Flashcards
HIV opportunistic infections - Fungal and Protozoal
Flashcards do conjunto (40)
- 1At a CD4 count of 200-500, what risk is there of OI?Little risk, except TB
- 2At a CD4 count of 100-200, what risk is there of OI? (3)1) Pneumocystis
2) Toxoplasmosis
3) Oesophageal Candida - 3At a CD4 count of <100, what risk is there of OI? (2)1) Mycobacterium avium intracellulare
2) Cytomegalovirus - 4How is HIV tested for in an adult?HIV antibodies at baseline
HIV PCR - also check genotype (CLADE)
HIV antibodies at 3 months - 5How is HIV tested for in a neonate? What are the ages?HIV PCR - can't check for antibody due to presence of maternal antibody
1) 1-3 days
2) 4-6 weeks
3) 8-12 weeks
Antibody at 18 months - 6Best mechanism for preventing OI? Primary prophylaxis takes place at what CD4 count? Secondary prophylaxis?1) Prevent with HAART
2) Antiviral/antibiotics at CD4 <200
3) Treatment to prevent relapse of infection that has already occurred - can stop when CD4 count rises - 7Candida Albicans Species? What disease does it cause? (2) Is it aids defining?Fungus
Oral and Oesophageal thrush
Oesophageal thrush is AIDs-defining - 8Signs and symptoms oral thrush?1) Taste perversion, oral discomfort, pharyngeal discomfort on swallowing, symptomatic.
2) Creamy white plaques (can be rubbed off unlike in OHL), erythematous patches, angular chelitis - 9Signs and symptoms oseophageal thrush?1) Dysphagia, odynophagia (retorsternal pain on swallowing), nausea
2) Creamy white plaques on endoscopy - 10Diagnosis candida albicans?Clinical --- treatment --- endoscopy if failure to respond to treatment
- 11Treatment oral/oesophageal thrush? If resistant or CD4 count <50?1) Topical Nystatin/Amphoterecin lozenges/ Fluconazole 50-100mg/day
2) long term use of Fluconazole or CD4<50: Itraconazole
IV Amphoteracin - 12Cryptococcus Neoformans Species? What disease does it cause? (3) Is it aids defining?1) Fungus
2) Skin, lung, meningitis
3) Cryptococcus menigitis is AIDS-defining - 13Skin disease caused by cryptococcus neoformens?Umblicated papules and ulceration
- 14Lung disease caused by cryptococcus neoformens? Chest x-ray? Diagnosis?Cough, SOB, fever,
Chest X-ray - consolidation +/- cavitation, infiltrates and effusions
Diagnosis: Bronchoalveolar lavage? - 15At what CD4 count does Cryptoccocal meningitis occur? Symptoms and Signs? Other neurological disease?1) CD4 <50
2) Headache, fever, mental change, asymptomatic (10%)
Signs may be absent or meningeal irritation or neurological signs (rare)
Cryptococcoma, space occupying lesion - 16Diagnosis of cryptococcus menigitis? (2)1) Serum CRAG (cryptococcal antigen)
2) CSF (India Ink, CRAG, culture +/- lymphocytes, low glucose, high protein, high pressure)
High pressure is an important feature! - 17Treatment of cryptococcal menigitis?6 weeks minimum
IV amphotericin +/- Flucytoscine if severe, then oral fluclozanole
Repeat LP at 6 weeks to confirm sterilization - 18Prophylaxis cryptococcal menigitis?Fluconazole 200-400mg/day
- 19Pneumocystis Jiroveci Species? What disease does it cause? (1) Is it aids defining?1) Fungal
2) Pneumocystis pneumonia
3) No - 20Symptoms and Signs pneumocystis pneumonia?1) Dyspnoea, non-productive cough, fever, weight loss, diarrhoea - develops over weeks
2) Pyrexia +/- chest signs, O2 desaturation on exercise - 21X-ray and bronchoalveolar lavage findings for pneumocystis pneumonia?1) May be normal, bat wings (bilateral infiltrates), effusions, consolidations, cavitation
2) Silver staining, immunofluorescence, PCR - 22Treatment pneumocystis pneumonia? If Severe (pO2<10kpa)?1) Co-trimoxazole 120mg/Kg over 3 doses/day
IV pentamidine
Clindamycin and Primaquine
2) IV methylpred. 40mg QDS 5-10 days
Oral pred. 40mg bd - 23Prophylaxis for pneumocystis pneumonia?Co-trimoxazole 960mg x 3 / week
ProNebulised Pentamidine
Dapsone - 24Aspergillus fumigatus Species? Disease? (1) AIDS-defining? X1) Fungus
2) Lung disease
3) No - 25Symptoms of Aspergillus fumigatus lung disease symptoms? Diagnosis? Risk factors? X1) Cough, fever, dyspnoea
2) X-ray - may see cavitation. Bronchoscopy
3) CD4 <30, neutropenia, steroids, cannabis smoking, neutropenia - 26Treatment Aspergillus fumigatus? XAmphoteracin B
Itraconazole - 27Histoplasma capsulatum Species? Disease? (1) AIDS-defining? X1) Fungus
2) Respiratory disease - fever, constitutional symptoms
3) Yes - 28Histoplasmosis signs? XHepatosplenomegaly
Enlarged Lymph Nodes
Chest signs
Rash (10%) - resembles folliculitis or molluscum
Neurological signs - 29Diagnosis of histoplasmosis? (4) XChest x-ray - diffuse infiltrates
Pancytopenia
Blood cultures
Biopsy of infected tissue - 30Treatment histoplasmosis? XItraconazole
Amphoteracin B - 31Penicillium marneffei Species? Signs/Symptoms? Diagnosis? Management? X1) Fungus
2) Fever, skin lesion (similar to haemorrhagic molluscum), enlarged lymph nodes, liver and spleen, anaemia and weight loss
3) Fungal culture of affected tissue
4) Amphotericin B or itraconzaole - 32Coccidioido immitis Causes? At what CD4 count? Is it AIDs defining? Treatment? X1) Diffuse and reticulonodular lung disease
2) <200
3) Extra-pulmonary coccidioidomycosis is AIDS defining
4) Amphotericin B or itraconazole - 33Toxoplasma Gondii Species? What disease does it cause? At what CD4 count does it appear?1) Protozoa (oocyte), found in cat faeces
2) Neurological disease
3) CD4< 200 - 34Signs and symptoms of toxoplasmosis?Fever
Confusion
Headache
Focal neurological signs
Fits - 35CT/MRI findings in TG? How is diagnosis confirmed?Ring enhancing lesions, classically multiple can be single - confirm diagnosis by response to treatment, repeat scan after 3 weeks
- 36Treatment TG? Prophylaxis?Sulphadiazine (or Dapsone or clindamycin + pyramethamine). Switch to oral after 6 weeks.
Dapsone + pyramethamine - 37Cryptosporidium parvum Species? What disease does it cause?1) Protozoa
2) Gastrointestinal - 38Symptoms of cryptosporidios?Profuse watery diarrhoea, sclerosing cholangitis, dilated biliary tree, raised ALP, RUQ pain
- 39Diagnosis of cryptosporidiosis?1) Ziehl-Neelson staining of stool - may need up to 10
2) Rectal biopsy - 40Cryptosporidiosis treatment?1) Avoided by boiling water
2) Paromomycin
3) Symptomatic treatment with anti-diarrhoeals and rehydration
Difficult to eradicate if CD4 <200
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- Sexual Health (HIV) FlashCards sobre HIV opportunistic infections - Fungal and Protozoal , criado por Anna Hogarth em 16-11-2020.
- Criado por
- Anna Hogarth
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