Term
| what are the pulmonary effects of AIDS characterized by? (*exam question*) |
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Definition
| *infectious and *neoplastic processes that reflect *profound impairment in *cell mediation |
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Term
| what is the most common interstitial lung disease of HIV? |
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Definition
| LIP (lymphoid interstitial pneumonia) |
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Term
| what is the first sign of someone getting infected w/HIV? |
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Definition
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Term
| what oral infection will HIV pts often have? |
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Definition
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Term
| what is a common ophthalmological presentation of HIV pts? |
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Definition
| cotton wool spots, hemorrhages, edema, exudates |
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Term
| what is a common dermatological presentation of HIV pts? |
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Definition
| red to purple non-blothin cutaneous nodules that may be kaposi sarcoma |
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Term
| where is pneumocystis seen? |
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Definition
| pneumocystis is ubiquitous, meaning most people w/healthy immune systems fight it off |
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Term
| what is the clinical presentation for pneumocystis pts? |
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Definition
| dyspnea, cough, fever, rales |
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Term
| what is a very important aspect of the pt hx w/pneumocystis? |
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Definition
| get a good sexual hx: need to ask if had unprotected sex, homosexual, drug user, etc. because important to the patient’s survival |
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Term
| what part of a pt's lab work is extremely important if dealing w/pts suspected of pneumocystis? (*exam question*) |
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Definition
| the CD4 count, which if under 200 think pneumocystis or TB (should be at a couple thousand). do a f/u CD4 count for these pts |
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Term
| what is a 90% effective way of testing a pt for pneumocystis? |
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Definition
| transbronchial bx, but this is avoided in HIV pts b/c the blood is contaminated - instead they do bronchial washings |
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Term
| what is the current DOC for pneumocystis? |
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Definition
| sulfamethoxazole or pentamidine |
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Term
| why are pts w/pneumocystis put on BiPAP? |
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Definition
| to keep them from choking to death |
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Term
| if a person is not responding to drugs what can help? |
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Definition
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Term
| why would you put someone w/pneumocystis on prophylaxis? |
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Definition
| b/c it is a permanent infection - it will come back with in six months in 18% cases, 46% in 9 months and continues to increase after. aerosolized pentamidine is often used in this case. |
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Term
| what are risk factors for TB? |
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Definition
| HIV, IV drug users, minorities and immigrants, and homosexuality |
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Term
| what does a 10mm+ PPD mean in the US? what about 5mm? |
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Definition
| 10mm+: pt has been exposed to TB, 5mm+ PPD in an HIV+ pt means they have been exposed |
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Term
| does a negative PPD exclude HIV/TB? |
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Definition
| no, you still need to do sputum or look at the lungs |
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Term
| what is the major problem with TB pts and HIV? |
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Definition
| HIV pts can't form granulomas, so the TB goes systemic |
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Term
| when does a TB dx come in relation to AIDs dx? (*exam question*) |
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Definition
| a TB dx generally will come before an AIDs dx (if patient has TB then do HIV test and CD4 count, especially if high risk (VERY IMPORTANT!)) |
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Term
| what are the two main varieties of TB? |
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Definition
| typical (niacin positive) and atypical (niacin negative -> *more resistant*) |
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Term
| which occurs first in HIV pts; pneumocystis or TB? |
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Definition
| TB occurs before pneumocystis in HIV pts b/c it is more virulent (nothing can stop TB, b/c WBCs are damaged) |
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Term
| what are the mechanisms of infection for herpes? |
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Definition
| direct destruction of tissue, elicitation of immunopathic response, and facilitation of neoplastic tranformation |
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Term
| can people survive CMV and pneumocystis coinfections? |
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Definition
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Term
| if you have HIV and cryptosporidium in your lung what is the prognosis? |
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Definition
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