Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
61 Cards in this Set
- Front
- Back
|
Significant concentrations of HIV present in these bodily fluids: |
Blood Semen Vaginal & Cervical Secretions CSF Lower concentrations in: Breast Milk Saliva |
|
|
Therapy that slows progression of HIV to AIDS |
HAART (Highly Active Antiretroviral Therapy)- combination of 3 or more antiretroviral drugs |
|
|
Risk factors associated with HIV |
Men who have sex with other men High-risk heterosexual behavior Injection drug use Blood transfusions Healthcare workers |
|
|
HIV virus infects what cells in the body? |
T lymphocytes |
|
|
Process of HIV infection |
Virus infects T lymphocyte cell Virus sheds protein coat Uses reverse transcriptase enzyme to convert RNA to DNA Viral DNA integrates into host cell DNA (duplicated during normal cell division) *virus may remain latent OR become activated to produce new RNA and form virions* Virus buds from cell surface > disrupts cell membrane >>destructs host cell |
|
|
Antibiodies produced to virus protein (even if virus is inactive) |
Seroconversion |
|
|
When are HIV antibodies usually detectable? |
6 weeks to 6 months after initial infection |
|
|
Symptoms of primary HIV infection (acute retroviral syndrome): |
Fever Sore throat Arthralgias & myalgias Headache Rash Nausea Vomiting Abdominal cramping Persistent generalized lymphadenopathy |
|
|
How long is the a asymptomatic HIV infection period & what affects the length of time? |
3 years to 15+ years Availability & adherence to treatment with antiviral medication |
|
|
HIV-associated neoplasms and opportunistic infections |
AIDS |
|
|
Symptoms of AIDS |
General malaise Fatigue Low grade fever Night sweats Involuntary weight loss Skin dryness Rashes Diarrhea Oral lesions >Hairy leukoplakia >Candidiasis >Gingival inflammation & ulceration |
|
|
Lab indicative of AIDS |
T-cell (CD4) count <200 per mm3 |
|
|
Neurologic symptoms of HIV |
Dementia Delirium Seizures |
|
|
Most common cause of mental status changes in patients with HIV infection |
AIDS dementia complex |
|
|
Manifestations of AIDS dementia complex |
Fluctuating memory loss Confusion Difficulty concentrating Lethargy Diminished motor speed Apathy Progressive symptoms: >Ataxia >Tremor >Spasticity >Incontinence >Paraplegia |
|
|
Sensory neuropathy manifestations in HIV infected patients |
Numbness \ Tingling 》in lower extremities Pain / |
|
|
Normal T-cell (CD4) count Count when immunodeficiency manifestations are seen Count when opportunistic infections and cancers are likely |
> 1000/mm3 < 500/mm3 < 200/mm3 |
|
|
Most common opportunistic infection in patients with AIDS |
Pneumocystis jiroveci (carinii) pneumonia [PJP] *common environmental fungus |
|
|
Most common cause of pulmonary disease in HIV patients |
Community-acquired bacterial or viral pneumonia (not PJP) |
|
|
Manifestations of PJP |
Fever Cough Dyspnea Tachypnea Tachycardia Mild chest pain Sputum may be noted Normal breath sounds initially >>> cyanosis & respiratory distress with severe disease |
|
|
Leading cause of death among HIV-infected patients |
TB |
|
|
Symptoms of pulmonary TB |
Productive cough with purulent sputum Fever Fatigue Weight loss Lymphadenopathy |
|
|
Manifestations of sinusitis |
Headache Fever Sinus congestion & discharge |
|
|
Treatment of sinusitis |
Antibiotics Guaifenesin- reduces sinus congestion |
|
|
Manifestations of Toxoplasma gondii infection (toxoplasmosis) |
Encephalitis Intracerebral mass lesion Changes in mental status Focal neurologic signs Seizures |
|
|
Presentation of Cryptococcus infection |
Meningitis Disseminated disease Primarily affects lungs |
|
|
Most common causes of diarrhea in AIDS patients |
Cryptosporidium (protozoan) Bacterial salmonella infections |
|
|
Manifestations of Candida albicans infection |
Oral thrush > White plaques on buccal mucosa and tongue > Early indication of progression to AIDS Esophagitis > Difficulty swallowing > Substernal pain > Burning increased with swallowing |
|
|
Major cause of "wasting syndrome" in patients with AIDS |
Mycobacterium avium complex (MAC) |
|
|
When does mycobacterium avium complex usually occur |
T-cell (CD4) counts < 50/mm3 |
|
|
Organisms causing mycobacterium avium complex (MAC) |
Those commonly found in food, water, and soil |
|
|
Treatment needed for PID in a patient with HIV |
IV antibiotics |
|
|
Infections and cancers associated with HIV/AIDS patients |
Pneumocystis jiroveci pneumonia Tuberculosis Herpes Sinusitis Toxoplasma gondii Cryptococcus neoformans Candida albicans Mycobacterium avium complex
Kaposi's sarcoma Lymphomas > non-Hodgkin's lymphoma > hodgkin's lymphoma > primary lymphoma of the brain Cervical cancer AIDS nephropathy |
|
|
Risk factors for Kaposi's sarcoma |
Human herpesvirus Men who have sex with other men Women who have sex with MSM Injection drug users Patients taking immunosuppressive meds after organ transplant |
|
|
Tumor of the endothelial cells lining small blood vessels |
Kaposi's sarcoma |
|
|
Manifestations of Kaposi's sarcoma |
