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44 Cards in this Set
- Front
- Back
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Two ways that HIV can be transmitted?
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Vertical transmission- mother to baby, blood transfusion
horizontal transfusion- dirty needles |
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Vertical transmission is decreased with use of _____ during pregnancy of HIV infected women?
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ZDV
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HIV is a?
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retrovirus composed of RNA and enzyme reverse transcriptase
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HIV viruses gains access to what cells in the human body?
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CD4+ cells
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HIV replicates in the CD4+ cells using?
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reverse transcriptase to synthesize HIV DNA
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The infected CD4+ cell is ______when the HIV virus leaves the cell?
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dies
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Clinical manifestations of AIDS in children include?
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lymphadenopathy
hepatospleenomegaly oral candidiasis chronic or reccurent diarrhea failure to thrive developmental delays parotitis ( salivary gland infection ) |
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In children the time from infection to AIDs diagnosis is?
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shorter
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Children under age ____ can develop AIDS within a ______?
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13, 1 year
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Children with HIV experience ?
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earlier opportunistic infections and greater number of bacterial infections from childhood illnesses.
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Perinatally infected infants are at high risk of?
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PCP - pneumocystis carineri pneumonia
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Because of the risk of PCP, children are put on ______ prophylactically starting as early as ________age?
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bactrum, 2 months of age
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Diagnosis of HIV in infants 18 months or older is done using?
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ELISA or the Western Blot
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For infants under 18 months HIV is diagnosed using ?
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HIV DNA-PCR test
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How many positive results are needed for a "confirmed" positive HIV test?
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2 + results on 2 separate blood specimens
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95% percent of infected infants are diagnosed by ?
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1-3 months
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The ELISA and western blot is not accurate in children under 18 months because?
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They don't have their own antibodies yet. The results are likely to show the mothers antibodies.
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Infant is kept on old medications prophylactically until?
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diagnosis is confirmed positive or negative by six months
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Clinical Staging of HIV, Stage N is?
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infected but not symptomatic
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Stage A of clinical staging?
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mild symptoms of infection
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Stage B of clinical staging?
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Moderate symptoms
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Stage C of clinical staging?
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Severe symptoms
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Once a patient is staged doctors cannot?
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go back on the staging to a lower stage, but can upgrade.
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Stage 1 of immunological Staging?
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no evidence of suppression
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Stage 2 of immunological staging?
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evidence of moderate suppression
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Stage 3 of immunological staging?
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sever suppression
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Immunological staging is based on ?
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# of CD4+ cells
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Indicators of AIDS in children under 13.
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LIP- lymphoid interstitial pneumonia
serious bacterial infection PCP CMV (herpes virus) Encephalopathy wasting syndrom candidal espophagitis pulmonary cnandidiasis herpes simplex disease cryptosporidiosis mycobacterium avium |
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If pregnant women has HIV viral load of > 1000 copies/ml
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cesarean section
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Women with HIV should not
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breastfeed
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Percent of HIV infected adolescents in the US are unaware of their infection?
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50%
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High risk patients should be tested for HIV between the ages of?
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16-18 years
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Average age in the US at which you can get tested without consent?
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13
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Tanner 1&2 patients should get ________drug dosing?
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pediatric
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Tanner 3-5 patients should get ________ dosing?
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adult
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Patients who acquire HIV perinatally vs new onset patients need?
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More agressive treatment
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Transitioning care can be ?
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difficult for children because they don't get the same kind of support as they do in pediatrics
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If you do not adhere to HIV medication you become?
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Resistant and cannot take any of the drug in that class of drugs
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Goals of HIV therapy?
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slow the growth of virus
promoting or restoring normal growth and development of child preventing complicating infections and cancers improving quality of life prolonging survival |
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HIV treatment drug regiment includes ?
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2 types of nucleoside reverse transcriptase inhibitors
and one protease or one non- nucleoside reverse transcriptase inhibitors |
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side effects of medication
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nausea, vomiting
headache diarrhea anorexia rash fever abdominal pain anemia |
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Combination therapy should be initiated ?
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as soon as diagnosis confirmed in infants younger than 1 year
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For children older then 1 year of age, who are asymptomatic treatment?
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should be deferred if viral load is low as is medical compliance risk
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Which vaccines should not be given to HIV positive children?
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varicella and MMR
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