kiss/touch, clothes/towel, toilet/shower

A

TT

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Q

which of the ff are pathophysiology of HIV

A. HIV attaches to host cells with glycoproteins then the virus then integrates its chromosomal material into that of the host cell, taking over cell to generate more viral proteins and genetic material. Eventually, the host cell will die, and other CD4 cells will be infected.

B. The number of CD4 cells within the affected individual will fall by approximately 50-80 cells/uL per year without the initiation of ART

C. With the addition of ART, cardiovascular disease is now the major cause of morbidity and mortality for HIV patients.

D. All of the above

A

D

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Q

modified T/F

One of the Affected Body Systems of HIV is the Cardiac System

ART and HIV infection are likely to contribute to increased cardiovascular disease in patients

A

TT

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Q

which of the ff are common signs/symptoms of the cardiac system when affected by HIV:

A. Chest pain, SOB, fatigue
B. Jugular distension
C. Abnormal heart sounds
D. Pericarditis due to mycobacterium tuberculosis
E. All of the above

A

E

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Q

T/F
the ff are HIV drug side effects:
CNS changes, liver toxicity, kidney impairment, lactic acidosis, drug sensitivity, hyperlipidemia

A

T

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Q

match the diseases in the Pulmonary System

URTI and acute bronchitis
Kaposi’s sarcoma
Non-Hodgkin’s Lymphoma
Sarcoidosis
Lung cancer
Emphysema

A. Infectious diseases
B. Non-infectious diseases

A

A
2-6. B

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Q

If the pulmonary system have HIV, we need to check for:

A. Signs of respiratory distress
B. tachypnea
C. cyanosis
D. adventitious lung sounds
E. All of the above

A

E

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Q

modified T/F

HIV medications can cause pancreatitis, hepatic steatosis, or hepatotoxicity

Hepatitis B or C co-infection as well as Candida esophagitis and Cryptosporidium diarrhea are HIV causes in the Oropharyngeal and Gastrointestinal System

A

TT

Candidia Esophagitis is a very common manifestation of HIV infection

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Q

T/F

Associated symptoms in the Oropharyngeal and Gastrointestinal System are Nausea, vomiting, diarrhea, constipation, melena, hematochezia, or urinary symptoms

A

T

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Q

modified T/F

when HIV has affected the Central Nervous System, it may include meningitis, focal demyelinating lesions,
malignancies from immunosuppresion

Presenting complaints include altered mental status, vision changes, focal
weakness, seizures, nausea & vomiting

A

TF

nausea & vomiting are NOT included

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Q

the ff are causes of HIV in Oncologic Problems and Hematologic System, EXCEPT:

A. Anemia, thrombocytopenia, and leukemia

B. ART and prophylactic medications can cause bone marrow toxicity

C. Petechia or purpura, anemia, weakness, fatigue, shortness of breath

D. Leukopenic patients will have concomitant infections symptoms & primary CNS lymphoma with Epstein Barr virus

E. None of the above

A

E

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Q

which of the ff are causes of HIV in the Dermatologic System

A. Maculopapular or morbilliform rash

B. Oral ulcers or lesions

C. Molloscum contagiosum and HPV infections

D. Kaposi’s Sarcoma (Most common AIDS related cutaneous problem) are vascular neoplasm surrounded by violaceous patches, nodules, or plaques

E. All of the above

A

E

Q

match the ff HIV testing options

measures: antigens & antibodies
results: 20 mins
measures: antibodies
results: 5-10 days
measures: HIV, RNA
results: a few days
measures: antibodies
results: 20 mins-1day

A. rapid point of care
B. at home rests
C. nucleic acid test
D. standard point of care

A

A
D
C
B

Q

which of the ff are the correct Prognosis of HIV

A. Most patients with HIV will develop AIDS within 10 years if left untreated

B. Asymptomatic phase = ~8 years

C. If ART is started even after an initial diagnosis of AIDS, the patient may live greater than 10 years

D. Patients who are diagnosed with AIDS and do not get ART will probably die within 2 years

E. All of the above

A

E

Q

which of the ff are true?