Vascular macules \ Papules 》on skin or viscera Violet lesions / >>> lesions initially painless, become painful as disease progresses Tumors may obstruct organ function & cause bleeding Pulmonary hemorrhage Visceral disease in: > GI tract > lungs > lymphatic system Common sites: Palate Toe webs Face > tip of nose > pinnae of ears |
|
|
Treatment for Kaposi's sarcoma |
Rapid disease: chemotherapy Slowly progressing: HAART |
|
|
Malignancies of the lymphoid tissue What tissues are included? |
Lymphomas Lymphoid tissue: >Lymphocytes >Lymph nodes >Lymphoid organs: >>> spleen >>> bone marrow CNS GI tract Liver Skin Mucous membranes |
|
|
Aggressive and rapid cancer in women with HIV |
Cervical cancer |
|
|
Recommendations for women with HIV, regarding cervical cancer prevention and detection |
Papanicolaou (Pap) smear every 6 months Aggressive treatment of cervical dysplasia with: > colposcopic exam > cone biopsy |
|
|
Cardiovascular and metabolic complications associated with HIV/AIDS |
Diabetes Dyslipidemia- leads to atherosclerosis > high cholesterol > high triglycerides > low high-density lipoproteins > high low-density lipoproteins |
|
|
Manifestations of HIV-associated nephropathy |
Excessive proteinuria Azotemia (excessive nitrogen in the blood) Normal-to-large kidneys Normal blood pressure Glomerular lesions |
|
|
Treatment for AIDS nephropathy |
HAART decreases incidence Nucleoside reverse transcriptase inhibitors (NRTIs) Nonnucleoside reverse transcriptase inhibitors (NNRTIs) |
|
|
Goals of care for a patient with HIV |
Early identification Promotion of health-maintenance activities to prong asymptomatic period Preventing opportunistic infections Treating disease complications (cancer) Providing emotional and psychosocial support |
|
|
CDC recommendations for HIV testing |
Persons 13-64 should receive screening, regardless of risk Persons being treated for TB should be screened Persons seeing treatment for STIs should be screened Persons should be encouraged to get screened before starting a new asexual relationship Persons with known risk should be screened at least annually |
|
|
Diagnostic testing for HIV |
*HIV rapid antibody test
*Western blot for confirmation- more reliable, time consuming, expensive- patient's serum is mixed with HIV proteins to detect reaction
*Enzyme-linked immunosorbent assay (ELISA) for confirmation- tests for HIV antibodies (may be negative in early course of infection when antibodies are not her present)- usually most accurate after 13 weeks of infection
*HIV viral load test- measures the amount of actively replicating HIV- levels > 5000-10000 copies/mL indicate need for treatment
*CBC- detect anemia, leukopenia, thrombocytopenia, lymphopenia (decreased lymphocytes)
*Absolute CD4 lymphocyte count- monitors progress of disease and guides therapy- recommended every 3-6 months |
|
|
Goals of medication for HIV |
Suppress infection Decrease symptoms Prolong life Provide prophylaxis of opportunistic infections Stimulate hematopoietic response Treat opportunistic infections and malignancies |
|
|
When should treatment be initiated (CD4 count) |
< 350/mm3 Between 500-1000 to protect immune system |
|
|
Indication of positive results of treatment |
Reduction in viral load Preservation of CD4 above 350/mm3 |
|
|
What patients are treated, regardless of CD4 counts or viral load |
Viral load > 100,000 copies Rapidly declining CD4 cell count (> 100/uL per year) Hepatitis B or C Cardiovascular disease risk HIV-associated nephropathy Pregnancy |
|
|
Six classes of antiretroviral drugs |
Nucleoside reverse transcriptase inhibitors (NRTIs) Nonnucleoside reverse transcriptase inhibitors (NNRTIs) Protease inhibitors (PIs) 3 types of entry inhibitors |
|
|
Inhibits the action of the retroviral enzyme that catalyzes the substrates for conversion and copying of viral RNA to DNA Example |
Nucleoside reverse transcriptase inhibitors (NRTIs) Zidovudine- causes anemia and neutropenia > used prophylactically following parenteral exposure |
|
|
Blocks the function of the enzyme necessary for formation of specific viral protein needed for viral assembly and maturation |
Protease inhibitors |
|
|
Side effects of Protease inhibitors |
Elevated cholesterol Elevated triglycerides Insulin resistance Diabetes mellitus Lipodystrophy- changes in body fat composition- abdominal obesity & skeletal wasting |
|
|
Antiviral drug that binds to the virus or host cells and prevents viral entry into the host cells |
Entry inhibitors |
|
|
Side effects of entry inhibitors |
Injection site pain Itching Hardening of tissue Allergic reactions Peripheral neuropathy Insomnia Depression Dyspnea Depression Anorexia Arthralgia |
|
|
Recommended vaccines for patients with HIV |
Pneumococcal Influenza Hepatitis B Haemophilus influenzae b |
|
|
Prophylactic treatment for PJP When is it begin? |
Trimethoprim-sulfamethoxazole CD4 below 200 |
|
|
When is prophylactic treatment for MAC begun? |
CD4 below 100 |
|
|
Recommended prophylactic treatment of possible HIV infection |
2 NRTIs- low risk exposure (3rd drug for high risk exposure) 4-week course Started within 72 hours of exposure (preferably 2-3 hours) |
|
|
Appropriate nursing diagnoses for HIV/AIDS |
Ineffective coping Risk for situational low self-esteem Impaired skin integrity Imbalanced nutrition: less than body requirements Ineffective sexuality pattern |
