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16 Cards in this Set
- Front
- Back
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HIV patient with eye infection, how do you differentiate between CMV vs HSV?
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HSV - painful, b/l vision loss, widespread pale peripheral retinal lesions and central necrosis of retina, marked keratitis
CMV - painless, more common, fluffy or granular retinal lesions near retinal vessels, associated hemorrhages, does NOT cause initial conjunctivitis or keratitis |
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What are recommendations for MMR vaccine in HIV patients?
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Give MMR vaccine to HIV patients with CD4 > 200, and NO prior aids defining illnesses
MMR does have live components, but is worthwhile b/c measels is such a high risk disease in HIV positive patients |
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What vaccines are contraindicated in HIV patients?
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live vaccines
BCG anthrax oral typhoid intranasal influenza oral polia yellow fever if CD4 < 200 then MMR also |
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In HIV patients, when is PPD positive? What is tx?
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PPD positive if > 5 mm
chemoprophylaxis is Isoniazid to tx TB, + pyridoxine to prevent neuropathy 9 months |
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What is the treatment for PCP pneumonia in HIV patient? When do you add additional drug?
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IV trimethoprim-sulfamethoxazole
add oral prednisolone if PaO2 < 70 |
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What does EBV DNA isolated in CSF of HIV patient mean?
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primary CNS lymphoma
will have a weakly ring-enhancing mass, solitary and periventricular on MRI |
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What is a solitary, periventricular, weakly ring enhancing mass on MRI in HIV patient?
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primary CNS lymphoma, will have EBV DNA in the CSF
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What causes pulmonary cavitation in HIV patient?
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Myco tuberculosis, atypical mycobacteria, Nocardia, gram neg rods, anaerobes
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Immunocompromised patient has an infection with characteristic cutaneous and visceral angioma-like blood vessel growths, what microbe?
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Bacillary angiomatosis, caused by Bartonella
constitutional symptoms, skin and viscera lesions extreme caution w/biopsy bc will hemorage |
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What is best treatment for disseminated histoplasmosis?
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Itraconazole
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What prophylaxis is required in HIV patients with CD4 ct < 50?
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Azithromycin for MAC (or clarithromycin)
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What should you think of in HIV patient with bloody diarrhea and negative stool exam?
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CMV, warrants colonoscopy biopsy
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What causes bacillary angiomatosis? How does it present? How is it treated?
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caused by Bartonella, gram-negative bacillus
bright red, firm, friable, exophytic nodules in an HIV infected patient tx - oral erythromycin |
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What is treatment for toxoplasmosis?
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Treatment - sulfadiazine and pyrimethamine
(prophylaxis - trimethoprim-sulfamethoxazole) |
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What are the associated HIV therapy reactions?
Didanosine - Abacavir - NRTIs- NNRTIs - Nevirapine Indinavir - |
Didanosine - induced pancreatitis
Abacavir - hypersensitivity NRTIs - lactic acidosis NNRTIs - Steven Johnson Nevirapine - liver failure Indinavir - crystal induced nephropathy |
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What is going on in HIV patient receiving tx that develops heamturia and needle-shaped crystal sediment?
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Crystal induced nephropathy
2/2 Indinavir (protease inhibitor) |
