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HIV/AIDS Management and Opportunistic Infections
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HIV/AIDS Management and Opportunistic Infections

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@RationalExpressionism

Questions and Answers

What is the CD4 count at which HIV infection meets one of the Centers for Disease Control and Prevention's definitions of AIDS?

Below 200 cells/mm3

What is the recommended daily regimen for sexually active adults at a substantial risk of HIV acquisition?

Tenofovir disoproxil fumarate (TDF) regimen

What is a common consequence of a CD4 count below 50 cells/mm3?

The immune system is severely impaired, making infections more common

What is a characteristic of patients with AIDS?

<p>They experience bouts of severe illness and debilitation alternating with periods of symptom stabilization</p> Signup and view all the answers

What is a common dermatological manifestation of HIV disease?

<p>Exacerbation of psoriasis</p> Signup and view all the answers

What is a potential complication of HIV disease when the CD4 count drops below 200 cells/mm3?

<p>Opportunistic infections or cancers become more common</p> Signup and view all the answers

What is being tested as a potential prevention method for HIV?

<p>Vaccines against HIV</p> Signup and view all the answers

What is a common experience of patients with AIDS?

<p>They experience several opportunistic infections or cancers</p> Signup and view all the answers

What is the primary goal of long-term suppressive therapy for opportunistic infections in patients with HIV/AIDS?

<p>To control the acute stage of infection and prevent recurrence</p> Signup and view all the answers

What is the purpose of ongoing intravenous (IV) therapies in patients with HIV/AIDS?

<p>To prevent blindness from cytomegalovirus (CMV) retinitis</p> Signup and view all the answers

What is a fundamental aspect of palliative care for patients with HIV/AIDS?

<p>Comprehensive care with respect for patient goals and preferences</p> Signup and view all the answers

What is a common comorbidity experienced by patients with HIV/AIDS?

<p>Cardiovascular disease and non-AIDS-defining cancers</p> Signup and view all the answers

What is the primary role of an interprofessional team in palliative care for patients with HIV/AIDS?

<p>To coordinate care and address the complex needs of patients and families</p> Signup and view all the answers

What is the primary goal of health prevention measures in patients with HIV/AIDS?

<p>To maintain a good QOL in patients with HIV/AIDS</p> Signup and view all the answers

What is a common consequence of opportunistic infections in patients with HIV/AIDS?

<p>A significant reduction in the patient's quality of life</p> Signup and view all the answers

What is the primary goal of administering primary prophylaxis in HIV patients?

<p>To prevent the initial infection of opportunistic diseases</p> Signup and view all the answers

What has been the significant outcome of the effectiveness of Antiretroviral Therapy (ART) in HIV patients?

<p>Decrease in the incidence of opportunistic infections</p> Signup and view all the answers

What is the administration of a pharmacological agent to prevent future occurrences of infection referred to as?

<p>Secondary prophylaxis</p> Signup and view all the answers

What is the main goal of palliative care and symptom management in HIV patients?

<p>To improve the quality of life for HIV patients</p> Signup and view all the answers

Why is prophylaxis for life for HIV-related coinfections no longer necessary in many cases?

<p>Due to the significant decrease in the incidence of opportunistic infections</p> Signup and view all the answers

Match the following data with the correct year:

<p>1.1 million AIDS-related deaths = 2015 1.7 million AIDS-related deaths = 2011 2.1 million people acquired HIV = 2015 18.2 million people receiving ART = 2016</p> Signup and view all the answers

Match the following outcome with the correct percentage:

<p>New HIV infections = 35% AIDS-related deaths = 28% People living with HIV globally = 50% People receiving ART = 40%</p> Signup and view all the answers

Match the following with the correct number:

<p>People living with HIV globally = 36.7 million People receiving ART = 18.2 million People who acquired HIV in 2015 = 2.1 million AIDS-related deaths in 2015 = 1.1 million</p> Signup and view all the answers

Match the following with the correct consequence:

<p>Availability of ART = Reduced mortality from HIV Easy access of ART = Increased AIDS-related deaths Multiple prevention choices = Reduced HIV incidence Global expansion of access to HIV treatment = Increased new HIV infections</p> Signup and view all the answers

Match the following with the correct description:

<p>HIV/AIDS epidemic = Volitale and dynamic ART therapy = General-purpose treatment Palliative care = Symptom management HIV/AIDS challenge = Pharmacological</p> Signup and view all the answers

Match the following with the correct outcome:

<p>Achieving universal access to ART = Reduced HIV incidence Easier access of ART = Increased AIDS-related deaths Multiple prevention choices = Reduced mortality from HIV Global expansion of access to HIV treatment = Increased new HIV infections</p> Signup and view all the answers

Match the following with the correct challenge:

