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50 Cards in this Set
- Front
- Back
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Lecture 42 – HIV/AIDS update
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ok
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What is the most common method of transmission now? (the most rapidly growing area of HIV)
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Through heterosexual transmission
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What would be the earliest manifestation clinically of someone who was recently infected?
Describe the symptoms: ... This is where the individual is most infectious. |
Acute retroviral syndrome
mono-like illness caused from HIV virus – (fever, myalgia, arthralgia, maculopapular rash, pharyngitis, lymphadenopathy |
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Acute Primary HIV Infection:
Symptoms occur 12 days after exposure Testing -... test – tests for the actual virus itself (during acute retroviral syndrome) -P24 antigen test |
HIV-PCR antigen
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What is one of the largest immunological organs in the body where you would see the majority of your T-cells?
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GI tract
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The prognostic indicators for developing AIDS revolves around both the ... and the degree of ...
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viral load
immunosuppression |
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Make sure that anybody with an ... gets tested for HIV
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STD
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What is a unique dermatologic manifestation of HIV?
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eosinophilic folliculitis
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To treat, it’s best to use ... active agents
initiate therapy when T-cells are ... or less |
3
350 |
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What is one of the biggest reasons of failure of treatment?
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non-adherence
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Lecture 43 – immunology of HIV
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CD4+ (helper) T cells: Are directed by ... cells to orchestrate either B cell or ... T cell mediated responses. They have an ... effect.
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dendritic
CD8+ Indirect |
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T Cell Dysfunction:
CD4+ T cells “direct” the development of the immune response CD4+ T cells are infected and killed by HIV virus decrease in CD4+ T cell count and ... in viral load = disease progression However, the vast majority of CD4+ and CD8+ T cell depletion ... due to direct viral infection ... activation appears to play a critical role in driving HIV pathology ... activated T-cells results in progressive immune dysfunction |
increase
is not Immune Chronically |
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T Cell Dysfunction:
Chronic activation of T cells, particularly ... CTL, is critical to the development and progression of disease |
CD8+
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True or false:
Immunosuppression increases risk of non-HIV related death |
true
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lecture 44 – opportunistic infections
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What is one of the most common opportunistic infections involved with HIV?
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Pneumocystis carinii PNEUMONIA
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Pneumocystis carinii Pneumonia diagnosis:
Symptoms: -mild fever, ... cough, dyspnea -progressive worsening of symptoms X-ray abnormalities: -interstitial then alveolar ..., usually bilateral Hypoxemia, hypocapnia CD4 count below ... Diagnostic procedures: -induced sputum: *highly specific but low sensitivity (50-60%) -bronchoalveolar lavage: *highly specific and sensitive |
non productive
pneumonia 200 |
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look at slide 6 in lecture 44
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ok
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look at slide 8 in lecture 44
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ok
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What opportunistic infection organism (commonly in HIV patients) causes encephalitis and presents with ring lesions (on CT/MRI) in the brain?
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Toxoplasma gondii
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look at slide 14-15 in lecture 44
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ok
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Pt. presents with AIDS and watery diarrhea – most common cause is ...
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cryptosporidium
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If a patient presents with AIDS (T-cell below 50) and has visual changes, you should think of ...
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Cytomegalovirus (CMV) chorioretinitis
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look at slide 53 in lecture 44
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ok
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lecture 47 – sepsis
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...:
Clinical evidence of infection plus evidence of systemic response to infection (Tachypnea, tachycardia, and hyperthermia or hypothermia) |
sepsis
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...:
Sepsis plus evidence of Altered organ perfusion (At least one of the following) -Hypoxemia -elevated lactate -oliguria -altered mentation |
sepsis syndrome
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...:
Sepsis syndrome plus hypotension (systolic blood pressure <90 or decrease in mean arterial blood pressure >40 from baseline) |
septic shock
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...:
septic shock plus duration >1 hour with lack of response to IV fluids or pharmacological intervention |
refractory septic shock
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look at slide 7
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ok
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Multiple organ system failure or MOF:
Likelihood of death is related to both the ... of organ systems affected and the ... of organ system failure |
number
duration |
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What is one of the early signs of sepsis?
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hyperventilation (Tachycardia and fever also)
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Syndrome: Disseminated intravascular coagulation: (microangiopathic hemolytic anemia)
-Platelet ... (or 25% ... from previously documented value) -Prolonged prothrombin time, prolonged partial thromboplastin time, or clinical evidence of ... -no medically significant confounding factors (e.g. liver failure, major hematoma, or anticoagulant therapy) -correct underlying condition |
depression
decrease bleeding |
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Lecture 48 – Tick related infections:
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Pathogenesis of Lyme disease:
organism: ... Can infect -rodents, deer, other wild and domestic animals Ixodid tick bites the infected animals Human host is bitten Lyme disease develops |
Borrelia burgdorferi
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What skin manifestation occurs with Lyme disease?
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Erythema chronicum migrans
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look at slide 11
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ok
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Rocky Mountain Spotted Fever:
Organism - ... Vector - Dermacentor andersoni Geographic range - USA (south central, southeastern) Incubation period - 2 to 14 days Duration - 10 to 20 days |
Rickettsia rickettsii
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Rocky Mountain Spotted Fever
Clinical Manifestations: Incubation period 7 days Early disease -Fever, headache, myalgia, malaise, nausea Later disease -Macules on wrists, ankles -Petechiae on ... and ... -Vascular collapse with increased permeability *Hypotension, pre-renal azotemia, ARDS -Central nervous system involvement *Encephalitis -Hepatic injury with increased bilirubin -Bleeding |
palms and soles
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Rocky Mountain Spotted Fever
Diagnosis: Clinical and Epidemiologic considerations (early) Fever and Rash -... and ... on wrists, ankles, palms, soles Serology -Indirect immunofluorescent assay (>1:64) -Usually positive 7-10 days after onset Skin biopsy -Immunohistologic exam -Good for acute diagnosis |
Macular and petechial
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Rocky Mountain Spotted Fever
Treatment: ... -Drug of choice for children and adults -Not used in pregnancy or allergy ... -Used if tetracycline cannot be |
Doxycycline
Chloramphenicol |
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What are the unique manifestations of Human Monocytic Ehrlichiosis?
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Leukopenia (lymphopenia), thrombocytopenia
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Babesiosis:
Etiologic agent -B. ... (most common) -B. ... (in splenectomized patients, seen more commonly) Tick vector -Ixodes scapularis Epidemiology -Northeastern coast -Vast majority of infections not clinically apparent -Transfusions another source Giemsa thick and thin blood smears -Intraerythrocytic parasites ( forms a ...) Resembles ... |
microti
divergens maltese cross malaria |
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Most tick related infections are treated with ...
The exception to that is ... |
Babesia
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Which organism causes an arthritic condition with an erythema chronicum migrans?
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Borrelia burgdorferi (Lyme’s disease)
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Which organism causes a macular rash with petechiae on the palms and soles and cause endothelial damage and hypotension and shock?
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Rickettsia rickettsii (RMSF)
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What are the 2 organisms that affect the WBCs?
Which one causes lymphopenia? Which one causes granulocytopenia? |
Human Anaplasmosis and Human Monocytic Ehrlichiosis
Human Monocytic Ehrlichiosis Human Anaplasmosis (HGE) |
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Which organism causes a very similar condition to what malaria would do? Viewed like a maltese cross. Can diagnose with both PCR and immunoflorescent antibody testing.
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Babesiosis
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Therapy for most tick-borne illnesses are with ... except for ....
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doxycycline
Babesiosis |
