Term
| Significant concentrations of HIV are present in |
|
Definition
| blood, semen,preseminlal fluid, rectal fluid, baginal and cerviacl secretions and cerbrospinal fluid of infected individuals |
|
|
Term
| ON entry into the body, the HIV virus infects cells that have the |
|
Definition
|
|
Term
| Once inside the cell, HIV sheds its protein coat and uses and enzyme called _ to convert the viral _ to _ |
|
Definition
| revers transcriptase; RNA, DNA |
|
|
Term
| although the virus may remain inactive in infected cells for years, antibodies are produced to its protiens, a process known as |
|
Definition
|
|
Term
| antibodies of HIV are usually detectable _ after the initial infection |
|
Definition
|
|
Term
| Healthcare workers can prevent most exposures to HIV by using |
|
Definition
|
|
Term
| an approved prep therapy for all adults and adolescents |
|
Definition
|
|
Term
| an approved prep therapy for some adults and adolescents because the effective ness of this medication has not been evaluated in those at reisk for HIV through receptive vaginal sex |
|
Definition
|
|
Term
| a combination of tenofovir disoproxil fumarate and emrtricitabine |
|
Definition
|
|
Term
| a combination of emtricitabine an tenofovir alafenamid |
|
Definition
|
|
Term
| truvada and descovy work by blocking important pathways that _ uses to set up an infection |
|
Definition
|
|
Term
| PEP needs to being within _ of an exposure and consists of two to three antiretroviral medications that must be taken for _ |
|
Definition
|
|
Term
| Typical manifestations of HIV include |
|
Definition
| fever, sore throat, arthralgia and myalgias, headach, rash and lympadenopathy, nausea/vomiting, abdominal cramping |
|
|
Term
| patients of attribute initial manifestations of HIV infection to a common viral illness such as |
|
Definition
| influenza, upper respiratory infection or stomach virus |
|
|
Term
| The lenght of asymptomatic period for HIV varies from |
|
Definition
|
|
Term
| Some patients with few other symptoms following HIV infection develop |
|
Definition
| persistant generalized lympadenopathy |
|
|
Term
| enlargment of two or more lymph nodes outside the ingenunal change with no other illness or condition to account for the lymphadenopathy |
|
Definition
| persistent generalized lympadenopathy |
|
|
Term
| the move from asymptomatic disease or persistent lympadenopath to AIDS often is not clearly defined, however the patient may complain of |
|
Definition
| general malaise, fever, fatigu, night sweats, involuntary weight loss, persistent skin dryness, rash, diarrhea, oral lesions such as hairy leukoplakia, candidiasis, gingival inflammation and ulceration |
|
|
Term
| the development of advanced HIV occurs between _ after initial infection |
|
Definition
|
|
Term
| Characteristic manifestations fo AIDS are the develpment of significant _ (very poor prognosis at this stage) |
|
Definition
| constitutional disease, neurologic manifestations, opportunistic infections or cancers |
|
|
Term
| Stages of HIV are defined by the severity of infection as determined by |
|
Definition
| t lymphocyte count, percentage of toal lymphoctyes or the presence of an AIDS-defining condition |
|
|
Term
| When t lymphocyt counts fall below _, ty lymphocyte percentage falls below _ or an _ condition is documented the patient has _ |
|
Definition
| 200, 14%, aids defining, stage 3 HIV or AIDs |
|
|
Term
| the most common cause of changes in mental status for patients with HIV infection |
|
Definition
|
|
Term
| manifestatiosn of AIDS dementia complex |
|
Definition
| fluctuating memory loss, confusion, difficulty concentrating, lethargy, diminished motor speed |
|
|
Term
| as the AIDS dementia complex progresses the patient develops sever dementa with motor disturbances such as |
|
Definition
| ataxia, trmeor, spasticity, incontinenc and paraplegia |
|
|
Term
|
