Immunity And Infection Aids

Front 1

What are the receptors for HIV on T cells and macrophages?

Back 1

CD4, CCR5, CXCR4

Front 2

What does transmission of HIV depend upon?

Back 2

Amount of infectious virus ina body fluid
Exposure time
Host susceptibility

Front 3

What body fluids carry a non-infectious load of HIV?

Back 3

Tears
Saliva
Sweat
Feces
urine

Front 4

What body fluids carry a larger load of HIV?

Back 4

Breast milk = large amount of virus shortly after acute infection but then decreases
Plasma/blood/bloodproducts
Semen/Vaginal and cervical secretions
Cerebrospinal fluid

Front 5

What has the highest risk of acquiring HIV after a single exposure?

Back 5

Pregnancy 1 - 3(5)

Front 6

What is the most common way in which HIV is transmitted?

Back 6

70-80% sexual
via genital fluids

Front 7

What is a normal CD4 count?

Back 7

>500

Front 8

What diseases are you at risk for with a CD4 count of 200-500?

Back 8

Thrush, shingles, pneumococcal pneumonia

Front 9

What diseases are you at risk for a CD4 count less than 200?

Back 9

Opportunistinc infections (PCP, candida esophagitis, toxoplasmosis)
Begin PCP prophylaxis)

Front 10

What diseases are you at risk for with a CD4 count of less than 50?

Back 10

Myc. Avium, CMV,
Begin MAC prophylaxis

Front 11

When infected with HIV what do 50% of patients have?

Back 11

A febrile, flu like illness due to cytokines
Fever, adenopathy, rash, pharyngitis, myalgias
Resembles EBV

Front 12

What CD4 count is AIDS defined as?

Back 12

CD4 < 200

Front 13

What is seroconversion?

Back 13

Detection of antibodies in serum

Front 14

What are the labs that one will find during acute retroviral syndrome?

Back 14

Lymphopenia followed by CD8 lymphocytosis
HIV may be negative, p24 antigen may be postivite

Front 15

Distinguish HIV from EBV

Back 15

HIV
Acute
Minor tonsil tissue, and exudate is rare, mucucutaneous ulcers common
Rash common

EBV
Subacute onset
Significant tonsil tissue hypertrophy and exudate is common
Mucocutaneous ulcers are rare
Rash is rare without use of penicillin/amoxicillin

Front 16

What are the clinical findings that suggest HIV?

Back 16

Persistent geralized lymphadenopathy
Unexplained anemia, leukopenia and/or thrombocytopenia
Recurrent pneumonias, especially pneumoccal or reccurent bacterial infections (PCP)
Karposi's sarcoma
Thrush
Wasting syndrome
TB
Pregnancy
STD
CNS (glove/stocking neuropaty, depression/memory loss)
Fever/constitutional compaints

Front 17

How many bars of bands p24, gp41, gp120/160 do there need to be in order to be called a positive test?

Back 17

2 out of 3 bars

Front 18

How is viral load measured?

Back 18

PCR

Front 19

What are the side effects of the Nucleoside Reverse Transcriptase inhibitors?

Back 19

DdI and d4T cause peripheral neuropathy and pancreatitis

AZT = macrocytic anemia

3TC = well tolerated, few side effects, works against Hep. B as well

AZT and d4T are antagonistic

Abacavir = hypertensitivity (Very dangerous! can be fatal!)

Front 20

What are the side effects of the nonnucleoside reverse transcriptase inhibitors?

Back 20

Rash
Efavirenz can cause severe birth defects in primate studies
Use nevirapine instead

Front 21

What are the side effects of the protease inhibitors?

Back 21

Ritonavir - diarrhea, nausea and vomiting
indinavir - hyperbilirubinemia, kidney stones
nelfinavir - diarrhea

All can cause diabetes and hyperglycemia

Front 22

What are the entry inhibitors and how do they work?

Back 22

Fuseon
Maraviroc - bind CCR5 co receptor

Front 23

How is AIDS defined?

Back 23

CD4 less than 200 or HIV infection, also disseminated leishmaniasis.

Front 24

When is risk for cytomegalovirus infection greatest?
What symptoms result?
Treatment?

Back 24

CMV greatest at CD4 <50
Chrioretinitis
pneumonia
colitis
esophagitis
Treatmetn = ganciclovir, foscarnet, cidefovir

Front 25

What is the most common bacterial infection in AIDS?

Back 25

MAC

Front 26

What symptoms does MAC cause?

Back 26

Fever, night sweats, weight loss with or without diarrhea

Front 27

How do you treat MAC?
Prophylaxis?

Back 27

macrolide + ethambutol + fluoroquinolone + aminoglycoside

Prophylaxis = azithromycin or rifabutin when CD4 < 100

Front 28

PCP
Symptoms
CD4 count
Radiology
Treatment

Back 28

CD4 <200
Symptoms = Gradual increase in dyspnea on exertion, fever, dry cough, weight loss.
Radiology = Interstitial infiltrates on CXR
Treatment = trim sulfa, prednisone

Front 29

Toxoplasmosis
Notable for:
Symptoms:
Prophylaxis
Radiology

Back 29

Notable for most common cause of encephalitis.
Symptoms: weakness, seizures, confusion, coma
Prophylaxis = Trim sulfa
Radiology = CT with ring-enhancing lesion

Front 30

Cryptococosis
Notable for:
Symptoms
Treatment:

Back 30

Notable for common cause of chronic meningitis in AIDS patients
Symptoms = subacute presentation with headache, fever, malaise

Front 31

Cryptosporidia
Symptoms
Treatment
Diagnosis

Back 31

Symptoms = diarrea, nausea vomiting, right upper quadrant pain
Treatment = paromomycin or azithromycin
Diagnosis = AFB stain

Front 32

Candida esophagitis treatment?

Back 32

Fluconazole

Front 33

PML
Symptoms.
Diagnosis
Treatment

Back 33

Symptoms = rapidly progressive focal changes, ataxia, hemiparesis, speech difficulties
Diagnosis is by MRI
Treatment is to raise CD4 count