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Questions and Answers
Which of the following best describes the action of reverse transcriptase in HIV pathophysiology?
Which of the following best describes the action of reverse transcriptase in HIV pathophysiology?
Which of the following is NOT a typical route of HIV transmission?
Which of the following is NOT a typical route of HIV transmission?
How does HIV primarily compromise the immune system?
How does HIV primarily compromise the immune system?
What is the primary distinction between HIV-1 and HIV-2 strains, based on the provided text?
What is the primary distinction between HIV-1 and HIV-2 strains, based on the provided text?
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What role does integrase play in the HIV viral replication cycle?
What role does integrase play in the HIV viral replication cycle?
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Besides common routes of transmission such as sexual contact, blood and mother to child, what other less common route is noted for the transmission of HIV?
Besides common routes of transmission such as sexual contact, blood and mother to child, what other less common route is noted for the transmission of HIV?
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Which of the following best describes the role of macrophages in HIV infection?
Which of the following best describes the role of macrophages in HIV infection?
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Why are heterosexual females considered at higher risk of contracting HIV than heterosexual males, according to the provided context?
Why are heterosexual females considered at higher risk of contracting HIV than heterosexual males, according to the provided context?
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A patient presents with a CD4 count of 600 cells/mm³. Which of the following best describes their immune status?
A patient presents with a CD4 count of 600 cells/mm³. Which of the following best describes their immune status?
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What is the most accurate way to describe the role of protease in the HIV life cycle?
What is the most accurate way to describe the role of protease in the HIV life cycle?
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How long after infection can HIV RNA be detected in the bloodstream using a blood test, according to the information?
How long after infection can HIV RNA be detected in the bloodstream using a blood test, according to the information?
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Which of these opportunistic infections is not typically associated with HIV/AIDS?
Which of these opportunistic infections is not typically associated with HIV/AIDS?
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What is the primary mechanism of action for antiretroviral therapy (ART) in managing HIV?
What is the primary mechanism of action for antiretroviral therapy (ART) in managing HIV?
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Which of the following is NOT a typical symptom of the acute phase of HIV infection?
Which of the following is NOT a typical symptom of the acute phase of HIV infection?
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What distinguishes the chronic phase of HIV infection from the acute phase?
What distinguishes the chronic phase of HIV infection from the acute phase?
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Which stage of HIV infection is primarily characterized by a prolonged period of reduced symptoms, despite the virus still being active?
Which stage of HIV infection is primarily characterized by a prolonged period of reduced symptoms, despite the virus still being active?
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What is the hallmark clinical characteristic that defines the AIDS stage of HIV infection?
What is the hallmark clinical characteristic that defines the AIDS stage of HIV infection?
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Which of the following situations indicates a diagnosis of AIDS?
Which of the following situations indicates a diagnosis of AIDS?
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According to the passage, which diagnostic test could show the presence of HIV earlier, before antibodies are present?
According to the passage, which diagnostic test could show the presence of HIV earlier, before antibodies are present?
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If a patient is given a short course of antiviral medication after a possible exposure to HIV, this is referred to as:
If a patient is given a short course of antiviral medication after a possible exposure to HIV, this is referred to as:
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Which of the following is a malignancy commonly associated with advanced HIV infection?
Which of the following is a malignancy commonly associated with advanced HIV infection?
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Which of the following is not a target of antiretroviral medications?
Which of the following is not a target of antiretroviral medications?
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Which of the following is a preventative strategy for HIV that uses antiviral medications before potential exposure?
Which of the following is a preventative strategy for HIV that uses antiviral medications before potential exposure?
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If a patient has prolonged swelling in the lymph nodes in the armpits, groin, or neck, what term best describes this symptom?
If a patient has prolonged swelling in the lymph nodes in the armpits, groin, or neck, what term best describes this symptom?
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Which method of HIV transmission poses the highest risk?
Which method of HIV transmission poses the highest risk?
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What is a crucial time frame for the effectiveness of HIV post-exposure prophylaxis?
What is a crucial time frame for the effectiveness of HIV post-exposure prophylaxis?
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What is a primary reason the normal immune response struggles to contain HIV infection?
What is a primary reason the normal immune response struggles to contain HIV infection?
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Which situation illustrates the highest risk of perinatal HIV transmission?
Which situation illustrates the highest risk of perinatal HIV transmission?
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What type of exposure represents a high-risk circumstance for HIV infection?
What type of exposure represents a high-risk circumstance for HIV infection?
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How frequently should individuals on PrEP follow up with their healthcare provider?
How frequently should individuals on PrEP follow up with their healthcare provider?
