Week 4 Mo Parturient with Systemic Diseases Flashcards Preview

SUM'20 - Advanced Principles > Week 4 Mo Parturient with Systemic Diseases > Flashcards

Flashcards in Week 4 Mo Parturient with Systemic Diseases Deck (149)
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31

HIV 1, what exactly is it?

single strand of RNA enclosed in a protein envelope, belongs to Retrovirus family.

32

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

33

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

34

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

35

CD4 count?

<200/mm^3

36

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

37

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

38

Is neurological dysfunction common with HIV?

Yes

39

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)

40

Stage 1 HIV, tell me about it?

Stage I can include a flu-like illness within a month or two of exposure.

41

What is seroconversion?

Seroconversion means the immune system is activated against the virus, and antibodies can be detected in the blood.

42

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.

43

Stage III of HIV?

Stage III occurs when the immune system loses the fight against HIV.

Symptoms worsen and opportunistic infectious develop

44

Four stages of infection with HIV?

1.Flu-like (acute)
2.Feeling fine (latent)
3.Falling count
4.Final crisis

During latent phase, virus replicates in lymph node.

45

Physical Examination of a person with HIV? (What signs and symptoms may you see (6 things))

Low grade fever, night sweat, weight loss

Facial seborrhea

Diffuse lymphadenopathy (like Mono)

Splenomegaly

Oral candidiasis “thrush”

Herpes zoster infection

46

Clinical features of a person with HIV?

Asymptomatic

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

47

Special features associated with HIV?

Fever
Lymphadenopathy is a common finding
Skin lesion
Dyspnea
Dysphagia
Diarrhea
Headache and seizures
Blindness
Hematological abnormalities

48

What is the most common complaint of a person with HIV, and what labs should be done in relation to this?

Fever!
Blood culture should be drawn for bacteria, fungus, atypical mycobacterium (MAI) and CMV

49

What kind of skin lesions do you see with HIV?

Pruritus and folliculitis common

Kaposi’s sarcoma

50

What may be causing the Dyspnea in an HIV patient? (also the leading cause of death)

Pneumocystis carinii pneumonia is leading cause of death

51

Other causes of pulmonary distress in the HIV patient?

Tuberculosis ( -ve tuberculin test)

Atypical mycobacteria

52

Dysphagia in an HIV patient may be related to?

Candidal esophagitis “oral thrush”.

53

Diarrhea in the HIV patient may be due to?

Cryptosporidium , microsporidium , giardia, E.histolytica

Colitis – CMV

54

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.

55

Blindness in the HIV patient may be due to?

CMV retinitis – “Cheese and ketchup lesion” MCC

56

Hematological abnormalities in the HIV patient may be due to?

ITP like thrombocytopenia

Anemia of chronic disease

Lymphocytopenia

57

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

58

What HIV medication is a reverse transcriptase inhibitor?

AZT

59

What is Trimethoprim-sulphamethoxazole given for?

With CD4 < 200 add pneumocystis prophylaxi (HIV patient)

60

What is Preganancy Induced Hypertension?

>140/90 mmHg after 20th week and resolve within 48 hrs after delivery.