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Questions and Answers
Histoplasma capsulatum is associated with weight loss and dyspnea.
True
A CD4+ cell count under 100/mm3 indicates a healthy immune system.
False
HIV can lead to conditions such as dementia and cerebral atrophy.
True
Pneumocystis jirovecii pneumonia typically shows 'ground-glass' opacities on imaging.
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JC virus reactivation is linked to the presence of enhancing areas of demyelination on MRI.
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HHV-8 is associated with Kaposi sarcoma and disseminated disease.
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Bartonella spp is linked to bacillary angiomatosis.
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Common symptoms of Histoplasma capsulatum include nausea and diarrhea.
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Oral thrush is commonly associated with the pathogen Candida albicans in HIV-positive adults with a CD4+ cell count below 500/mm3.
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Unscrapable white plaque on the lateral tongue is indicative of EBV-related oral hairy leukoplakia.
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Kaposi sarcoma is primarily caused by HPV in HIV-positive individuals.
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Squamous cell carcinoma can occur at sites of sexual contact in HIV-positive individuals infected with HPV.
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Candida albicans causes esophagitis characterized by white plaques on endoscopy.
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The presence of scrapable white plaques indicates EBV infection.
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Mycobacterium tuberculosis is associated with an increased risk of reactivation of latent TB infection in HIV-positive adults.
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CMV infection is associated with cells that have intranuclear inclusion bodies resembling "owl eyes".
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Perivascular spindle cells on histology indicate HPV infection.
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Cryptococcus neoformans can be identified through the presence of encapsulated yeast visible on India ink stain.
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Cryptosporidium spp. are known to cause bloody diarrhea.
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A CD4+ cell count below 500/mm3 is significant for the development of opportunistic infections in HIV-positive adults.
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EBV is associated with B-cell lymphoma and may present as ring-enhancing lesions.
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Mycobacterium tuberculosis primarily presents as encapsulated yeast on biopsy.
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CMV retinitis is characterized by linear ulcers on endoscopy.
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A biopsy revealing cells with neutrophilic inflammation is characteristic of Cryptococcus neoformans infection.
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Oral hairy leukoplakia is associated with EBV and presents as a scrapable white plaque.
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Kaposi sarcoma is linked to HHV-8 and histology shows spindle cells forming vascular tumors.
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Squamous cell carcinoma in HIV-positive individuals is most commonly found in the mouth and throat.
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Candida albicans commonly presents as systemic infections in HIV-positive individuals.
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An increased CD4+ cell count decreases the risk of opportunistic infections.
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Mycobacterium tuberculosis infection in HIV-positive adults typically causes a reactivation of latent TB.
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HPV infection in HIV-positive adults can lead to localized cutaneous disease.
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The presence of pseudohyphae on microscopy indicates infection by Mycobacterium tuberculosis.
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Histoplasma capsulatum is characterized by the presence of spherical yeast cells within macrophages.
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A CD4+ cell count equal to or below 100/mm3 is associated with a significantly compromised immune system.
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Pneumocystis jirovecii pneumonia typically presents with 'hazy glass' opacities on imaging.
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Cerebral atrophy can be observed on neuroimaging in patients with HIV-related dementia.
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Kaposi sarcoma is associated with the HHV-3 virus.
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JC virus reactivation can lead to progressive multifocal leukoencephalopathy.
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Bartonella spp. is known to cause bacillary angiomatosis, which typically presents as multiple blue to purple lesions.
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Cryptosporidium spp. primarily causes chronic, watery diarrhea.
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Acute weight loss can be symptomatically linked to infections such as those caused by Histoplasma capsulatum.
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Candida albicans is associated with the presence of encapsulated yeast on India ink stain.
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CMV infections can result in retinitis and are identified by the presence of intranuclear inclusion bodies.
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HIV-related EBV infections can lead to non-Hodgkin lymphoma in the central nervous system.
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The presence of acid-fast oocysts in stool is indicative of a Cryptococcus neoformans infection.
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Linear ulcers on endoscopy are associated with Mycobacterium tuberculosis infections.
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A biopsy revealing neutrophilic inflammation indicates a likely infection with CMV.
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White plaques on endoscopy are a common manifestation of Candida albicans infection.
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Study Notes
Common Diseases of HIV-positive Adults
CD4+ Cell Count < 500/mm3
-
Candida albicans:
- Oral thrush presentation with scrapable white plaque and pseudohyphae observed on microscopy.
-
EBV (Epstein-Barr Virus):
- Causes oral hairy leukoplakia characterized by unscratchable white plaque on the lateral tongue.
-
HHV-8 (Human Herpesvirus 8):
- Associated with Kaposi sarcoma, showing localized cutaneous disease with perivascular spindle cells invading and forming vascular tumors on histological analysis.
-
HPV (Human Papillomavirus):
- Linked to squamous cell carcinoma at sites of sexual contact, particularly the anus, cervix, and oropharynx.
