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Clinical Medicine II

What is unique about HIV retrovirus carry RNA genetic code, but produce reverse transcriptase wihich converts RNA into DNA, and settles into host cell’s where it waits for activation
What kills CD4 cells the “kick out” of the virus from the cell destroys it
What HIV test may be positive gp120 protein on the surface
What is significant for gp120 has a high affinity for the CD4 receptor cells
What is the purpose of reverse transcriptase virus gets in, releases RNA w/ viral enzymes: reverse transcriptase and integrase which reads viral RNA and builds corresponding DNA strands, DNA moves into cell nuclease where cell clones these genes and virus is to be spread when cell divides
How is the virus activated when infected host cell is activated and divides, the proviral DNA is transcribed into RNA which turns into viral proteins and polyproteins
What is patho of the HIV virus 1) many virus replicate in each CD4 cells 2) these cells are getting destroyed
Why should post exposure be done w/I 72 hours want to get it prior to reaching the CD4 cells in blood
What does HIV latency time depend on amount in blood, general health, presence of other illnesses
HIV infected with HIV virus
AIDS acquired immune deficiency syndrome caused by HIV virus
The higher the viral load the ↑ risk of opportunistic infections
First antiretroviral approved by FDA AZT 1987 (5 years post identification)
What is the Ryan white care act provides assistant to pt’s w/o insurance (was a 7-8yo hemophiliac got HIV from transfusion)
What is HAART highly active antiretrovirus therapy
Results from the HAART now a chronic dz NOT a death sentence, LTSE’s for antivirals: renal and other metabolic dz
How do we test for HIV serum ab (Elisa), aliva/urine ab, rapid finger test stick.
How do we confirm HIV western blot assay: identifies positive gp120 protein
How long does antibody take to become positive 22-27days
+ ELISA and- western blot means HIV-
Pt comes in acute viral sxs, HIV exposure 1-2 weeks ago, what is next test to order HIV viral RNA load (if present means have virus)
Who do we test for HIV 13-64 in health care settings, based on suspicion
Lab markers of HIV infection and monitoring Viral load, and CD4 count
What would classify a false + viral load <10,000 copies/mL, should be considered “indeterminate” until ruled out
When do HIV infected pt’s become infectious seroconversion (body makes ab for it)
What defines AIDS CD4 <200, and presence of OI’s
Primary HIV inx S/S mononucleosis- like illness 1-4wks post-exposure
What viral bacterial, parasitic, and fungal infx are OI’s V: Kaposi sarcoma, Herpes, flu B: TB, S. pneumo P: pneumocystis carinii F: candida Cryptococcus
MC presentation of acute HIV fever, fatigue, HA, maculopapular rash on face and trunk (rare on extremities)
Neuro sxs for HIV meningitis, neuropathy/radiculopathy, facial palsy, GBS, brachial neuritis, cong impairment, psychosis
5 P’s of HIV during hx sexual practices, past STDs, preg hx, protection from STDs, partners in last 6m/1yr
Neoplastic clues of HIV kaposi’s, basal ad squamous cell
Derm cues infectious, neoplastic, inflammatory
Late-stage presentation of HIV muscle wasting, lethargy, wt loss, look very sick
Why are we concerned about when HIV was contracted drug resistance, if infected w/I last 2-3 yrs, get resistance testing
How can we tell if it is a new or old infx lab test: absolute CD4, if low, usually older infx
What must we test w/ new HIV test LFT’s, Renal fxn, other OI’s test
With a – Hep C ab titer and is a drug user what should we do HCV RNC PCR viral load test d/t such a correlation b/w HIV and Hep C
F/U with HAART pts 3m w/ labs, utilizing pharm, nutrition, mental health care
Vaccines for HIV pts Hep A, B, pneumococcal, influenza, tetanus
What nl test should be looked at d/t SE’s of NRTIs cholesterol screening d/t its ↑ w/ dyslipidemia
Main challenge in tx HIV raising the immune system values, the drugs can ↓ the viral load significantly, but hard to ↑immune system
SE’s with HIV mediciatons dyslipidemia, glucose metabolism, ↓ bone mineral density, hypogonadism, renal, haptic, psych d/os, neurocog, neuropathy, CAD
Created by: becker15
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