Micro 53 & 54

Front 1

HIV. Name the 3 main protiens associated

Back 1

Front 2

HIV. Describe the following proteins
1. gp120
2. gp41
3. p24 (gag)
4. p17
5. pol

Back 2

gp120 → docking glycoprotien
gp41 → Transmembrane protein
p24 → Capsid protein
p17 → matrix protein
pol → Reverse Transcriptase

Front 3

HIV binds to on
`1. T cells (2)
2. Macrophages (2)

Back 3

1. CXCR4 & CD4
2. CCR5 & CD4

Front 4

HIV 4 stages of Infection
1. Pneumonic
2. During what phase does replication occur? Where?

Back 4

Four Fs
Flulike (acute)
Felling Fine (latent)
Falling Count
Final Crisis

2. Latent phase in Lymph Nodes

Front 5

For HIV Infection, with the following CD4 counts, think of what BUG
1. CD4 < 400
2. CD4 < 200 (3)
3. CD4 <100 (3)
4. CD4 < 50 (3)

Back 5

1. C. albicans (oral)
2. JC virus, Cryptosporidium spp. & Pneumocystis jirovecci
3. C. a;bicans (Esophageal), Histoplasma capsulatum & Toxoplasma gondii
4. Cryptococcus neofromans, CMV (retiniti) MAC

Front 6

For HIV, name the SYSTEMIC Clinical Presentation & Findings/Labs for:
1. Histoplasma capsulatum (4 & 2)

Back 6

1. Low-Grade feverm Cough, hepatosplenomegaly & Tongue Ulcer
2. Oval yeast cells w/in Macrophages & CD4<400

Front 7

For HIV, name the DERMATOLOGIC Clinical Presentation & Findings/Labs for:
1. C. albicans- (2 & 3)
2. Bartonella genselae (2 & 1)

Back 7

1a. Thrush & Fluffy White Cottage-Cheese lesions
1b. Pseudohyphae. CD4<400 → oral & CD4 <100 → Esophageal
2a. Superficial vascular proliferation & Bacillary angiomatosis
2b. Neutrophilic inflammation on biopsy

Front 8

For HIV, name the GASTROINTESTINAL Clinical Presentation & Findings/Labs for:
1. Cryptosporidium spp (2 & 2)

Back 8

1a. CHRONIC & WATERY diarrhea
1b. CD4 <200 & Acid-Fast cysts

Front 9

For HIV, name the NEUROLOGIC Clinical Presentation & Findings/Labs for:
1. JC virus reactivation (2 & 2)
2. Toxoplasma gondii (1 & 2)
3. Cryptococcus neoformans (2 & 3)
4. CMV (1 & 3)
5. Directly associated w/ HIV (1 & 1)

Back 9

1a. PML & Encephalopathy
1b. CD4 < 200, reactivation of latent virus & demyelination
2a. Abscesses
2b. CD4 < 100 & Ring enhancing lesions on IMAGING
3a Encephalitis & Meningitis
3b. CD4 < 50 & India Ink Stain → Yeast w/ narrow based budding & large capsule
4a. Retinitis
4b. CD4 < 50, Cotton Wool spots on fundoscopic exam & Esophagitis
5a. Dementia
5b. rule out Other causes

Front 10

For HIV, name the ONCOLOGIC Clinical Presentation & Findings/Labs for:
1. HHV-8 (2 & 2)
2. EBV (2 & 2)
3. May be associated w/ HBV (2 & 2)
4. Often associated w/ EBV (1 & 3)
5 HPV (1 & 2)

Back 10

1a Karposi Sarcoma & Superficial NEOPLASTIC proliferation of vasculature
1b, LYMPHOCYTIC inflammation on biopsy
2a. Hairy leukoplakia
2b. Lateral tongue
3a. NHL, large cell type
3b. Oropharynx w/ Waldeyer's ring
4a. Primary CNS lymphoma
4b. Focal or Mulriple (differentiate vs. toxoplasmosis)
5a Squamous cell carcinoma
5b Anus (MSM) & Cervix (females)

Front 11

For HIV, name the RESPIRATORY Clinical Presentation & Findings/Labs for:
1. CMV (1 & 2)
2. Aspergillus fumigatus (3 & 1)
3. Pneumocystis jiroveci (1 & 1)
4. MAC (avium & intraceukkulare) (1 & 1)

Back 11

1a. Interstitial pneumoniae & 1b. 1b. Owl's eye intranuclear inclusion bodies o BIOPSY
2a. Invasive asoergillosis
2b. Pleuritic pain, Hemoptysis & Infilitrate on Imaging
3a. Pneumoniae
3b .CD4 < 200
4a Tuberculosis like disease
4b. CD4 < 40

Front 12

HIV in the USA
1. #?
2. Letter?

