CCU FINAL EXAM QUESTIONS AND ANSWERS
HIV is transmitted how? When do prenatal infections occur? what causes transmission
? name standard precautions - Answers - • Transmitted by body fluids containing HIV or
infected CD4 lymphocytes
- Blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk
- Most prenatal infections occur during delivery
• Casual contact does not cause transmission
- High risk behaviors
• Breaks in skin or mucosa increase risk
•
• Standard precautions
• Safer sex practices and safer behaviors
• Abstain from sharing sexual fluids
• Reduce the number of sexual partners to one
• Always use latex condoms; if allergic to latex, use non-latex condoms
• Do not share drug injection equipment
• Blood screening and treatment of blood products provide a marker for immune
function
Explain the ranges of CD4 counts and what CD4 dectects - Answers - CD4 count:
800-1200 normal
under 200- converted and you have aids (karposi carcinoma is huge and no one else
gets it, but you can also get pneumonia, yeast infections (thrush→painful)
around 600- below normal but still only have HIV and could have resp infections
The CDC case definition of AIDS for adults states that AIDS is present if the CD4 count
is below 200 and there is evidence of infection or disease process such as cancer
Used also in starting medications
CD4 is important because it indicates the amount of the virsus
CD4 is important because it indicates the amount of the virsus
normal= over 800-1200
under 200- converted and you have aids (karposi carcinoma is huge and no one else
gets it, but you can also get pneumonia, yeast infections (thrush→painful)
around 600- below normal but still only have HIV and could have resp infections
Explain the acute stage of HIV - Answers - • Acute/Primary infection
1. AKA acute HIV infection/acute HIV syndrome
2. Part of CDC category A
3. Symptoms: none to flu-like syndrome
4. Window period: lack of HIV antibodies
5. Period of rapid viral replication and dissemination through the body
6. Viral set point: balance between amount of HIV and the immune response
,7. Category A consists of one or more of the conditions listed below in an adolescent or
adult (greater than or equal to 13 years) with documented HIV infection. Conditions
listed in Categories B and C must not have occurred.
8. Asymptomatic HIV infection
9. Persistent generalized lymphadenopathy
10. Acute (primary) HIV infection with accompanying illness or history of acute HIV
infection
Explain early Chronic of HIV aids - Answers - 1. CDC category A
2. More than 500 CD4+ T lymphpocytes/mm3
3. Upon reaching the viral set point, chronic asymptomatic state begins
4. Body has sufficient immune response to defend against pathogens
Explain intermiediate of HIV aids - Answers - 1. CDC category B
2. 200-499 CD4+ lymphpocytes/mm3
3. CD4 T cells gradually fall
4. The patient develops symptoms or conditions related to the HIV infection, which are
not classified as category C conditions
5. Patients who are once treated for a category B condition are considered category B
explain late chronic of HIV aids - Answers - 1. CDC category C
2. Less than 200 CD4+ lymphocytes/mm3
3. As levels drop below 100 cell/mm3 the immune system is significantly impaired
4. Development of listed conditions
Explain the four stages in relation to symptoms of HIV aids - Answers - N=No symptoms
A=midly have symptoms
B=Moderately have symptoms
C= Severely have symptoms
explain screening for HIV aids and the problem - Answers - • Detect HIV-specific
antibodies.
• Window period
• 2 months delay
• may not test positive for HIV-antibody.
EIA, or western block. EIA is first and you can get false postivies so you need to do it
twice. Lyme disease lupus syaphillis all effect EIA
Explain viral load to aids - Answers - Viral Load
• Measure viral activity
• Lower the viral load the less active the disease
• Undetectable means the # is too low to be counted by the test not that there is no
disease.
,Viral load is important because talks about the amount of the virus you have in the
blood. The lower the viral load, the HIV cocktails are working and keep it from
replicating.
name complications from HIV/Aids - Answers - • Pneumocystis jiroveci pneumonia
(PCP)
1. Most common infection
2. Initial symptoms may be nonspecific and may include nonproductive cough, fever
chills, dyspnea, and chest pain
3. If untreated, progresses to pulmonary impairment and respiratory failure
4. Treatment: TMP-SMZ or pentamidine, prophylactic TMP-SMZ
5.
• Mycobacterium avium complex (MAC)
• Kaposi sarcoma.
1. Cutaneous lesions, but may involve multiple organ systems
2. Lesions cause discomfort, disfigurement, ulceration, and potential for infection
3.