-
Mycobacterium tuberculosis:
- Increased risk of reactivation of latent tuberculosis infection.
CD4+ Cell Count < 200/mm3
-
Histoplasma capsulatum:
- Symptoms include fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting, and diarrhea, with oval yeast cells identified within macrophages.
-
HIV:
- Can cause dementia and HIV-associated nephropathy, with neuroimaging showing cerebral atrophy.
-
JC virus (reactivation):
- Leads to progressive multifocal leukoencephalopathy, characterized by no enhancing areas of demyelination on MRI.
-
HHV-8:
- Associated with disseminated Kaposi sarcoma involving pulmonary, gastrointestinal, and lymphatic systems.
-
Pneumocystis jirovecii:
- Causes pneumonia, identifiable by "ground-glass" opacities on chest imaging.
CD4+ Cell Count < 100/mm3
-
Bartonella spp:
- Causes bacillary angiomatosis with multiple red to purple papules or nodules; biopsy typically shows neutrophilic inflammation.
-
Candida albicans:
- Esophagitis presents with white plaques visible on endoscopy; biopsy reveals yeast and pseudohyphae.
-
CMV (Cytomegalovirus):
- Manifestations include colitis, retinitis, esophagitis, encephalitis, and pneumonitis, with characteristic linear ulcers on endoscopy and cotton-wool spots on fundoscopy; biopsy shows cells with intranuclear (owl-eye) inclusion bodies.
-
Cryptococcus neoformans:
- Causes meningitis, diagnosed by encapsulated yeast seen on India ink stain or positive capsular antigen test.
-
Cryptosporidium spp:
- Leads to chronic, watery diarrhea, detectable via acid-fast oocysts in stool.
-
EBV:
- Can cause B-cell lymphoma (e.g., non-Hodgkin lymphoma, CNS lymphoma), primarily identified by ring-enhancing lesions that may be solitary, differentiable from Toxoplasma infections.
Common Diseases of HIV-positive Adults
CD4+ Cell Count < 500/mm3
-
Candida albicans:
- Oral thrush presentation with scrapable white plaque and pseudohyphae observed on microscopy.
-
EBV (Epstein-Barr Virus):
- Causes oral hairy leukoplakia characterized by unscratchable white plaque on the lateral tongue.
-
HHV-8 (Human Herpesvirus 8):
- Associated with Kaposi sarcoma, showing localized cutaneous disease with perivascular spindle cells invading and forming vascular tumors on histological analysis.
-
HPV (Human Papillomavirus):
- Linked to squamous cell carcinoma at sites of sexual contact, particularly the anus, cervix, and oropharynx.
-
Mycobacterium tuberculosis:
- Increased risk of reactivation of latent tuberculosis infection.
CD4+ Cell Count < 200/mm3
-
Histoplasma capsulatum:
- Symptoms include fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting, and diarrhea, with oval yeast cells identified within macrophages.
-
HIV:
- Can cause dementia and HIV-associated nephropathy, with neuroimaging showing cerebral atrophy.
-
JC virus (reactivation):
- Leads to progressive multifocal leukoencephalopathy, characterized by no enhancing areas of demyelination on MRI.
-
HHV-8:
- Associated with disseminated Kaposi sarcoma involving pulmonary, gastrointestinal, and lymphatic systems.
-
Pneumocystis jirovecii:
- Causes pneumonia, identifiable by "ground-glass" opacities on chest imaging.
CD4+ Cell Count < 100/mm3
-
Bartonella spp:
- Causes bacillary angiomatosis with multiple red to purple papules or nodules; biopsy typically shows neutrophilic inflammation.
-
Candida albicans:
- Esophagitis presents with white plaques visible on endoscopy; biopsy reveals yeast and pseudohyphae.
-
CMV (Cytomegalovirus):
- Manifestations include colitis, retinitis, esophagitis, encephalitis, and pneumonitis, with characteristic linear ulcers on endoscopy and cotton-wool spots on fundoscopy; biopsy shows cells with intranuclear (owl-eye) inclusion bodies.
-
Cryptococcus neoformans:
- Causes meningitis, diagnosed by encapsulated yeast seen on India ink stain or positive capsular antigen test.
-
Cryptosporidium spp:
- Leads to chronic, watery diarrhea, detectable via acid-fast oocysts in stool.
-
EBV:
- Can cause B-cell lymphoma (e.g., non-Hodgkin lymphoma, CNS lymphoma), primarily identified by ring-enhancing lesions that may be solitary, differentiable from Toxoplasma infections.
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Description
Explore the various common diseases that affect HIV-positive adults based on their CD4+ cell count. This quiz covers conditions associated with CD4+ cell counts below 500/mm3 and below 200/mm3, including Candida infections, EBV, HHV-8, HPV, and more. Test your understanding of the clinical presentations and implications of these infections.
