Flashcards in Week 4 Mo Parturient with Systemic Diseases Deck (149)
HIV 1, what exactly is it?
single strand of RNA enclosed in a protein envelope, belongs to Retrovirus family.
What is reverse transcriptase? (has to do with how HIV replicates)
Viral replication is dependent upon a DNA polymerase known as reverse transcriptase, which is responsible for copying the viral RNA to DNA
How does HIV (AIDS) weaken the cellular immunity?
Additional transcription of DNA results in billions of new viral particles that are extruded from cell membrane by killing the T-helper cells (CD4) weakness of cellular immunity
Where does incorporation of DNA take place (talking about HIV)
Incorporation of DNA then takes place into the host cell genome; the T-helper cells (CD4) cell genome
RISK FACTORS for HIV?
Transmitted by body fluids e.g. semen, blood, vaginal fluids and breast milk
Homosexual and bisexual men
IV drug abusers
Hemophiliacs and recipient of other blood products before 1985
Sexual partners of these groups
Vertical transmission through placenta
HIV - Pathogenesis?
(what cells does HIV mess with and what does this cause?)
T-helper cells coordinates the immune response of T & B lymphocytes, monocytes and macrophages
Therefore, impaired immunity of both cell-mediated and humoral immunity occur
HIV is also neurotropic and neurological dysfunction is common
Is neurological dysfunction common with HIV?
HIV- Laboratory diagnosis?
Look for antibodies against viral proteins
Presumptive Dx made with ELISA “RULE OUT test”
Positive results are then confirmed with Western blot assay “ RULE IN test”
HIV PCR / viral load tests
AIDS diagnosis less than or equal to 200 CD4 (N=500-1500)
Stage 1 HIV, tell me about it?
Stage I can include a flu-like illness within a month or two of exposure.
What is seroconversion?
Seroconversion means the immune system is activated against the virus, and antibodies can be detected in the blood.
Stage II of HIV?
Sage II, the individual usually remains free of major disease, even without treatment.
It can last 6-8 years, during which HIV levels in the blood slowly rise.
Stage III of HIV?
Stage III occurs when the immune system loses the fight against HIV.
Symptoms worsen and opportunistic infectious develop
Four stages of infection with HIV?
2.Feeling fine (latent)
During latent phase, virus replicates in lymph node.
Physical Examination of a person with HIV? (What signs and symptoms may you see (6 things))
Low grade fever, night sweat, weight loss
Diffuse lymphadenopathy (like Mono)
Oral candidiasis “thrush”
Herpes zoster infection
Clinical features of a person with HIV?
Persistent fevers and chill
Drenching night sweats
Fatigue, arthralgias, myalgias
Unintentional weight loss “HIV wasting syndrome”
Depression, apathy, as early signs of HIV-related encephalopathy
Special features associated with HIV?
Lymphadenopathy is a common finding
Headache and seizures
What is the most common complaint of a person with HIV, and what labs should be done in relation to this?
Blood culture should be drawn for bacteria, fungus, atypical mycobacterium (MAI) and CMV
What kind of skin lesions do you see with HIV?
Pruritus and folliculitis common
What may be causing the Dyspnea in an HIV patient? (also the leading cause of death)
Pneumocystis carinii pneumonia is leading cause of death
Other causes of pulmonary distress in the HIV patient?
Tuberculosis ( -ve tuberculin test)
Dysphagia in an HIV patient may be related to?
Candidal esophagitis “oral thrush”.
Diarrhea in the HIV patient may be due to?
Cryptosporidium , microsporidium , giardia, E.histolytica
Colitis – CMV
HA and seizures in the HIV patient may be due to?
Toxoplasma is the most common finding with patients presenting with headache, confusion and seizures.
Blindness in the HIV patient may be due to?
CMV retinitis – “Cheese and ketchup lesion” MCC
Hematological abnormalities in the HIV patient may be due to?
ITP like thrombocytopenia
Anemia of chronic disease
Therapy for HIV?
Azidotheymidine (AZT) with CD4 < 500
With CD4 < 200 add pneumocystis prophylaxis
Vaccination for pneumococci, influenza and hepatitis
No live vaccine (polio, rubella) should be administered.
High risk of TB
What HIV medication is a reverse transcriptase inhibitor?
What is Trimethoprim-sulphamethoxazole given for?
With CD4 < 200 add pneumocystis prophylaxi (HIV patient)