Definition
| toxoplasmosis, non hodgkin lymphoma |
|
|
Term
| toxoplasmosis and nonhodgkin lymphoma are space occupying lesions that may cause |
|
Definition
| headache, altered mental status, neurologic deficits |
|
|
Term
| _ are also common in patients with aids |
|
Definition
|
|
Term
| one of the most common forms of peripheral neuropathies related to HIV |
|
Definition
| distaly symmetric ply neuropathy |
|
|
Term
|
Definition
| aching, tingling, burning, or stabbing sensations in the lower extremitis |
|
|
Term
|
Definition
| distal symmetric polyneuropathy |
|
|
Term
| the most common manifestations of AIDS and ppatients may eoften have multiple infections |
|
Definition
|
|
Term
| the normal CD4 count is greater than |
|
Definition
|
|
Term
| when the CD4 count falls below _ manifestations of immunodeficiency develop |
|
Definition
|
|
Term
| caused by a common enviornmental fungus that is not pathogenic in patients with intac immune systems |
|
Definition
|
|
Term
| the most common opportunistic infection affecting patients with AID |
|
Definition
|
|
Term
|
Definition
| pneumocystis jiraveci pneumonia |
|
|
Term
| patients with pjp often present with |
|
Definition
| fever, nonproductic cough, dyspnea, tachypnea and tachycardia, mild chest pain, (with progression of disease) respiratory distress and cyanosis |
|
|
Term
| a common fungal infection in patients with AIDS |
|
Definition
|
|
Term
| candidiassi usually manifests as |
|
Definition
| oral throush or esophagitis |
|
|
Term
| presents a s white, firable plaques on the buccal mucosa or tongue and in the patient with HIV infection, is the first inidcation of progression to AIDS |
|
Definition
| oral thrush (candidiasis) |
|
|
Term
| MAC occurs when CD4 counts are less than |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| chills, fever, weakness, night sweats, abdonminal pain, diarrhea, weight loss |
|
|
Term
| most people with MAC develop |
|
Definition
|
|
Term
| cytomegaloviros can affect the |
|
Definition
| retina, GI tract or lungs |
|
|
Term
|
Definition
| encphalitis or intracerbal mass lesion |
|
|
Term
| _ may result from toxoplasmosisis |
|
Definition
| changes in mental sttus, focal neurologic signs and seizures |
|
|
Term
| cryptococcus infecton may present as either _ or disseminated diseas primarily affecting th _ |
|
Definition
|
|
Term
| a protazoan affecting the GI tract, is an important cause of prolonged diarrhea in patients with AIDS |
|
Definition
|
|
Term
| women with AIDS have a high incidence of |
|
Definition
| pelvic inflammatory disease (PID) |
|
|
Term
| the CDC clasification of AIDS currently includes four cancers: |
|
Definition
| kaposi sarcoma, non-hodgkin lymphoma, primary lymphoma of the brain and invasive cervical carcinoma |
|
|
Term
| my progress slowly or rapidly and it is an indicator of late stage HIV disease |
|
Definition
|
|
Term
| the average survival time after diagnoissi of KS is |
|
Definition
|
|
Term
| Arising from the cells that line the lymph or small affecting the skin and viscera blood vessels, KS presents as _ |
|
Definition
| vascular macules, papules or violet lesions |
|
|
Term
| common site for skin lesions r/t to KS |
|
Definition
| the faces especially tip of the noses and pinnae of the ears |
|
|
Term
| Common sites for visceral disease r/t to KS include |
|
Definition
| GI tract, lungs and lymphatic system |
|
|
Term
| IN patients with AIDS tow lymphomas are common: |
|
Definition
| nonhodgkin lymphoma and primary lymphoma of the CNS |
|
|
Term
| Primary lymphoma of othe CNS starts in the: |
|
Definition
|
|
Term
| Lyphomas are usually found in the CNS but may also be found in the: |
|
Definition
| bone marrow, GI tract, liver, skin and mucous membranes |
|
|
Term
| common early symptoms of lymphomas affecting the cns |
|
Definition
| HEADACH AND CHANGES IN MENTAL STATUS |
|
|
Term