Back 12

1. HIV-1
2. HIV - B

Front 13

HIV
1. Family
2. Nucleic Acid
3. Baltimore Class

Back 13

1. retrovirus
2. 2 copires of +ss RNA w/ Reverse Transcriptase
3. Group VI

Front 14

For Retroviruses, name the characterestics & examples associated w/
1. Oncovirinae B
2. Oncovirinae C
3. Oncovirinae D
4. Lentivirinae
5. Spumavirinae
6. Endogenous viruses

Back 14

Front 15

Retroviruses
1. Simple Retrovirusus encode what genes (3)
2. COMPLEX (5)
3. Lentiviruses associated w/ (2)

Back 15

1. Gag, Pol & Env
2. tat, rev, nef, vif & vpu
3. Neurological & Immunosupressive disease

Front 16

Retrovirusus. Encode for
1. gag (froup specific antigen) (2)
2. Pol: polymerase (3)
3. Env: envelope (1)

Back 16

1. Core & Capsid protiens
2. Reverse Transcriptase, Protease & intergrase
3. Glycoproteins

Front 17

Retroviruses
1. 2 copies of (+) RNa are
2. Provirus is formed by?
3. Intergrated into? by?
4. What are viral m RNA

Back 17

1. non-infectious
2. Reverse Transcripatse
3. Host genome, by intergrase
4. non-structural 7 structura proteins

Front 18

HIV. Characterestics
1. 2 copies of
2. Orfs
3. Proteins

Back 18

1. Genome
2. 9
3. 15

Front 19

HIV.
1. Name the 3 main genes
2. 4 accessory genes
3. Name the regulatory genes & role

Back 19

1. Gag, Pol & Env
2. vif, vpr, vpu & nef
3. TAT→ Transactivating protein → Regulates cellular genes
REV→ RNA splicing & Exporting to Cytoplasm

Front 20

Name the SEVEN steps in the HIV life cycle

Back 20

1. Fusion
2. Entry
3. Viral DNA via RT
4. Viral DNA:transport to nucleus, intergration
5. New vRNA → genomic RNA, viral proteisn
6. New vRNA + proteins move to cell surface→ new, immature, HIV virus
7. Virus matures by protease releasing HIV proteins

Front 21

HIV what is required for
1. Budding & Fusion
2. Formation of viral DNA
3. Transport into the nucleus membrane & addition into genome
4. Transcription (Provirus → mRNA)
5. Required for assembly

Back 21

1. CD4 receptor w/ CCR5 or CXCR4
2. Reverse transcription
3. Intergrase
4. Host RNA polymerase
5. HIV protease

Front 22

HIV
1. When you from the ds DNA, type of interaction
2. Linked by
3. ds DNA is

Back 22

1. Kissing interaction
2. Dimer linkage
3. Is variant, d/t lack of proof reading

Front 23

HIV
1. transmission (2)
2. Vehicle (3)
3. Survival outside host

Back 23

1. Sexual contact & Needles
2. Blood, Semen & Vaginal Fluid\
3. Rate

Front 24

HIV epi for Children <15 yrs & total, describe
1. People living w/ HIV
2. Newly infected
3. AIDS deaths

Back 24

1. 34.2 mill, 3.4 mil
2. 2.5 mil, 330, 000
3. 1.7 mil, 230, 000

Front 25

HIV Epi
1. Spiked in the?
2. Since? d/t?
3. Which is the only region in the world to show a DECREASE in life expectancy, despite the introduction of ARVT
4. 3 countries with highest mortality
5. In adults 15 & older, of new HIV, almost 48% are?
6. 42%

Back 25

1. 90s
2. Decreasing d/t ARVT
3. CENTRAL africa
4. Bostwana, Zimbabwe & Swaziland
5. Women
6. 15-24 yrs old

Front 26

HIV Pathogenesis
1. MAJOR DETERMINANT (2)
2. Has also been found in what cells

Back 26

1. Tropism for CD8+ T-cells & Macrophages
2. Multipotent Hematopoietic Stem & Progenitor Cells

Front 27

Desribe HIV pathogensis
1. Portal of Entry
2. Macrophage involvment
3. CD4 + T Cells

