Term
| What sexual orientation show the highest rate of HIV globally and domestically |
|
Definition
Global: Heterosexual
Domestic: Homosexual/Bisexual |
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Term
| What ethnicity shows the highest rates of HIV infection in the US |
|
Definition
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Term
| Does Pa require written consent for HIV diagnosis and how is HIV diagnosed |
|
Definition
Written consent is required
Elisa and confirmed with Western Blot
Western Blot: Need gp120 or gp160 and gp41 or gp24 |
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Term
| Describe the viral life cycle of HIV |
|
Definition
Binding(CD4, CCR5, CXCR4)
Fusion(Uses Gp41)
RT
Integrase
Replication
Protease
Budding |
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|
Term
| What are the stages of HIV infection |
|
Definition
Primary: wks 3-6, viral symtoms(MONO), lymphadenopathy, Timeframe for HIV RNA by PCR
Latency: Low viral loads, declining CD4s
Signs:lymphadenopathy, night sweats, pneumonia, VZV, yeast infections |
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Term
| What is the best prognostic indicator for HIV prognosis? |
|
Definition
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Term
| What is the average decline in CD4 count per year |
|
Definition
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Term
| What are the prophylactic therapies for HIV positive patients |
|
Definition
CD4<200:
Hep A&B, Tetanus, pneumococcal, Flu vaccines
Pap every 6 months
PPD Annual
CMV Ab screen
Bactrim(Trimethoprim/Sulfamethoxazole) for pneumocystis
CD4 <50:
Azithromycin for MAC
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Term
| When can Prophylaxis treatment for HIV be terminated |
|
Definition
| Rebound CD4 with low viral counts |
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Term
| When must ART HIV treatment be used? |
|
Definition
CD4 <500
AIDS defining lesion
Symptomatic
Pregnant
Nephropathy
Hep B |
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|
Term
| What are the main types of drugs used to treat HIV |
|
Definition
Protease inhibitor
Integrase inhibitor
CCR5 inhibitor
Fusion inhibitor
NNRTI's
NRTI's |
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|
Term
| What are the recommended treatments of HIV? |
|
Definition
NNRTI w/ NRTI's (Atripla: One Pill)
Efavirenz w/ Tenofovir/Emtricitabine
Protease Inhibitr w/ NRTI's
Atazanavir/Ritonavir w/Tenofovir/Emtricitabine
Darunavir/Ritonavir w/ Tenofovir/Emtricitabine
Integrase Inhibitor w/ NRTI's
Raltegravir w/ Tenofovir/Emtricitabine |
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|
Term
| What HIV drug should be avoided if the possibility of pregnancy |
|
Definition
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|
Term
| What drug combos should be avoided in HIV treatment |
|
Definition
Stavudine and Didanosine
Stavudine and Zidovudine
Emtricitabine and Lamivudine |
|
|
Term
| Can a single drug be dropped from a combo regimen |
|
Definition
| It shouldn't, all of them should be dropped and regimen resumed later |
|
|
Term
| What are the most common causes of Treatment failure for HIV |
|
Definition
Inadequate drug levels(interactions, noncompliance)
Resistance |
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|
Term
| What are the methods of assessing resistance and which is cheaper and when is it indicated? |
|
Definition
Genotypic(Cheaper)
Phenotypic
Recommended:
Starting therapy first time
Ineffective suppression
Resistance
Pregnancy
Acute Infection |
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|
Term
| Does being resistant to a ART drug in the past eliminate its use in the future |
|
Definition
|
|
Term
| HIV therapy recommended for pregnancy |
|
Definition
| Lopinavir/Ritonavir w/ Zidovudine/Lamivudine |
|
|
Term
| What are the opportunistic infections seen at CD4 counts >200 |
|
Definition
Candidiasis
TB
Generalized Lymphadenopathy
Bacterial Pneumonia
Non-hodgkin's Lymphoma
Karposi Sarcoma |
|
|
Term
| Opportunistic infections common with CD4 counts <200 |
|
Definition
Pneumocystis
AIDS Wasting |
|
|
Term
| Opportunistic Infections seen with CD4 counts <100 |
|
Definition
Cryptococcus
Toxoplasmosis |
|
|
Term
| What are the opportunistic infections seen with CD4 counts <50 |
|
Definition
|
|
Term
| How is TB in HIV patients different than TB in immunocompentent patients |
|
Definition
Require onlty 5mm PPD for Positive
More atypical presentations
More MDR-TB |
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|
Term
| How does lymphadenopathy in HIV differ by progress of HIV illness |
|
Definition
| Lower CD4 count show less lyphadenopathy |
|
|
Term
| Most common cause of pneumonia in HIV patients |
|
Definition
|
|
Term
| What is the pathogen causing karposi sarcoma and how does it appear? |
|
Definition
HHV-8
Reddish-purple macropapular Rash |
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|
Term
| What is the treatment for pneumocystis OI's in HIV patients |
|
Definition
Trimetoprim/Sulfamethoxazole
If PO2 is low add steroids |
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|
Term
| What is the diagnosis and treatment of cryptococcus in HIV pateints |
|
Definition
Cryptococcal antigen test
Tx: Amphotericin for life or until CD4's >100 |
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|
Term
| What is the differential for ring enhancing lesions on MRI of a HIV patient which is most common and how are they treated |
|
Definition
Toxoplasmosis:Most common, treated with Pyrimethamine/Sulfamethoxazole
CNS Lymphoma: chemo |
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|
Term
| What are signs of CMV infection in an HIV patient and what is the treatment |
|
Definition
Retinitis, Chronic Colitis
Tx:Valganciclovir |
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|
Term
| What is the diagnosis and treatment of MAC in a HIV patient |
|
Definition
Culture
Tx: Clarithromycin or Arithromycin w/ Ethambutol
Add Rifabutin if low CD4 and high MAC load
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|
|
Term
| How is PML typically diagnosed in HIV patients and what are the common signs |
|
Definition
Signs:
Visual
Dementia
Hemiparesis
Seizures
Dx: Non-enhancing white matter lesions |
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