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Study Notes
Human Immunodeficiency Virus (HIV)
- HIV is a retrovirus, meaning its genetic material is RNA
- HIV has 2 major strains: HIV-1 (most common in the US) and HIV-2 (primarily in West Africa)
- HIV is a slowly progressive disease with 3 stages: Retrovirus, Acute HIV, and Chronic HIV leading to AIDS.
- Transmission routes include blood, semen, vaginal fluids, transplacental transmission, and breast milk. HIV must enter the bloodstream through mucous membranes (rectum, vagina, mouth, tip of penis, open cuts) or direct injection. Saliva might transmit HIV with open mouth wounds.
- HIV attacks CD4 cells and macrophages. CD4 cells are crucial for both humoral and cell-mediated immune responses.
- Macrophages serve as virus reservoirs, aiding in its spread, thus going undetected. They are found in mucous membranes.
- HIV slowly weakens the body's immune system, affecting T cells and B cells.
HIV Pathophysiology
- HIV fuses with a CD4 cell receptor.
- Reverse transcriptase converts viral RNA into DNA, which is then incorporated into the host cell's DNA.
- Integrase allows viral DNA to integrate into the host cell's DNA.
- The host cell then produces viral particles.
- Protease assists in assembling protein components for new viruses.
- The host cell becomes a viral production factory.
- The virus buds off from the host cell, destroying it and weakening the immune response.
Stages of HIV Infection
- Acute infection: Presents like a flu-like virus, similar to mononucleosis. Symptoms include fever, headache, fatigue, pharyngitis, lymphadenopathy, myalgia (muscle aches), and GI symptoms. This phase lasts a couple of weeks and often resolves. Symptoms are often mistaken.
- Chronic infection: Known as the latent stage, symptoms are often mild or absent. This stage can last from 6 months to 10 years. Symptoms can include malaise, headache, neuropathy, lymphadenopathy (swollen lymph nodes), and opportunistic infections.
- AIDS (Acquired Immunodeficiency Syndrome): The most advanced stage, marked by a severely compromised immune system. CD4 cell count drops to 200 cells/mm3 or less. Opportunistic infections and cancers become common. Symptoms include rapid weight loss, recurring fever, night sweats, rash (usually non-itchy on torso), prolonged swelling of lymph nodes, neurological issues, eye problems, lung complications, tumors, and opportunistic infections.
Risk Factors for HIV
- Unprotected sexual activity (heterosexual females at higher risk than males)
- Men who have sex with men (MSM), anal intercourse (receptive partners at higher risk)
- IV drug use
- History of STDs
- Frequent blood transfusions
- Offspring of infected mothers (during pregnancy and breastfeeding)
Clinical Manifestations (AIDS)
- Symptoms include: progressive weight loss, recurring fever, night sweats, a non-itchy rash (commonly on the torso), swollen lymph nodes, and opportunistic infections and cancers.
Treatment and Management of HIV
- Currently, antiretroviral therapy (ART) is the only effective long-term treatment. It targets the virus at various stages (e.g., protease inhibitors, transcriptase inhibitors, integrase inhibitors).
- Early initiation of ART is crucial for preserving immune function and reducing complications.
Laboratory Studies and Diagnostics
- Screening for HIV is vital.
- HIV RNA blood test detects the presence of the virus.
- CD4 count monitors the course of the disease. A normal range is 800-1200, and a count below 500 indicates impaired immunity.
- Viral load measures the amount of HIV in the blood. High viral loads can increase the risk of transmission.
- HIV antibody tests detect antibodies produced to fight HIV. It can take 2 weeks to 6 months for antibodies to develop.
Complications of HIV/AIDS
- Opportunistic infections (e.g., tuberculosis, candidiasis, pneumonia)
- Cancers (e.g., Kaposi sarcoma, lymphoma)
- Other complications (e.g., neurological issues, heart strain, gastrointestinal problems, skin disorders)
Practice Questions and Answers (Page 4)
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Question 1: Highest risk factors for HIV transmission
- A: Transmission to women or men during sexual intercourse
- B: First 2-6 months of infection is higher risk vs 1 year after infection
- C: Perinatal transmission from HIV-infected mothers without ARV is higher than mothers on ARV
- D: Needle stick exposure to HIV-infected blood is a higher risk than a splash exposure.
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Question 2: Reason for immune system failure
- A: CD4+ T cells become infected and are destroyed.
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Description
This quiz explores the pathophysiology of HIV, including its classification as a retrovirus and its effects on the immune system. Learn about the different strains of HIV, transmission routes, and how it gradually progresses to AIDS. Understand the significance of CD4 cells and macrophages in the context of HIV infection.