Back 27

Front 28

HIV
1. Portals of entry
2. Virus resevoir
3. Clinical latency before
4. Clinical effects of macrophage (3)
5. CD4 + T cell lysis effects(5)
6. In brain
7. Loss of T cell function leads to

Back 28

1. blood, Colon-Rectum & Vagina
2. Macrophages
3. Invovlement of CD$ T cell
4. Dysfunction, Virus Release & Dysregulation of Immune functions (via cytokines
5. Lymphadenopathy, Loss of DTH fxn, Cutaneous infetions, Intracellular pathogens & Hyper-Ig-emia
6. Dementia
7. Severe systemic Opportunistic Infections, Karposi's sarcoma & Lymphoma

Front 29

AIDS when

Back 29

1. CD4+T cells drop below a certain level, where oppurtunistic infections & Tumours occur

Front 30

HIV Pathogenesis
1. Enters body via (2)
2. Carry virus to? Resulting in infection of
3. Resivour

Back 30

1. Macrophages & Dendrites
2. LN → CD4+ T cell infection
3. MACROPHAGES

Front 31

HIV-Pathogenesis
Mo Immune Evastion (5)

Back 31

1. Antigenic variation
2. Carb MASKING of target EPITOPEs
3. Comfirmational changes by ENVELOPe to MASK targets
4. Downregulation of host HLA
5. Latency in T-cells & APC

Front 32

HIV Encephalopathy & Dimentia
1. Inlcusion bodies (3)
2. Spread of virus via

Back 32

1. Macrophages & Mircoglia → Synctia
2. Cell → Cell
3.

Front 33

HIV diagnosis
1. Screening test (2)
2. Confirmatory test
3. Sample of (3)

Back 33

1. ELISA & antigen test vs. p24
2. Western Blot
3. Serum specimenes (from Venipuncture & Finger stick), Oral fluid, Urine & Fi

Front 34

HIV Treatement, Prevention & Control
1. Universal testing for
2. Prevention (2)
3. Trhearpy begins at what time
4. HAART contains (3)
5. Contains
6. Therapy length

Back 34

1. Prenatal
2. Condoms & Once daily pil
3. CD4+ Tcells < 350
4. Protease inhibitor & 2
nucleoside RT inhibitors
5. RNA level below ASSAY DETECTION limits
6. LIFE LONG

Front 35

HIV patients w/o THERAPY
Progression
1. 80%
2. 5-10%
3/ 10-15%

Back 35

1. Typical → 7-10Yrs
2. Rapid → w/in 2 years
3. NON →7-10+yrs (CD$ count high

Front 36

Course of HIV progression
1. Clinical Latency =
2. If HIV test
3.

Back 36

1. Winrdow Period

Front 37

Final Stage of HIV infection
1. What has happened
2. Indicators of AIDS (3)

Back 37

1. Virus has weakened the immune system, so can not defend vs infection
2. 1 or More specific infections, Certain cancers &/or very low # of Tcells

Front 38

Name the FIVE starges of AIDS progression

Back 38

1. Acute Infection
2. Strong anit-HIV immune defense
3. A latent resevoir
4. loss of CD4+ T cells & Immune response
5. Onset of AIDS

Front 39

Strep. pneumoniae in HIV
0. Key
1. Colonizes oropharynx via
2. Spread via (2)
3. Stimulate Local Inflammatory response via (3)
4. Evade phagocytic Killing

Back 39

0 Most common bacterial infection
1. Surface Protein Adhesins
2. Pneumolysin & IgA protease
3. Teichoic acid, Peptidoglycan Frags & Pneumolysisn
4. PLS Capsule

Front 40

MAC
1. Are (2)
2. Infection when CD4 coutn <
3. Causes what dieasese (3)
4. In patients w/ aids
5. Describe symptoms invovled (6)

Back 40

1. Mycobacterium avium & Intracellulare
2. <50
3. Asymptomatic colonization, Localised pulmonary disease & Solitary nodule
4. Disseminated disease (Tuberculosis like)
5. Night Sweats, Weight Loss, Abdominal Pain, Fatigue, Diarrhea & Anemia

Front 41

MAC infections
1. Immunocompetent
2. Advanced ADIS
3. In children

Back 41

1. Pulmonary MAC
2. Disseminated MAC
3. MAC lymphadenitits

Front 42

AIDS & Tuberculosis are
1. Leading cause among people living w/ AIDS
2. Greatest risk factor for TB

Back 42

0. TWIN EPIDEMICS
1. TB
2. AIDS

Front 43

Salmonella & AIDS
1. Salmonellosis More common in

Back 43

1. HIV+>AIDS

Front 44

Bartonella henselae
1. Type of bacteria
2. Bacillary Angiomastosis
3. Infection of
4. Key HISTORY
5. Histo
6. On biopsy (vs. Karposi)

Back 44

1. Gram-ve, non enteric rod
2. Superfical Vascular Proliferative disease (Purplish, bright red)
3. Skin, LN, Liver or Spleen
4. Cat scratch
5. Stellate non-casseating granuloma
6. Neutrophil inflammation (vs. Lymphocyte)

Front 45

HIV & Hepatititis more like to develop
Why?