| _ dysplagia is common in women infected with HIV |
|
Definition
|
|
Term
| It is recommmended that women with HIV infection have a papanicolasu test ever _ and aggressive treatment of cervical dysplasia with _ |
|
Definition
| 6 month; colposcopy and ocnization |
|
|
Term
| most widely used screening test of rHIV infection |
|
Definition
| enzyme linked immunosorben assay (ELISA) |
|
|
Term
| ELISA tests for _ and does not detect the virus itself |
|
Definition
|
|
Term
| A patient may have a negative ELISA test early in the course of infection before detectable _ have develop |
|
Definition
|
|
Term
| theses fourth generation tests can detect HIV-1 and HIV-2 as wella s group M and group O infections |
|
Definition
| combination HIV antigen and antibody tests |
|
|
Term
| a rapid laboratory test used to confirm a postiiv fourth generation combination assay and to distignuish between HIV-1 and HIV-2 infection |
|
Definition
| HIV-1/HIV-2 differentiation immunoassay |
|
|
Term
| the confirmatory test of choice over the wetern blot test, resultgs are reported in less thatn 20 minutes |
|
Definition
| HIV-1/HIV-1 differentiation immunoassay |
|
|
Term
| assesses a blood sample to detect the presence of HIV antibodies and is used to conferim a reactive ELISA screening test, usually takes several days to weeks to be reported |
|
Definition
| wester blot antibody testing |
|
|
Term
| This test looks for HIV in the blood and not the antibodies (very expensive and not routinely used for screening) |
|
Definition
|
|
Term
| these tests measure the amount of actively replicating HIV |
|
Definition
|
|
Term
| Levels higher than _ in the HIV viral load tests inidcated the needd for treatment |
|
Definition
|
|
Term
| antiretroviral resistance testing can be classified as either |
|
Definition
|
|
Term
| genotypic assay tests are preferred due to _ for detecting mixtures of drug resistantce mutation in the HIV genome |
|
Definition
| faster relust time, lower const and greater sensitivity |
|
|
Term
| CBC is performed to detect _ which are often present in patients with HIV infection |
|
Definition
| anemia, leukopenia, lymphopenia and thrombocytopenia |
|
|
Term
| To detect possible tuberculosis infection |
|
Definition
|
|
Term
| Done to identify lymphomas on the brain |
|
Definition
|
|
Term
| Pharmacologic treatment of HIV disease has four primary foci |
|
Definition
| suppress the infection itself, provide prophylaxis for opportunistic infections, stimulate hematopoietic response, treat opportunistic infections and malignancies |
|
|
Term
| Effectiveness of HIV treatment is monitored by |
|
Definition
| viral load and CD4 counts |
|
|
Term
| ART genrally combines two _ with a third drug either an _ to reduce the incidenence fo drug resistance |
|
Definition
| NRTIs; NNRTI, PI or INSTI |
|
|
Term
| The recommended regimens for most patients with HIV infection are _ based |
|
Definition
|
|
Term
| the six classes of drugs used in antiretroviral treatment include |
|
Definition
| nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, protease inhibitors, entry inhibitors, integrase strand transfer inhibitors, cytochrom p-450 inhibitors |
|
|
Term
| inhibit the action of viral reverse transcriptase, a retroviral enzyme that atalyzes the substrates for converting and copying viral RNA to DNA sequences |
|
Definition
|
|
Term
|
Definition
| nucleoside reverse transcriptase inhibitors |
|
|
Term
| the first NRTI and the first antiretroviral agen approved for use with HIV infection |
|
Definition
|
|
Term
| often is given to patients with CD4 cell count less than 500 mm3 because of evidence that it slows the progression to sever disease |
|
Definition
|
|
Term
| bind to viral reverse transcriptase and block viral RNA from changing into viral DNA that can unite with lymphocty DNA |
|
Definition
|
|
Term
|
Definition