<p>HIV/AIDS epidemic = Complexity due to virus mutation ART therapy = Pharmacological challenges Palliative care = Pain and symptom management HIV/AIDS treatment = Limited resources</p> Signup and view all the answers

Match the following with the correct outcome:

<p>Reduced mortality from HIV = Transformed AIDS into a manageable chronic illness Reduced HIV incidence = Increased AIDS-related deaths Increased access to ART = Reduced new HIV infections Global expansion of access to HIV treatment = Reduced mortality from HIV</p> Signup and view all the answers

Match the following opioid withdrawal symptoms with their prevalence:

<p>Lack of energy = 65% Drowsiness = 57% Difficulty sleeping = 56% Pain = 55%</p> Signup and view all the answers

Match the following groups with their reported symptom burden:

<p>African Americans = Fewer symptoms Whites or mixed/other race = More symptoms Women = More symptom burden Those with an AIDS diagnosis = Higher symptom burden scores</p> Signup and view all the answers

Match the following reasons with why patients may wish to continue ART:

<p>Symptom relief = Prevention of future symptoms related to opportunistic infections Side effects = Acceptance of mortality and wish to stop antiretrovirals Prevention of future symptoms = ART because of its symptom relief Opportunistic infections = Patients may wish to continue ART</p> Signup and view all the answers

Match the following decisions with their contingency:

<p>Continuation of ART in hospice or palliative settings = Feelings of patients regarding the therapy Stopping antiretrovirals = Side effects and acceptance of mortality Starting ART = Symptom burden and CD4 cell count ART regimen = AIDS diagnosis and race</p> Signup and view all the answers

Match the following factors with their relationship to symptom burden:

<p>Age = Unrelated CD4 cell count = Unrelated AIDS diagnosis = Higher symptom burden scores Race = Symptom burden varied among races</p> Signup and view all the answers

Match the following symptoms with their prevalence in the sample:

<p>Lack of energy = Most prevalent Drowsiness = Second most prevalent Difficulty sleeping = Third most prevalent Pain = Fourth most prevalent</p> Signup and view all the answers

Match the following aspects with their importance in patients entering hospice:

<p>Acceptance of mortality = Greater acceptance Symptom relief = Less important Prevention of future symptoms = Less important Side effects = More important</p> Signup and view all the answers

Match the following symptoms with their correlation to ART:

<p>Lack of energy = Less severe with ART Drowsiness = Less severe with ART Difficulty sleeping = Less severe with ART Pain = Less severe with ART</p> Signup and view all the answers

Match the following phrases with their corresponding descriptions:

<p>PreEP = A potential prevention method for HIV DISEASE TRAJECTORY = The natural history or progression of HIV infection PATHOGENESIS OF HIV = The process of how HIV virus survives and reproduces in a host cell Palliative Care = A type of care focused on relieving symptoms and improving quality of life</p> Signup and view all the answers

Match the following terms with their corresponding characteristics:

<p>Retrovirus = A type of virus that can reproduce itself in a host cell HIV and AIDS = Synonymous terms for the same disease Opportunistic infections = Infections that occur when the immune system is weakened CD4 cell count = A measure of the immune system's functionality</p> Signup and view all the answers

Match the following statistics with their corresponding descriptions:

<p>8,500 = The number of women living with HIV who give birth annually 21,956 = The number of cases of perinatally acquired HIV infections prevented between 1994 and 2010 1,372 = The average number of new cases of perinatally acquired HIV infections per year 80% = The efficacy rate of PreEP in preventing HIV transmission</p> Signup and view all the answers

Match the following terms with their corresponding effects on the immune system:

<p>Progressive immune-system dysfunction = A characteristic of the disease trajectory of HIV infection Decrease in CD4 cell count = A consequence of HIV infection Persistent viral replication = A characteristic of the disease trajectory of HIV infection Increase in plasma HIV-RNA levels = A consequence of HIV infection</p> Signup and view all the answers

Match the following terms with their corresponding relationships with HIV:

<p>Palliative Care = A type of care focused on relieving symptoms and improving quality of life for patients with HIV/AIDS Cofactors = Influencing agents in the attachment of HIV virus to host cells Opportunistic infections = Infections that occur when the immune system is weakened due to HIV infection Antiretroviral Therapy (ART) = A treatment for HIV patients</p> Signup and view all the answers

Match the following phrases with their corresponding descriptions:

<p>Symptom management = A goal of palliative care in HIV patients Long-term suppressive therapy = A treatment goal for opportunistic infections in patients with HIV/AIDS Primary prophylaxis = Administration of a pharmacological agent to prevent future occurrences of infection Health prevention measures = A goal of care focused on preventing the transmission of HIV</p> Signup and view all the answers

Match the following terms with their corresponding characteristics of HIV infection:

