dewitt chapter 11
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| immune deficiency | insufficient production of either antibodies or immune cells or a combination of the two
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| autoimmune disease | body is unable to differentiate between foriegn cells and self
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| depression of short term immune function | most commonly caused by viral infections such as flu, mononucleosis, measles
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| HIV | human immunodeficiency virus causes AIDS
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| AIDS | Aquired immuno deficiency syndrome- groups of symptoms associated with depression of immune system caused by HIV infection
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| goal of aids treatment | slow and eventually stop transmission of virus
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| mode of transmission | infected blood body fluis and tissue
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| retrovirus | virus that integrates itself into the genetic material of host cell thus changeing the DNA of host cell
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| CD4 lymphocyte | primary host cell in HIV infection
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| mode of exposure to HIV | exposure to body fluids, blood or tissue is the ONLY mode. does not include perspiration.
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| most HIV cases spread through | sexual contact
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| Nonoxynyl-9 | shown in studies to inactivate or kil HIV in test tubes, but because of irritation factor to mucosal membranes, increases transmission risk. Found in spermacides
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| fetal transmission | through breastmilk to newborns, may or may not be transmitted to fetus during gestation. risk increases with vaginal deliveries
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| retrovirus | viral disease that integrates itself into the genetic material of the cell it affects changing the host celss DNA
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| CD4 T-lymphocyte | primary host sight for HIV
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| Defintion of AIDS | acc to CDC- HIV infected person witha CD4 count of less than 200 cells/mm3
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| HIV-1 | one of two types of HIV virus
most common in US Europe and Asia
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| HIV-2 | one of two types of HIV virus
most common in AFRICA
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| reverse transcriptionase | enzyme that allows for retroviral reproduction in host cells
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| CD4+ | refers to T lymphocytes that have the CD4 protien on their surface membrane.
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| function of CD4+ T cells | activate the B cells, natural killer cells and Phagocytes
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| how HIV infects | virus attaches to cell at CD4 receptor sights
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| OI | opportunistic infections. environmental organism that infect at time of immunosuppression
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| sentinel infection | infection that may indicate underlying immunosuppression
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| ELISA | Enzyme Linked ImmunoSorbent Assay- most common test for HIV determination
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| HIV status | not confirmed until two seperate ELISA tests are performed (1-3 mos apart) BOTH - or +
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| management of early HIV | particular attention is paid to eye/mouth condition nuero status, skin, lymph nodes and S&S of OIs
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| NNRTIs | nonnucleoside reverse transcriptionase inhibitors- act by binding to and disabling Reverse transcriptionase protiens (block HIV replication)
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| Protease inhibitors | PIs prevent HIV from being assembled and released by disabling a protien needed for replication
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| HAART | Highly Active AntiRetroviral Therapy- combincation of drugs most commonly recommended as HIV treatment ( and for KS)
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| MOst Common OIs | Herpes (entire spectrum) hepatits, Cytalo megalo virus (CMV), Mycobacterial Tb (MTb) and avium complex (MAC) PCP, candidiasis, histoplasmosis, toxoplasmosis, cryptosporiadiasis
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| MTb | 50% of all HIV infected persons get MTb in places OUTSIDE OF LUNGS
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| Herpes | clear liquid from lesions is highly contagious
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| Prodrome | Period of time during which early symptoms precede actual herpetic vesicle outbreaks
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| HSV 1 | sexually transmitted forms of herpes
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| Herpes Zoster (HZV) | aka varicella Zoster. the herpetic virus that cause chickenpos and shingles.
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| why is shingles os painful | viral vesicles appear along dermatomes (nerve tracts)
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| recurrent HZV | outbreak usually occurs at time of increased stress. may occur because of increased immunosuppression.
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| 7th cranial nerve | HZV eruptions of face usually occur here, and are dangerous because of increased risk of corneal scarring and blindness
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| acyclovir (Zovirax) | drug of choice for herpes treatment
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| foscarnet (Foscavir) | IV drug for treatment of advanced HZV infections. HIGHLY NEPHROTOXIC.
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| IV treatments for HZV | all IV treatments for HZV require PREINFUSION HYDRation b/c they are so nephrotoxic
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| CMV | spread in person to person contact via body fluids. form of Herpes virus that affect CNS circulatory,lungs or hepatic tracts but is most common in retina and GI tract.
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| retinal CMV | requires continmuous tretment to prevent blindness. may be treated with intravitreal implants of ganciclovir
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| Ganciclovir | IV or intravitreal drug that treats CMV. Valgancyclovir (Valcyte) is oral version
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| cidofivir (Vistide) | IV drug for CMV retinitis. Highly nephrotoxic and requires pre and post hydration
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| Directly observed therapy | notation by DHHS stating that healthcare workers should DIRECTLY OBSERVE MEDICATION CONSUMPTION to assure compliance. common for MTb patients
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| MAC | Mycobacterium avium complex- acid fast bacillus mycobacterium that affect GI and respiratory tracts and BONE MARROW. occurs with seriously depleted CD4 copunts
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| cryptococcosis (cryptooccus neoforms) (do not confuse with Cryptosporidosis) | fungal infection that causes fungal meningitis ro highly disseminated fungitis in HIV infected persons with CD4 counts <100cells/mm3
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| histoplasmosis | environmentally related OI fungal infection common along the northeastern US region and candian border gnerally a pulmonary infection
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| candidiasis | "yeast" fungal infection that affect epithelial and mucosal linings.
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| recurrent vaginal candidiasis | most common presenting symptom of HIV (early ) in women
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| Pnuemocystis jiroveccii | formerly p. carinii. fungal pnuemonia common in in HIV infection when CD4+ count is >200. Deactivates when CD$ is less than 200
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| pnemocystosis | infection with a form of fungal pnuemonia
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| cryptosporidosis (crypto) | InNtestinal PROTOZOAN that casues excessive, watery, foul smelling diarrhea. Spreads rapidly by contaiminated food water and personal contact via human or VECTOR. may be transmitted to healthy individuals but is usually self limiting.
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| dangers of crypto | severe rapid elektrolyte depletion and dehydration
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| toxoplasmosis (toxo) | protozoan infection. found in poorly cooked meats (esp. pork and wild game) and in CAT Feces. Most commonly affect the CNS, but may hit GI (esp.colon), or CV organs. extremely tetratogenic
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| KS Karposi Sarcoma | most common neoplasm of MALE HIV+. initiated by a Herpes virus(human herpesvirus 8)
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| cervical cancer | most common neoplasm of HIV+ female
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| Lymphoma | cancer or neoplasm of immune system (specifically of Lymphatic tissues) Non hodgkins Lymphoma (NHL) is most common HIV-related
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| HIV encephalopathy | HIV induced encephalopathy> S&S are similiar to depression, parkinsons and alzheimers
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| asssessment in HIV+ persons | must include psychosocial, mental and physical aspects. HIPAA strictly followed
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| wasting syndrome | caused by ADvancing HIV disease characterized by a loss of lean muscle mass and sub cutaneous fat stores.
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| Skin turgor in HIV+ population | Bc of wasting syndrome, turgor is NOT a good measure for hydration levels in this population
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| lymphedema | abmormal collection of lymph fluid causing swelling
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| anascara | generalized massive wedema caused by a severe depletion of albumin due to inadequite nutritional intake
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| whos is more vulknerable to HIV infection | generally women, because semen contains a far higher concentration of HIV than vaginal secretions
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