| nonnucleoside reverse trnascriptase inhibitors |
|
|
Term
| NNRTIs that may be used in combination with NRTIs and PIs |
|
Definition
| nevirapine (viramune), delavirdine (rescriptor), efavirenz (Sustiva) |
|
|
Term
| One limitation of NNRTIs is the high incidence of cross-resistance to _ |
|
Definition
|
|
Term
| Only one _ should be used at a time |
|
Definition
|
|
Term
| Some studies have shown that _ may significantly reduce serum levels of the PIs |
|
Definition
|
|
Term
| Nivirapine has a reported risk for |
|
Definition
| liver toxicity and stevens johnson syndrome |
|
|
Term
| a viral enzyme used in the formation of specific viral protein segments for viral assembly and maturation |
|
Definition
|
|
Term
| PIs bond chemically with _ to block the function of the enzyme and result in the production of immature, non-infectious viral _ |
|
Definition
| protease; viral particles |
|
|
Term
| when combined with other antiviral durgs PIs increase the chance of eliminating the virus by interfering with different stages of its _ |
|
Definition
|
|
Term
| inhibit or increase the metabolismof other drugs so their use with other medications as well as the dosage of thos medications must be carfully planned |
|
Definition
|
|
Term
| PIs and NRTs are associated with serious metabolic derangements including |
|
Definition
| elevated cholesterol, triglycerides, insulin resistance and diabetes mellitus and changes in body fat composition |
|
|
Term
| Elevated cholesterol should be treated with the antilipdemic drugs: |
|
Definition
| pravastatin or atorvastatin |
|
|
Term
| other antilipidemic drugs such as _ interact with PIs so they should be avoided |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| prevent HIV from entering lymphocytes by biding to protein envelope that surrounds the virus |
|
Definition
|
|
Term
|
Definition
|
|
Term
| a viral enzyme that inserts the viral DNA strand into the lymphoctye's DNA |
|
Definition
| integrase strand transfer inhibitors |
|
|
Term
|
Definition
| integrase strand transfer inhibitors |
|
|
Term
| enhance the effectiveness of certain antiretroviral drugs |
|
Definition
| cytochrome P-45o inhibitors |
|
|
Term
| cytochrome P-45o inhibitors are given as a single drug or in combination with one or more: |
|
Definition
|
|
Term
| interferon alfa-2b is used to treat KS and in combination with _ to slow disease progression |
|
Definition
|
|
Term
| the use of _ is contraindicated for patients receiving an antiretroviral therapy |
|
Definition
|
|
Term
| risk factors for perinatal transmission include |
|
Definition
| cigarette smoking, illicit drug use, sexually transmitted infections and unprotected sexual intercourse with multiple partners |
|
|
Term
| Assessment of the pregnant woman with HIV should include assessment for STIs and secondary infections such as |
|
Definition
| tuberculosis and cervical dysplasia |
|
|
Term
| vaccinations recommended for pregnant women with HIV |
|
Definition
|
|
Term
| When a woman with HIV who is under treatment comes pregnant she should continue her existing HIV treatment regimen if it is effective but should not receive any medications tat are teratogenic such as |
|
Definition
|
|
Term
| Invasive procedures such as _ are avoided when possible to reduce the risk of perinatal transmission |
|
Definition
|
|
Term
| Intrapartum _ is indicated for all pregnant women regardless of their prenatal therapy regimen |
|
Definition
|
|
Term
| scheduled cesarean birth at _ is recommended for women with elevated viral loads |
|
Definition
| 38 weeks gestation and before rupture of the membranes |
|
|
Term
| women who are HIV positive should be carefully monitored for complications such as |
|
Definition
| intrapartum or postpartum hemorrhage, postpartum infection, poor wound healing and infections of the genitorinary tract |
|
|
Term
| It is alwo recommended that IV AZT be administered _ prior to scheduled cesarean birth |