<p>Asymptomatic infection = An early stage of HIV infection Life-threatening illness = A potential consequence of HIV infection Immune-system dysfunction = A characteristic of HIV infection Viral replication = A process of HIV infection</p> Signup and view all the answers

Match the following terms with their corresponding goals of care in HIV/AIDS:

<p>Palliative Care = Relieving symptoms and improving quality of life Primary prevention = Preventing the transmission of HIV Secondary prevention = Detecting and treating HIV early Interprofessional team = Providing comprehensive care to patients with HIV/AIDS</p> Signup and view all the answers

Match the following medications with their potential benefits for individuals with HIV/AIDS:

<p>Opioids = Relieving neuropathic pain Tricyclic antidepressants = Reduction of emotional symptoms Cannabis = Relief from stress and anorexia Neuroleptics = Management of extrapyramidal side effects</p> Signup and view all the answers

Match the following aspects of life with their influence on QOL in individuals with HIV/AIDS:

<p>Physical = Ability to control physical symptoms Emotional = Ability to cope with emotional distress Social = Ability to participate in social activities Cognitive = Ability to maintain mental function</p> Signup and view all the answers

Match the following medications with their potential side effects in individuals with HIV/AIDS:

<p>Neuroleptics = Increased risk of extrapyramidal side effects Tricyclic antidepressants = Reduced emotional symptoms Cannabis = Relief from neuropathic pain Anticonvulsants = Reduced seizure frequency</p> Signup and view all the answers

Match the following symptom management considerations with their corresponding descriptions:

<p>Risks versus benefits of treatments = Consideration of treatment options for patients with late-stage AIDS Use of psychostimulants = Treatment of fatigue in patients with late-stage AIDS Aggressive antiemetic therapy = Treatment of PI-induced nausea and vomiting Continuation of suppressive therapy = Prevention of opportunistic infections</p> Signup and view all the answers

Match the following assessment techniques with their corresponding purposes:

<p>Thorough history and physical examination = Diagnosis of signs and symptoms of disease Numerical scale from 0 to 10 = Rating of symptom severity Rating of symptom interference with daily activities = Assessment of quality of life Questions about symptom location and duration = Understanding of symptom presentation</p> Signup and view all the answers

Match the following researchers with their study on QOL in individuals with HIV/AIDS:

<p>Vigneshwaran et al. = Study on physical and emotional symptoms Trescot et al. = Study on effective medications for pain relief Vosvick et al. = Study on functional QOL in men and women with AIDS Harris et al. = Study on cannabis benefits for HIV patients</p> Signup and view all the answers

Match the following symptoms with their potential relief through medication:

<p>Neuropathic pain = Opioids and adjuvant medications Emotional distress = Tricyclic antidepressants Anorexia = Cannabis Seizures = Anticonvulsants</p> Signup and view all the answers

Match the following treatment options with their corresponding indications:

<p>Blood transfusions = Treatment of severe anemia in patients with late-stage AIDS Corticosteroids = Treatment of fatigue in patients with late-stage AIDS Prophylactic medications = Prevention of opportunistic infections in dying patients Antiretroviral therapy (ART) = Treatment of HIV infection</p> Signup and view all the answers

Match the following symptom management strategies with their corresponding goals:

<p>Prevention of symptoms = Anticipation of symptoms and prevention of their occurrence Aggressive treatment of symptoms = Relief of symptom severity Rating of symptom severity = Assessment of treatment effectiveness Continuation of suppressive therapy = Prevention of opportunistic infections</p> Signup and view all the answers

Match the following aspects of QOL with their impact on daily living:

<p>Physical functioning = Ability to perform daily activities Emotional functioning = Ability to cope with emotional distress Social functioning = Ability to participate in social activities Cognitive functioning = Ability to maintain mental function</p> Signup and view all the answers

Match the following patient assessments with their corresponding purposes:

<p>Rating of symptom severity = Assessment of symptom impact on daily life Rating of symptom interference with daily activities = Assessment of quality of life Thorough history and physical examination = Diagnosis of signs and symptoms of disease Questions about symptom location and duration = Understanding of symptom presentation</p> Signup and view all the answers

Match the following medications with their potential benefits for pain relief:

<p>Opioids = Relief from neuropathic pain Anticonvulsants = Reduction of seizure frequency Tricyclic antidepressants = Relief from emotional distress Cannabis = Relief from stress and anorexia</p> Signup and view all the answers

Match the following researchers with their findings on QOL in individuals with HIV/AIDS:

<p>Vosvick et al. = Functional QOL in men and women with AIDS Harris et al. = Cannabis benefits for HIV patients Trescot et al. = Effective medications for pain relief Vigneshwaran et al. = Impact of physical and emotional symptoms on QOL</p> Signup and view all the answers

Match the following treatment considerations with their corresponding goals:

