Fichas
HIV opportunistic infections - bacterial
Fichas del conjunto (24)
- 1Bacterial caused of CAP?Streptococcus Pneumoniae
Haemophilus Influenzae
Mycoplasma Pneumoniae
Staphylococcus Aureus - 2General treatment of CAP?Penicillin/cephalosporin + macrolide
- 3Bacterial causes of HAP?Pseudomonas Aeruginosa
Escheria Coli
Legionella Pneumophilia - 4Treatment of HAP?3rd Generation cephalosporins + macrolide.
I.e. Ceftazidime + Gentamycin - 5Bacterial causes of meningitis?Strep Pneumoniae
Neisseria Meningitides
Haemophilus Influenzae
Listeria Monocytogenes
Gram -tive infections - 6Bacterial causes of brain abscesses?Streptococcus viridans/milleri
Staphylococcus
Klebsiella - 7Bacteria which cause septicaemia?Pneumococcus
Staphylococcus
Meningococcus
Salmonella
E. Coli - 8Which two recurrent illnesses are AIDS-defining?Recurrent Salmonella Septicaemia
Recurrent Pneumonia - 9Salmonella typhi and paratyphi - likely disease in individual with HIV?Bacteraemia, often without diarrhoea
- 10Treatment and secondary prophylaxis of HIV?Ciprofloxacin
- 11At what CD4 count do patients with HIV get TB? Is it generally primary or secondary? What type of TB are they likely to have?1) Any CD4 count (CD4 count is also unlikely to be accurate as TB can lower the peripheral CD4 count)
2) It's usually reactivation of latent TB
3) Disseminated/extrapulmonary TB
AIDS-defining - 12How does TB tend to present in HIV?Disseminated within the chest and generalised lymph node involvement
- 13Diagnostic investigations into TB in HIV? How may the CXR appear? Why isn't a mantoux test performed?1) Microscopy for AFB and culture of material
2) May be normal - lack of inflammatory/granulomatous response due to immunosuppression
3) Immunosuppression - no reaction - 14How can mycobacterium tuberculosis be distinguished from mycobacterium avium intracellulare?Culture the sample
- 15Treatment paradigm for TB? What must be given as prophylaxis against peripheral neuropathy? If there is CNS involvement? What else must be done if someone if diagnosed with TB?6 months in total
1) Initiation: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol (2 months)
Continuation: Rifampicin and isoniazid (4 months)
2) Pyridoxine
3) Extend treatment to 12 months
4) Notifiable disease - notify PHE, also refer to TB nurses/centre etc. - 16Which HIV drugs do rifampicin interact with?Protease inhibitors and non-nucleoside RT inhibitors
- 17Side effects rifampicin?Nausea, thrombocytopenia, vomiting
Discolouration of urine, tears and sweat,
Can cause abdominal discomfort, adrenal insufficiency, AKI, muscle weakness, and flushing - 18Side effects of Isoniazid?Hepatic disorders, peripheral neuropathy (likely if there is pre-existing RF i.e. diabetes, alcohol dependence, chronic renal failure, pregnancy, malnutrition, HIV), ototoxicity.
Agranulocytosis, nerve disorders, optic atrophy, pancreatitis, psychosis, seizure - 19SE Pyrazinamide? If Renal impairment?Aggravation of gout
Hepatic disorders
Photosensitivity reactions
Flushing
Dose adjust according to BNF - 20Ethambutol SE?Ototoxicity and peripheral neuropathy (increased if renal impairment, synergistic effect with isoniazid).
Nerve disorders
Hyperuricaemia, confusion, gout, nephrotoxicity. - 21Indication for TB prophylaxis? What is used?Exposure
Isoniazid - 22At what CD4 count to patients get MAI? Symptoms?1) CD4 <100 (i.e. tends to be at late stage)
2) Fever, night sweats, weight loss, anorexia, fatigue, abdominal pain (abdominal lymphadenopathy). Can infect the small bowel leading to diarrhoea and malabsorption. Can cause hepatomegaly and RUQ pain.
Infection of the bone marrow leads to pan cytopenia and red cell hypoplasia - 23How is MAI diagnosed? (bloods, radiology, culture)Bloods: Anaemia - pancytopenia, raised ALP, low albumin
Radiology - intra-abdominal lymphadenopathy
Blood cultures - X 3, Bactect bottles.
Culture organism from sterile site (blood, bone marrow, lymph node) - 24MAI treatment? Primary prophylaxis? (what CD4 count) Secondary prophylaxis?1) Clarithromycin/Azithromycin + ethambutol +/- rifabutin
2) Macrolide if CD4 <50
3) Macrolide
Información
- Descripción
- (HIV) Sexual Health Fichas sobre HIV opportunistic infections - bacterial, creado por Anna Hogarth el 16/11/2020.
- Creado por
- Anna Hogarth
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