80% of people with HIV/AIDS experience

A. Pain and muscle weakness (impairment)

B. Inability to walk, do self care, and bed mobility (activity limitations)

C. Inability to work (participation restriction)

D. All of the above

A

D

Q

modified T/F

Physical therapists help manage complications or other disease conditions that are set in or worsened due to their HIV status

Physical therapy is important in the continuum of HIV/AIDS care and can slow deterioration and enable the
patient to achieve independence

A

TT

Q

which of the ff are Goals of PTs treating pt with HIV

A. Improvement of quality of life

B. Keeping the patient active in both his/her life and in the community.

C. Improve their ability to do daily activities, balance, reduce pain, and maintain a healthy body weight

D. Proper home exercise programs

E. All of the above

A

E

Q

T/F

the ff are Indications for physical therapy management:
- Atrophy
- Muscle weakness
- Arthritis
- Myelopathy
- Pain
- Lymphadema (Secondary to Kaposi’s Sarcoma)
- Polymyositis
- Peripheral neuropathy
- Guillain-Barre Syndrome
- Swelling

A

T

Q

modified T/F

treatments for HIV are exercise like aerobic, resistive/progressive resistive, and therapeutic exercise to help reduce body fat, increase lean muscle,
reduce HIV symptoms, and improvement in self efficacy and cardiovascular fitness

Indications include muscle atrophy and weakness

A

TT

Q

which of the ff are true on manual therapy as a treatment for HIV

A. Massage, joint and soft tissue mobilization

B. Compression bandages and garments for swelling

C. Indications include pain, lymphadema, swelling, tightness

D. Helps in the reduction of neuropathic pain, and pain in general which leads to an increased quality of life.

E. All of the above

A

E

Q

T/F

treatment for HIV include Gait and ADL training with the use of orthotic sandals, treatment of gait problems and transfer training which is good for teaching independence

A

T

Q

modified T/F

Chest/Pulmonary PT are part of treatment in pt with HIV such as the use of positive expiratory pressure mask in the management for recurrent pulmonary infection, DRP, proper breathing techniques and pacing, proper coughing with or without splinting

Counseling and health education is also part of treatment in pt with HIV

A

TT

Q

which of the ff are the Role of PT in Social health

A. Participants living with HIV described experiencing social challenges such as social isolation, stigma and unstable living conditions.

B. They outlined how physical therapy may help to reduce feelings of social isolation and provide strategies for increasing social engagement.

C. Participants with HIV felt interacting with peers in a physical therapy program would allow them to “meet more people” and engage in “exercises together or go walking together.”

D. All of the above

A

D

Q

modified T/F on Client-centered care

refers to the interdependency of health domains in the role of physical therapy in HIV care, focused on specific needs and goals of people living with HIV

Many participants living with HIV identified that although physical therapy could address psychological, physical and social health

A

TT

Q

which of the ff are Precautions for the PT since HIV/AIDS is transmitted with bodily fluids and patients have a myriad of other diseases

A. Use of PPE when handling the patient with open wounds or coughing episodes

B. Careful monitoring of vital signs during exercises

C. Precautions based on other presenting diseases

D. All of the above

A

D

Q

the ff are barriers to PT treatment, EXCEPT:

A. Not all participants living with HIV were able to access physical therapy or attend all the sessions they required

B. Some referred to financial barriers, including lack of stable income or access to private insurance as a
limiting factor to accessing physical therapy.

C. Others described the lack of knowledge among health care professionals in outpatient physical therapy clinics about HIV and episodic disability

D. None of the above

A

D

Q

modified T/F on Framework of physical therapy role in HIV care

(1) multidimensional roles of physical therapy in client- centered HIV care

(2) contextual factors for consideration in HIV care.

A

TT

Q

modified T/F

Physiotherapists have responsibility to treat their patient without any form of
stigmatization.

Based on the ethical principles of beneficence, non-maleficence and justice, physiotherapists do not have the right to refuse to treat persons living with HIV/AIDS (PLWHA).

A

TT

Q

which of the ff are true about AIDS Dementia Complex

A. Is one of the most common and clinically important CNS complications of late HIV-1 infections

B. It is a source of great morbidity and when severe, is associated with limited survival

C. ADC is caused by HIV itself, and not by another opportunistic infection

D. Primary sensory, motor, and premotor cortices were 15%
thinner

E. All of the above

A

E

Q

match the ff clinical s/sx of HIV dementia

sx
1. gait instability
2. poor concentration
3. forgetfulness
4. urinary urgency/hesitation
5. loss of interest in friends, hobbies

A. Cognitive
B. Motor
C. Behavior

A

B
A
A
B
C

Q

match the ff clinical s/sx of HIV dementia

signs
1. apathy
2. saccadic ocular pursuit movements
3. executive cognitive dysfunction
4. slowness of thought
5. slow repetitive movements

A. Cognitive
B. Motor
C. Behavior

A

C
B
A
A
B

Q

the ff are true on the Incidence of AIDS dementia complex, EXCEPT:

A. 1 in 1000 patients not treated with HAART and with low CD4 counts would progress to HAD

B. Europe - incidence of HAD of 0.66 per 1000 persons

C. US - 10.5 cases per 1000 patients

D. None of the above

A

D

Q

which of the ff are Prevalence of AIDS Dementia Complex

A. Neurocognitive deficits are the presenting complaint in 4% to 15% of patients diagnosed with HIV

B. Neuropsychological testing may reveal subtle cognitive deficits (ANI or MND) in as many as 40% of HIV-infected patients treated with antiretrovirals