|
Definition
|
|
Term
| low risk infants at or greater than 35wks gestation born to infected motheres recive AZT prphylactically _ beginning as soon after birht as possible |
|
Definition
|
|
Term
| High risk infants receive either _ for 6 weeks |
|
Definition
| empiric HIV therapy or a two drug ART regimen |
|
|
Term
| all infants of infected mothers hsould start prhylazis against PJP by _ of age, and should continue to _ unless tow of the three HIV PCR tests are documented as negative |
|
Definition
|
|
Term
| signs of HIV that may be seen in early infancy include |
|
Definition
| enlarged spleen and liver, swollen glands, recurrent resp infections, rhinorrhea, interstitial pneumonia, recurrent GI manifestations, urinary system infections, persistent or recurrent oral candidiasis infections and loss of acheived dvelopmental mile stones |
|
|
Term
| most children wiht AIDS have nonspecific findings including |
|
Definition
| hepatosplenomegaly, cardiomyopathy, nephropathy, seophageal or pulmonary canddidasis linear gingival erythema, weightloss, failure to thrive, recurrent or chornic diarrhea, chronic eczema and dermatitis and fever |
|
|
Term
| Specific symptoms in children with AIDS appear within 2 years and include |
|
Definition
| otitis media, sinusitis, pneumonia and oral cadidiasis |
|
|
Term
| serious bacterial and opportunistic infections such as _ occur in children as the disease progresses |
|
Definition
| streptococcus, hamophilus influenzae, salmonella, CMV, KS, lymphoma, |
|
|
Term
| common manifestatoi of pediatric AIDS |
|
Definition
| lymphocytic interstitial pneumonia or pulmonary lymphoid hyperplasia complex |
|
|
Term
| Children with AIDS often develop encepholpathy, resulting in failure to attain or loss of _ or a deterioration of _ |
|
Definition
| developmental milestones; motor skills and intellectual functioning |
|
|
Term
| children with HIV should be immunized as soon as the reac the age recommended for |
|
Definition
| DTaP, inactivated polio virus, Hib, HepB, pneumococcal and annual influenza vaccines |
|
|
Term
| Live MMR vaccine is administered at _ months of age unless the child is severly immunocompromised because measles raises the risk of serious outcomes |
|
Definition
|
|
Term
| _ vaccine should be adminstered if the child has no mild symptoms of HIV |
|
Definition
|
|
Term
| If the child is exposed to varicella, the parents should notify their HCP because the child may need varicella zoster immunoglobulin within _ of exposure |
|
Definition
|
|
Term
| If exposed to measels the child may need vaccinatio within _ of exposure |
|
Definition
|
|
Term
| the combination _ vaccine is contraindicated for children with HIV |
|
Definition
| measles, mumps, rubella and varicella |
|
|
Term
| younger children are more likely to die of |
|
Definition
| pulmonary diseases or infection |
|
|
Term
| Children who survive past 10 years of age are more likely to die of _ |
|
Definition
| cardiac disease, wasting syndrome, encephalopathy and infection with mycobacterium avium complex |
|
|
Term
| _ tests cannon distinguish between infant and maternal antibodies, therefore, these tests are inappropriate to use as diagnostic tools for infants _ of age |
|
Definition
| elisa and wester blot, 18 months |
|
|
Term
| Infants with knonw perinatal HIV exposure should receive virologic diagnostic testing at ages _ |
|
Definition
| 14 to 21 days, 1 to 2 months and 4 to 6 months |
|
|
Term
| _ contribute to impaired integrity of the skin of the paitent with HIV disease |
|
Definition
| dryness, malnutrition, immobility from fatigue, and skin lesions on pressure sites |
|
|
Term
| _ may be manifestations of the disease or the result of antiretroviral therapy |
|
Definition
|
|
Term
| HIV patients should have a diet: |
|
Definition
| high in calories and protien |
|
|