Back 45

1. Liver toxicity from meication
2. HAART metabolized in liver

Front 46

CMV (HHV-5)
0. Most common
1. Member of what family
2. Established latent infection in
3. Baltimore

Back 46

0. VIRAL cause of Congenital defects
1. Betaherpesviridinae (largest genome)
2. Mononuclear lymphocytes 7 Stromal cells
3. ClassI

Front 47

CMV & AIDS
1. Organs (3)
2. Lung causes
3. Diagnostic for lun
4. Eyes causes? @ CD4+ level
5. Diagnostic for Eye

Back 47

1. Lung, Eye & GIT
2. interstitial pneumoniae
3. OWL EYE inclusion bodies
4. Retinititis <50
5. Cotton Wool spots on Fundoscopy

Front 48

HHV-1 & -2 & AIDS
1. HIV increases
2. Severe symptoms include (2)
3. Who is at risk for Disseminated, Life threatening disease (2)

Back 48

1. Infection more, sever, longer
2. Blindness & Brain damage
3. immunicompromised & Neonates

Front 49

HPV & AIDS
1. Especially pronve to infection
2. Lead to what tumour
3. Females
4. MSM

Back 49

1. HIV +
2. Squamous Cell Carcinoma
3. Cervical
4. Anal

Front 50

JC Virus & AIDS
1. JC virus causes
2. Symptoms (4)
3. Gross Brain (2)
4. CD4+ levels

Back 50

1. Progressive Multifocal LUKOENCEPHALOPATHY
2. Speech problesm, ONE SIDED: weakness, vision loss & numbness
3. Granularity white matter (vs. MS)
4. <200

Front 51

KSHV (HHV-8) & AIDS
1. Most frequently
2. Tumor of
3. Biodpy
4. Clinical Presentation
5. Can affect

Back 51

1. Detected TUMOR in AIDS patients
2. Blood vessel wall (Superfical Neoplastic Proliferation of Vasculature)
2. LYMPHOCYTEs
3. Pink, Red, PURPLE lesions on skin & mouth
4. GIT & Lungs

Front 52

Non-Hodgkin's Lymphoma
1. Originates
2. MOST commonly found in patients (3)
3. Viral Infections which ↑ risk
4. Often found on? with

Back 52

1. Lympocytes
2. Inherited immunodefeciency, Autoimmune Disese & HIV
3. HTLV-1, Hep C & EBV
4. Oropharynx (Waldeyer'r Ring)

Front 53

Candida Albicans & HIV
1 Leading to onset of
2. On microscopy
3. CD4+ levels < 400
4. CD4+ levels <100

Back 53

1. Candida pneumoniae
2. Pseudohyphae
3. Oral Thrush
4. Esophageal Thrush

Front 54

Cryptococcal Neoformans & HIV
1. In environment found (3)
2. CD4+ levels
3. Affects CNS
4. Stain? Shows?
5. Able to grow

Back 54

1. Soil, Bat droppings or bird
2. <100 (1st aid <50)
3. MENINGITIS
4. India Ink Halo & Large Capsule
5. Yeast @ 37⁰c

Front 55

Pneumocystis jirovecii
1. CD4+
2. Causes
3. Reduced infection viA

Back 55

1. <200
2. Pneumoniae
3. ARVT

Front 56

Toxoplasmii gondii & AIDS
1. tyoe of organism (bartonella)
2. Spread by primarily
3. Or eating Raw
4. CD4+
5. Causes (2)

Back 56

1. Parastive (vs. Non-enteric -ve rod)
2. Cats
3. Prok, Lamb & Venison
4. <100
5. Encephalitis & Abscess

Front 57

Cryptosporidiosis & AIDS
1. Ingestion of
2. CD4+
3. Symptom
4. Disease w/ therapy is
5. Found in stool

Back 57

1. Contaminated Food & Water
2. <200
3. Chronic Watery diarrgea
4. refactory
5. Acid Fast cysts