C. Prevalence of HAND among white and non-white patients as well as between men and women appears
to mimic that of HIV infection and increases with age

D. All of the above

A

D

Q

the ff are Pathophysiology of AIDS Dementia Complex, EXCEPT:

A. Reduction in the cortical gray matter and brain atrophy

B. Perivascular macrophage and lymphocyte infiltration, multinucleated giant cells, myelin loss, and white
matter astrogliosis

C. The basal ganglia is the least commonly affected

D. Encephalitis due to progressive multifocal leukoencephalopathy, non-Hodgkin lymphoma, infection such as from cytomegalovirus, toxoplasmosis, varicella-zoster, herpes simplex, or
BK virus

A

C. The basal ganglia are MOST commonly affected

Q

which of the ff are Etiology of AIDS Dementia Complex

A. Proteins expressed from viral genes in infected cells can directly damage neurons

B. Cytokines produced by activation of the immune response in surrounding healthy glial cells may also contribute to neuronal damage

C. Autoimmune antibodies against brain tissue have been isolated in HIV-infected patients

D. All of the above

A

D

Q

which of the ff are true on the Medical Prognosis of AIDS Dementia Complex

A. Mean survival in HAD without ART is 3 to 6 months, increased to 38.5 months with the initiation of ART
therapy

B. Worse prognosis is associated with the following factors: lower educational level, increasing age,
lower CD4 count, higher viral load, decreasing hemoglobin, decreasing platelets, lower body mass index, hepatitis C co-infection, intravenous drug use and poor medication adherence

C. Presence of HAD is an independent predictor of risk of death in HIV-infected patients

D. All of the above

A

D

Q

match the stage of AIDS Dementia Complex

nearly vegetative, intellectual & social comprehension & output are at a rudimentary level. Nearly/absolutely mute. Paraparetic/paraplegic with urinary & fecal incontinence
Able to perform basic activities of self-care but can’t work/maintain the more demanding aspects of daily life. Ambulatory, but may require a single prop.
Major intellectual incapacity (can’t follow news/personal event, can’t sustain complex conversation, considerable slowing of all output) or motor disability (can’t walk unassisted, usually with slowing & clumsiness of arms as well.

Stage
A. 0 (normal)
B. 0.5 (equivocal/subclinical)
C. 1 (mild)
D. 2 (moderate)
E. 3 (severe)
F. 4 (end stage)

A

F
D
E

Q

match the stage of AIDS Dementia Complex

normal mental & motor function
absent, minimal/equivocal sx without impairment of work/capacity to perform ADLs. Mild signs (snout response, slowed ocular/extremity movements) may be present. Gait & strength are normal.
Able to perform all but the more demanding aspects of work/ADLs but with unequivocal evidence (s/sx that may include performance on neuropsychological testing) of functional, intellectual/motor impairment. Can walk without assistance

Stage
A. 0 (normal)
B. 0.5 (equivocal/subclinical)
C. 1 (mild)
D. 2 (moderate)
E. 3 (severe)
F. 4 (end stage)

A

A
B
C

Q

modified T/F on the Presentation of AIDS Dementia Complex

Alteration in mental status is common in HIV infected patients

Cognitive deficits associated with HAD include impaired executive function, decision making and language; these are generally slow and progressive
in onset

A

TT

Q

the ff are problems in AIDS Dementia Complex, EXCEPT:

A. Movement, Gait, Visual & speech problems
B. Clumsiness
C. Ataxia
D. Progressive weakness
E. Loss of sensation on unilateral UE and LE

A

E. Loss of sensation of (B) UE and LE

Q

which of the ff are true on the Intervention for AIDS Dementia Complex

A. The mainstay of prevention and treatment of HAND spectrum disorders is adherence to ART

B. Appropriate treatment of HIV infection shows improvement in cognitive function in patients diagnosed with severe deficits

C. The selection of a specific ART regimen should follow standard protocols based on viral ribonucleic acid (RNA) load, genotype, drug interactions and presence of comorbidities

D. Psychiatric comorbidities may be present and treatment should be initiated following a psychiatric
evaluation

E. All of the above

A

E

Q

which of the ff are PT Goals for AIDS Dementia Complex

A. Improving quality of life & keeping the patient active with proper home exercise program

B. Quality of life issues & Work hardening

C. Community management skills

D. Integumentary care

E. All of the above

A

E

Q

which of the ff are PT Management for AIDS Dementia Complex

A. Aerobic activity for 20 minutes at least 3 times a week for 5 weeks

B. Improvement of CV fitness, body composition, and psychosocial status

C. Low to moderate intensity exercise to improve aerobic capacity

D. Strengthening exercises

E. All of the above

A

E