• Collaborative problems/ potential complications
• Opportunistic infections
• Impaired breathing or respiratory failure
• Wasting syndrome
1. 10% weight loss and chronic diarrhea or chronic weakness and fever with absence of
other cause
2. Protein energy malnutrition
3. Anorexia, diarrhea, GI malabsorption, and lack of nutrition may contribute
4.
• Fluid and electrolyte imbalance
• Adverse reaction to medication
• Management of HIV is complicated by the many opportunistic diseases that can
develop as the immune system deteriorates.
• Examples of opportunistic infections include
• Oral candidiasis
1. May progress to esophagus and stomach
2. Treatment with Mycelex troches or nystatin, ketoconazole
• HIV encephalopathy
1. Progressive cognitive, behavioral, and motor decline
2. Probably directly related to the HIV infection
• Cryptococcus neoformans
• Other neurologic disorders
• Depression
• Fetus
1. Because antibodies are transmitted from the mother to the fetus during intrauterine
life, all infants of HIV-positive mothers will test positive at birth. Ongoing antibody (or
viral) testing is needed to determine whether the infant is infected with HIV.
, 2. Transmission of the virus can occur during fetal life even if the mother does not have
AIDS.
3. Infants of HIV-positive mothers are not routinely star
what are the isolation techniques for HIV aids - Answers - no isoloation just standard
precaustions unless there is esopharlyniges occur.
Standard Precuations and Examples of:
2. Viral meningitis
3. Varicella Zoster
4. Malaria
5. Lyme disease
7. Seasonal Influenza
8. Noroviruses
9. Rotavirus
10. Rhinovirus - Answers - Standard-wash hands, wear gloves, 7-10 days,Difference
btw viral and bacteria.... Protiens elevated with bacteria.
Standard, Airborn, Contract (bc of sluffing skin),Until lesions dry up and
crust.Herpes/shingles/chicken pox/cold sores. What is the problem→ it lays dormant,
and you can shed the virus before you have symptoms.
Standard,Carried through mosquitos, usually seen in the jungle. What do we want to
do→ get vaccinated.
Look for ticks, we need to burn them, tweeze the head out, snuff the oxygen away from
them, standard
Droplet ,H!1N1, (HN95 mask)
Standard but if acticely s/s than contact,C.diff, chlorea, E.coli
Who get its? Children, standard
Usally contact but droplet if s/s are present, common cold
Standard Precautions
Tb.
HIV is transmitted how? When do prenatal infections occur? what causes transmission
? name standard precautions - Answers - • Transmitted by body fluids containing HIV or
infected CD4 lymphocytes
- Blood, seminal fluid, vaginal secretions, amniotic fluid, and breast milk
- Most prenatal infections occur during delivery
• Casual contact does not cause transmission
- High risk behaviors
• Breaks in skin or mucosa increase risk
•
• Standard precautions
• Safer sex practices and safer behaviors
• Abstain from sharing sexual fluids
• Reduce the number of sexual partners to one
• Always use latex condoms; if allergic to latex, use non-latex condoms
• Do not share drug injection equipment
• Blood screening and treatment of blood products provide a marker for immune
function
Explain the ranges of CD4 counts and what CD4 dectects - Answers - CD4 count:
800-1200 normal
under 200- converted and you have aids (karposi carcinoma is huge and no one else
gets it, but you can also get pneumonia, yeast infections (thrush→painful)
around 600- below normal but still only have HIV and could have resp infections
The CDC case definition of AIDS for adults states that AIDS is present if the CD4 count
is below 200 and there is evidence of infection or disease process such as cancer
Used also in starting medications
CD4 is important because it indicates the amount of the virsus
CD4 is important because it indicates the amount of the virsus
normal= over 800-1200
under 200- converted and you have aids (karposi carcinoma is huge and no one else
gets it, but you can also get pneumonia, yeast infections (thrush→painful)
around 600- below normal but still only have HIV and could have resp infections
Explain the acute stage of HIV - Answers - • Acute/Primary infection
1. AKA acute HIV infection/acute HIV syndrome
2. Part of CDC category A
3. Symptoms: none to flu-like syndrome
4. Window period: lack of HIV antibodies
5. Period of rapid viral replication and dissemination through the body
6. Viral set point: balance between amount of HIV and the immune response
,7. Category A consists of one or more of the conditions listed below in an adolescent or
adult (greater than or equal to 13 years) with documented HIV infection. Conditions
listed in Categories B and C must not have occurred.