<p>Risks versus benefits of treatments = Optimization of treatment outcomes Use of psychostimulants = Treatment of fatigue in patients with late-stage AIDS Continuation of suppressive therapy = Prevention of opportunistic infections Aggressive antiemetic therapy = Treatment of PI-induced nausea and vomiting</p> Signup and view all the answers

Match the following symptom management approaches with their corresponding descriptions:

<p>Anticipatory symptom management = Prevention of symptoms through early intervention Active symptom management = Aggressive treatment of symptoms Prophylactic symptom management = Prevention of opportunistic infections Palliative symptom management = Relief of symptom severity</p> Signup and view all the answers

Match the following symptom assessment tools with their corresponding purposes:

<p>Numerical scale from 0 to 10 = Rating of symptom severity Thorough history and physical examination = Diagnosis of signs and symptoms of disease Questions about symptom location and duration = Understanding of symptom presentation Rating of symptom interference with daily activities = Assessment of quality of life</p> Signup and view all the answers

Study Notes

Opportunistic Infections and HIV/AIDS

  • Most opportunistic infections are incurable and can only be palliated to control acute stages and prevent recurrence through long-term suppressive therapy.
  • HIV/AIDS patients often experience concurrent or consecutive opportunistic infections and various malignancies, causing severe symptoms.
  • Opportunistic infections can be prevented through health prevention measures, such as ongoing intravenous (IV) therapies to prevent blindness from cytomegalovirus (CMV) retinitis.

Morbidity and Mortality

  • HIV-infected patients have a higher risk for non-AIDS-related diseases and cardiovascular, renal, and non-AIDS-defining cancers than uninfected patients.
  • The onset of these diseases occurs at similar ages in both groups.
  • Gynecological infections are common in women with HIV disease, as well as dermatological manifestations, including bacterial, fungal, viral, neoplastic, and other conditions.

HIV Prevention and Treatment

  • Pre-exposure prophylaxis (PreP) has become an important part of HIV prevention since its approval by the FDA in 2012.
  • Daily regimen with tenofovir disoproxil fumarate (TDF) is recommended for sexually active adults at a substantial risk of HIV acquisition.
  • Prophylaxis for life for HIV-related coinfections is no longer necessary in many cases due to the effectiveness of ART.

Palliative Care and Quality of Life

  • Palliative care (PC) includes comprehensive care with respect for patient goals, preferences, and choices, and acknowledgment of caregivers' concerns.
  • PC is fundamental in addressing the complex needs of patients and families with HIV/AIDS and requires the coordinated care of an interprofessional team.
  • HIV/AIDS patients often experience bouts of severe illness and debilitation, alternating with periods of symptom stabilization.
  • The administration of prophylactic and/or suppressive therapies can support and maintain the immune system, decreasing the frequency or severity of opportunistic infections.
  • Identifying changes in QOL and implementing appropriate interventions can improve QOL outcomes for HIV/AIDS patients.

HIV/AIDS Overview

  • 36.7 million people are living with HIV globally, and 18.2 million people are receiving Antiretroviral Therapy (ART) by mid-2016.
  • The global expansion of access to HIV treatment is considered one of the great recent achievements in public health.

Incidence and Prevalence

  • New HIV infections fell by 35%, and AIDS-related deaths fell by 28% between 2011 and 2015.
  • In 2015, there were 1.1 million AIDS-related deaths, compared to 1.7 million in 2011.
  • Approximately 8,500 women living with HIV give birth annually, with advances in HIV research, prevention, and treatment allowing them to give birth without transmitting the virus.
  • An estimated 21,956 cases of perinatally acquired HIV infections were prevented between 1994 and 2010.

Pathogenesis of HIV

  • HIV survives by reproducing itself in host cells, replacing genetic machinery, and eventually destroying the cell.
  • The HIV life cycle consists of attachment, replication, and destruction of host cells.

Disease Trajectory

  • Without treatment, HIV infection progresses to life-threatening illness characterized by opportunistic infections and cancers.
  • The disease trajectory is associated with progressive immune-system dysfunction and persistent viral replication.

Symptom Management in HIV Disease

  • Symptom management is crucial in HIV care, with patients experiencing a high burden of pain and chronic symptoms.
  • Key symptoms experienced by patients include lack of energy, drowsiness, difficulty sleeping, and pain.
  • Symptom relief is a primary consideration in ART continuation decisions.

Palliative Care and HIV/AIDS

  • Palliative care focuses on symptom relief, comfort, and quality of life (QOL) for patients with HIV/AIDS.
  • QOL is associated with health maintenance, physical and emotional symptoms, and functioning in activities of daily living and social functioning.
  • Effective symptom management can improve QOL for individuals with HIV/AIDS.

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Description

This quiz covers the treatment of chronic and acute opportunistic infections in HIV/AIDS patients, including the importance of long-term suppressive therapy and maintaining a good quality of life.

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