Hiv/aids

Front 1

What are the infectious modes of transmission of HIV?

Back 1

When infected blood, semen, or vaginal secretions are deposited onto mucous membrane or into the blood.

Front 2

What are some non infectious routes of HIV spread which can be mistaken for infectious ones?

Back 2

Sweat, saliva, urine, feces : all are not infectious UNLESS contaminated with blood.

Front 3

Which is a more efficient route of transmission male to female or vice versa?

Back 3

male to female transmission is 7x-9x more efficient that female to male

Front 4

What is the most frequent mode of transmission of the HIV virus?

Back 4

sexual ( unprotected ) 75%-85%

Front 5

What are the modes of transmission via the blood route and which one is the most common?

Back 5

IVDA**
transfusions
needlesticks

Front 6

HIV can cross the placenta spreading the virus from the mother to the infant. T/ F?

Back 6

False, HIV doesnt cross the placenta. Infections occur at time of birth.

Front 7

What are some ways to prevent the spread of HIV via blood and sexual routes?

Back 7

sexual: reduce high risk behaviour such as anal sex and promiscuity. Use condoms if having sex at all.

Blood: avoid IVDA, if still using then at least use a different needle every time and if not possible, wash with bleach.

Healthcare workers take precautions

Front 8

How do you prevent the spread of the virus from mother to infant?

Back 8

ART anti retroviral therapy
avoid breast feeding

Front 9

How is HIV screening preformed?

Back 9

ELISA ---> if positive then do confirmatory test Western Blot

Front 10

What are the two forms of HIV and their associations with AIDS?

Back 10

HIV-1: associated with AIDS in most of world
HIV-2: associated with AIDS in western Africa

Front 11

How is genetic information carried in HIV?

Back 11

RNA

Front 12

What are the major drug targets for HIV meds?

Back 12

three viral enzymes: protease, reverse transcriptase, integrase

Front 13

Why is HIV considered a retrovirus?

Back 13

Normally genetic information is stored on DNA which is then used to make RNA. HIV does this backwards.

Front 14

What type of cells does HIV target?

Back 14

Tcells, by attaching on the CD4 receptor

Front 15

Which enzyme is used to make double stranded DNA from RNA?

Back 15

reverse transcriptase

Front 16

Which enzyme is used when viral DNA integrates into host nucleus and is inserted into the cells original DNA?

Back 16

Integrase

Front 17

What happens in the budding stage of the HIV life cycle?

Back 17

New mature viron released from CD4

Front 18

What is the importance of CD4 cells?

Back 18

CD4 cells orchestrate immune response to pathogens. They recognize foreign antigens and help activate B lymphocytes. They coordinate cell mediated immunity .

Front 19

An infected CD4 cell will make new copies of HIV that are released into the bloodstream to infect more CD4 cells. T/F

Back 19

True

Front 20

What is the strongest predictor of subsequent disease progression and survival ?

Back 20

CD4 cell count

Front 21

What are some uses of CD4 cell count?

Back 21

1. determines when to start antiretrovirals,
2. assessment of immunologic response to therapy
3. need for initiating chemoprophylaxis for opportunistic infections

Front 22

What happens when CD4 cells are depleted?

Back 22

development of opportunistic infections and malignancies

Front 23

What is viral load?

Back 23

number of viral RNA copies per ml

Front 24

What is the significance of viral load?

Back 24

viral load used as a prognostic factor to monitor disease progression and effects of treatment. Its critical for evaluating response to therapy. There is a significant association between reduced plasma viremia and improved clinical outcomes.

Front 25

HIV Classification Category 1

Back 25

CD4 >500 cells/mm3

Front 26

HIV Classification Category 2

Back 26

CD4 200-499 cells/mm3

Front 27

HIV Classification Category 3

Back 27

CD4 <200 cells/mm3

Front 28

In which clinical category would someone who has presence of AIDS defining illness be classified?

Back 28

Clinical category C:

Front 29

Clinical category B is characterized by...

Back 29

symptoms of immune deficiency not serious enough for AIDS

Front 30

In which clincal category would someone who is asymptomatic has persistent generalized lymphadenopathy & acute seroconversion be classified?

Back 30

Clinical category A

Front 31

When is someone diagnosed with AIDS?

Back 31

When CD4 count falls below 200 cells/mm3

Front 32

How long does the acute seroconversion phase last?

Back 32

lasts 2-4 weeks

Front 33

What are some symptoms experienced in the acute seroconversion phase ?

Back 33

symptoms: fever, rash, myalgias, sore throat, night sweats, GI problems, lymphadenopathy, headache, pharyngitis

Front 34

In which phase is a patient asymptomatic?

Back 34

Latent phase

Front 35

How is length of the latent phase classified?

Back 35

length of latency varies
typical progressor (60-70%)
~ 10-11yrs to progress to AIDS
rapid progressor (10-20%)
progress to AIDS in < 5 years
slow progressor (5-15%)
>15 years to progress to AIDS

Front 36

In which phase of the clinical course of the disease does CD4 count drops from normal (800-1000 cells/mm3) to <200 cells/mm3?

Back 36

Latent phase

Front 37

What happens in the last phase of the disease progression?

Back 37

CD4 falls below 200 cells/mm3 or AIDS defining illness occurs

Front 38

How long can someone who is Dx with AIDS survive w/o drug therapy?

Back 38

without therapy, death likely in 2-3 years

Front 39

What are OI's?

Back 39

infections with common organisms that do not produce infection in individuals with a normal immune system

Front 40

When do OI's thrive?

Back 40

typically occur when CD4 drops below 200 cells/mm3

Front 41

The risk of _____________ is inversely related to the patient's CD4 count, and increases significantly when the CD4 count decreases below 50 cells/mm³.

Back 41

Mycobacterium avium complex (MAC)

Front 42

What complications can occur from OIs'?

Back 42

respiratory
gastrointestinal
nervous system
malignancies
wasting syndrome
Other: CMV, Herpes Zoster, MAC

Front 43

What could cause false positive results on ELISA?

Back 43

hematologic malignancy
DNA viral infection (EBV, infectious mononucleosis)
autoiimmune disorders
immunizations
chronic renal failure

Front 44

What is OraQuick®?

Back 44

OraQuick is a fingerstick antibody test that provides results in 20 minutes. (+) requires confirmatory test.

Front 45

How do Nucleoside reverse transcriptase inhibitors
work?

Back 45

NRTIs work by incorporating into the growing DNA chain(by reverse transcriptase) in error resulting in chain termination.

Front 46

What is the MOA of Integrase inhibitors?

Back 46

Interfere with integrase ability to incorporate viral DNA into host genetic material ending life cycle.

Front 47

List targets of drug therapy?

Back 47

Reverse Transcriptase: Nucleoside reverse transcriptase inhibitors, Non-nucleoside reverse transcriptase inhibitors
Protease
Integrase
Entry: Fusion, Coreceptor binding inhibition

Front 48

The first test (1985) to screen for HIV used antibody detection. what was wrong with it?

Back 48

HIV antibodies develop 2-6 months after infection which means false negatives may occur during this window period

Front 49

Should all pregnant women be screened for HIV?

Back 49

Yes, CDC recommends opt out program, patient informed HIV testing will be done unless the patient declines.

Front 50

Who are the high risk patients that should be screened annually for HIV and other STDS?

Back 50

injection drug users and their sex partners
persons who exchange sex for money or drugs
sex partners of HIV infected persons
individuals with multiple sex partners (or whose sex partner has multiple sex partners)