8. Asymptomatic HIV infection
9. Persistent generalized lymphadenopathy
10. Acute (primary) HIV infection with accompanying illness or history of acute HIV
infection
Explain early Chronic of HIV aids - Answers - 1. CDC category A
2. More than 500 CD4+ T lymphpocytes/mm3
3. Upon reaching the viral set point, chronic asymptomatic state begins
4. Body has sufficient immune response to defend against pathogens
Explain intermiediate of HIV aids - Answers - 1. CDC category B
2. 200-499 CD4+ lymphpocytes/mm3
3. CD4 T cells gradually fall
4. The patient develops symptoms or conditions related to the HIV infection, which are
not classified as category C conditions
5. Patients who are once treated for a category B condition are considered category B
explain late chronic of HIV aids - Answers - 1. CDC category C
2. Less than 200 CD4+ lymphocytes/mm3
3. As levels drop below 100 cell/mm3 the immune system is significantly impaired
4. Development of listed conditions
Explain the four stages in relation to symptoms of HIV aids - Answers - N=No symptoms
A=midly have symptoms
B=Moderately have symptoms
C= Severely have symptoms
explain screening for HIV aids and the problem - Answers - • Detect HIV-specific
antibodies.
• Window period
• 2 months delay
• may not test positive for HIV-antibody.
EIA, or western block. EIA is first and you can get false postivies so you need to do it
twice. Lyme disease lupus syaphillis all effect EIA
Explain viral load to aids - Answers - Viral Load
• Measure viral activity
• Lower the viral load the less active the disease
• Undetectable means the # is too low to be counted by the test not that there is no
disease.
,Viral load is important because talks about the amount of the virus you have in the
blood. The lower the viral load, the HIV cocktails are working and keep it from
replicating.
name complications from HIV/Aids - Answers - • Pneumocystis jiroveci pneumonia
(PCP)
1. Most common infection
2. Initial symptoms may be nonspecific and may include nonproductive cough, fever
chills, dyspnea, and chest pain
3. If untreated, progresses to pulmonary impairment and respiratory failure
4. Treatment: TMP-SMZ or pentamidine, prophylactic TMP-SMZ
5.
• Mycobacterium avium complex (MAC)
• Kaposi sarcoma.
1. Cutaneous lesions, but may involve multiple organ systems
2. Lesions cause discomfort, disfigurement, ulceration, and potential for infection
3.
• Collaborative problems/ potential complications
• Opportunistic infections
• Impaired breathing or respiratory failure
• Wasting syndrome
1. 10% weight loss and chronic diarrhea or chronic weakness and fever with absence of
other cause
2. Protein energy malnutrition
3. Anorexia, diarrhea, GI malabsorption, and lack of nutrition may contribute
4.
• Fluid and electrolyte imbalance
• Adverse reaction to medication
• Management of HIV is complicated by the many opportunistic diseases that can
develop as the immune system deteriorates.
• Examples of opportunistic infections include
• Oral candidiasis
1. May progress to esophagus and stomach
2. Treatment with Mycelex troches or nystatin, ketoconazole
• HIV encephalopathy
1. Progressive cognitive, behavioral, and motor decline
2. Probably directly related to the HIV infection
• Cryptococcus neoformans
• Other neurologic disorders
• Depression
• Fetus
1. Because antibodies are transmitted from the mother to the fetus during intrauterine
life, all infants of HIV-positive mothers will test positive at birth. Ongoing antibody (or
viral) testing is needed to determine whether the infant is infected with HIV.
, 2. Transmission of the virus can occur during fetal life even if the mother does not have
AIDS.
3. Infants of HIV-positive mothers are not routinely star
what are the isolation techniques for HIV aids - Answers - no isoloation just standard
precaustions unless there is esopharlyniges occur.
Standard Precuations and Examples of:
2. Viral meningitis
3. Varicella Zoster
4. Malaria
5. Lyme disease
7. Seasonal Influenza
8. Noroviruses
9. Rotavirus
10. Rhinovirus - Answers - Standard-wash hands, wear gloves, 7-10 days,Difference
btw viral and bacteria.... Protiens elevated with bacteria.
Standard, Airborn, Contract (bc of sluffing skin),Until lesions dry up and
crust.Herpes/shingles/chicken pox/cold sores. What is the problem→ it lays dormant,
and you can shed the virus before you have symptoms.
Standard,Carried through mosquitos, usually seen in the jungle. What do we want to
do→ get vaccinated.
Look for ticks, we need to burn them, tweeze the head out, snuff the oxygen away from
them, standard
Droplet ,H!1N1, (HN95 mask)
Standard but if acticely s/s than contact,C.diff, chlorea, E.coli
Who get its? Children, standard
Usally contact but droplet if s/s are present, common cold
Standard Precautions
Tb.
