Hiv

Front 1

During primary HIV infection, what is the only way to diagnose HIV presence?

Back 1

looking for the virus itself (HIV RNA PCR --- antibodies are not made)

Front 2

This is the flu-like symptom phase of HIV infection where viral load is high and antibodies to HIV are not present?

Back 2

Primary HIV infection

Front 3

What is HAART?

Back 3

Highly active anti-retroviral therapy -- need at least 3 antiretroviral medications --- < 3 is just ART

Front 4

What is IRIS?

Back 4

immune reconstitution inflammatory syndrome; paradoxical worsening of a condition or appearance of a new condition after starting HAART due to restored function of the immune system

Front 5

What is the highest transmission method of HIV in the US?

Back 5

male-male sexual content

Front 6

What is one reason why anti-retroviral drugs only work on replicating viruses?

Front 7

What body fluids do not transmit HIV?

Back 7

tears, saliva, urine, stool

Front 8

What is the highest risk of transmission based on mode of transmission (anal intercourse, vaginal intercourse, needle stick, maternal-fetal)?

Back 8

Maternal-fetal (anal is higher than vaginal)

Front 9

A person infected with HIV has a higher risk of transmission during what phases of his infection?

Back 9

Primary infecttion and AIDS

Front 10

What cells in the lamina propria become infected upon transmission and travel to lymph nodes to infect CD4 T-cells?

Back 10

Dendritic cells

Front 11

After 2 weeks of infection with HIV, viral load peaks, what causes the viral load to start to decline?

Back 11

A limited host response with CTL

Front 12

The higher the viral load set point, the (slower or faster) the progression toward AIDS

Back 12

Faster

Front 13

What are the most common physical exam findings in Primary HIV infection?

Back 13

lymphadenopathy; Oral ulcers (rarely splenomegaly)

Front 14

What are some common lab findings during primary HIV infection?

Back 14

thrombocytopenia; leukopenia; elevated liver enzymes

Front 15

What is the "usual" HIV test and what does it detect?

Back 15

HIV ELISA detects antibodies

Front 16

If an HIV ELISA is positive, what test must be run to confirm it?

Back 16

Western Blot (detect antibodies to certain HIV antigen)

Front 17

What test should be run under a high index of suspicion in Primary HIV infection?

Back 17

HIV RNA PCR (run in conjunction with ELISA)

Front 18

If you suspect mono, what else should you suspect?

Back 18

Primary HIV

Front 19

What finding on PE will differentiate Group A strep and Primary HIV?

Back 19

thick white exudates over the tonsils

Front 20

What kind of rash is associated with primary PHI?

Back 20

erythematous and maculopapular (not disseminated gonorrhea > small cluster of blisters/vesicles)

Front 21

How can rocky mountain spotted fever and syphilis be discriminated from Primary HIV?

Back 21

They do not cause sore throat

Front 22

What kind of rash would coxsackie present with?

Back 22

vesicles

Front 23

What test would you order to evaluate viral mononucleosis?

Back 23

monospot test

Front 24

What is asymptomatic HIV infection?

Back 24

after primary HIV, before AIDS (or onset of destruciton of immune)

Front 25

Why must mental health be assesed in patients with HIV?

Back 25

depression is fairly common

Front 26

What could you order to evaluate a patient's stage of infection?

Back 26

CD4 count (<200 predicposes to opportunistic, > 500 is normal)

Front 27

What labs should be ordered when seeing a patient with asymptomatic HIV?

Back 27

CD4 count; viral load; CBC with diff; liver and renal function tests; STD screen; naseline fasting lipoprotein; G6PD (meds can induce hemolysis in those who are G6PD deficient); PPD; Toxoplasmosis serology; HIV genotype (look for mutations)

Front 28

What are typical symptoms of symptomatic HIV infection?

Back 28

weight loss, loss of apetite, fatigue (may also show neurocognitive impairment)

Front 29

What CD4 count is expected in symptomatic HIV?

Back 29

200-400

Front 30

What are some cancers that AIDS patients present with due to resurgence of oncogenic virus?

Back 30

lymphoma (EBV); cervical cancer (HPV); Kaposi sarcoma (HHV-8)

Front 31

Below what CD4 count does disseminated mycobacterium avium complex usually occur?

Back 31

< 50 (PCP < 200)

Front 32

What test should be run under a high index of suspicion in Primary HIV infection?

Front 33

When is HAART recommended?

Back 33

Primary HIV; < 350 CD4 + AIDS defining illness; pregnancy, HIV-associate nephropathy, HBV (regardless of CD4 counts)

Front 34

What prophylactic is administered for CD4 < 50?

Back 34

mycobacterium aviam (azithromycin)

Front 35

What prophylactic is administered for CD4 < 100?

Back 35

Against toxoplasmosis (trimethoprim- sulfa)

Front 36

What prophylactic is administered for CD4 < 200?

Back 36

againste PCP (tri-sulfa)

Front 37

Is strict adherence to HAART required and why?

Back 37

Yes to prevent resistance

Front 38

What is the risk of getting HIV infection from a needle stick?

Back 38

0.3% (Hep c is 3%, Hep B is 30%)

Front 39

What increases the risk of getting an HIV infection from a needle stick ?

Back 39

Hoolow bore needled; in a blod vessel; visible blood; deeper stick; stage of infected person (PHI and AIDS)

Front 40

What should an occupational worker be started on after a post-exposure needle stick with blood from an infected person?

Back 40

post-exposure prophylaxis with ART (28 days of therapy)

Front 41

What kind of pregnancy is performed in a mother with a viral load > 1000?

Back 41

C-section