Micro Block 10 Atchley not Objective

what three ways can diabetes be tested for, what levels indicate diagnosis
blood HBA1C 6.5% and glucosem>125 fasting
urine glucose >120 shows glucose in urine – old way
what is the best test for nutritional analysis
pre-albumin
what are the 4 tests in a lipid panel
cholesterol, HDL, LDL, TG
what are the five parts to a hematology test
anemia testing
PLT/clotting time
ESR
sickle cell
WBC differential
what are the four anemia tests
RBC count
hematocrit
Hb
indices
what are the three RBC indices, describe them
MCV – mean cell volume
MCHC – mean corpuscular Hb concentration
RDW – red cell distribution width
what is the purpose of a ESR, what is another option, which is better
ESR – measure sedimentation rate which tells about inflammation

C-reactive protien also tells about inflammation and is better because it tells about the action of NSAIDs

what cells are examined in a WBC differential, what are their relative percentages
neutrophils 60%
leukocytes 30%
monocytes 6%
eosinophils 3%
beans 1%
what is tested for during endocrine testing (4)
thyroid: T3, T4, TSH
B-HCG
what blood disorder can be seen from a CBC (4)
anemia, polycythemia, leukemia, thrombocytopenia
what are the nine immunology lab tests
IgG
IgM
titer
RA/RF
monospot
rubella/titer
syphillis
hepatitis
CMV
what does a monospot test for
mononucleosis
what are the three syphillis tests
RPR, VDRL
FTA-ABS
RFR/VDRl how do they work
use trepillina like antigen which is sensitive but not specific for antibodies to syphilis
what is FTA-ABS what does it stand for
conformation test for syphilis, more specific
flourescent trepinemal antigen antibody screen
what type of molecules are looked for in a hepatitis test
anti-HAV, HAV, HBsAg, anti-HBc, anti-HBe, anti-HB
what is checked for in blood type matching, why can this be done
ABO/Rh
screen for unsuspected antibodies
RBC have no HLA
what is rhogam
Rh immune globulin
what blood components are harvested in the clinical lab, what are they used for (4)
cryopercipitate: concentrated clotting factors (8, hemophelia)
fresh frozen plasma: burns
packed RBC: trauma
platlets
define renal threashold
level in the blodo when they kidney cannot absorb anymore
what 10 things are tested for on urine dip sticks
specific gravity: hydration
pH
leukocyte esterase
blood
nitrate
ketones
bilirubin: liver function
urobilinogen
protein
glucose (>120 excedes renal threashold and glucose will show in urine – diabetes)
define reference range, give some other ways to say this definition
normal
normal distribution: range covers 95% of the people. mena +/- two standard deviations

expecte, healthy, typical, average, natural, regular, standard, gaussian, normal

what is the reference range determined by (3), what percautions should be taken (2)
age, gender, geographical location
find out your hospitals ranges and O2 contant in atmosphere
what are the ten capsulated bacteria, say something special about the ones that deserve it
strep pneumonia (#1 communitu acquired)
kelbsiella pneumonia
haemophilus influenza
pseudomonas aeruginosa (CF silme producer, #1 hospital pneumonia)
neisseria meningitidis
cryptococcus neoformans (fungi)

maningeal E. coli with K1 capsule
cacillus anthracis
salmonella typhu
strep pyogenes with hyalyronic acid capsule

what is kosch’s postulate (4), what is wrong with it (3), what are the additions to fix it (2)
approach to lab diagnosis

pathogen present in diseased animal
pathogen isolated and grown
innoculation of animal
isolation from re-innoculation the same

exceptions: viruses, prions, non-culturable microbes

added
recovery of pathogen or evidence of its presence in diseased host
clinical signs and symptoms compatiable with infection presence

what can be assumed when looking at a lab sample from a sterile site, what are the exceptions
anything that shows up is a concern or a contamination

sometimes you have to pull a sterile sample through a non-sterile region (contamination. respiratory, bladder)

what are examples of sterile regions
blood, csf, pleura, peritoneal, synovial, tissues, lower respiratory, bladder
what can be assumed when looking at a lab sample from a non-sterile region, what can you do to fix this
normal flora will be present, know how to identify them and how much is appropirate
what are examples of non-sterile regions
mouth, nose, upper respiratory, skin, GI, urethra
what different ways can a culture based test be done (3)
microscopy: wet mount, stained
culture media
antibiotic susceptability
what things do non-culture based tests examine
pathogen specific antibodies in serum
pathogen antigens or nucleic acids in specimen
general or non-specific tests (CBC, flow, chemistry, UA)
what are some generalizations to remember which are gram negative
most pathogens are gram negative rods
what is a back to back lancet, what is it mistaken for
gram positive diplococci – strep pneumonia

not all diplococci are s. pneumonia. it could be staph aureus

that does a tzanck smear detect, how is it foemed
detects multinucleated cells from irritated tissue that sloughed off and clumped
what microbes does tzanck find (4)
HSV1: cold sore
HSV2: genital herpes
VSV: chicken pox, shingles
zinc cells clumped: viral infection
what does india ink test for, how does it look, who would you do this test in
identifies cryptococcus neoformans

polysaccharide capsule make halo in black (ghost cells)

this microbe only shows in immune compormized

silver stain: aka, what does it find
gomori methenamine

pneumoncystis juroveci fungi

buffered charcoal yeast extract (BCYE): what does it show legionella
how is a sample collected from the throat
get sample from oropharynx and tonsils
avoid lips and cheeks
what is ruled out of a throat ample
strep pyrogenes, group A strep, aka strep throat (B-hemolytic)
what are the key select pathogens from teh throat (4)
S. pneumona (CAP), S. aureus, P, aeruginosa, K. pneumoniae (HAP)
how is a sample collected from a wound
debris completely or it will always be colonized
swab center
try not to expose to air (first swab put directly into anaerobic container it is toxic)
what is ruled out in a wound swab
anaerobic vs aerovic
what are the key select pathogens in a wound swab (8) give a general reason for their presence
B. fragilis
S. aureus
S. pyogenes (abscess)
C. perfingenes (trauma)
S. aureus (surgical)
pasturella (dog or car bit)
barinella (cat scratch)
inchinella crodans (human bite)
spinal culture, what is ruled out (3), what cannot be ruled out (1)
meningitis, abscess, subdural empyema

encephalitis

spinal culture key select pathogens (3), what relates them
N. mengitis, s. punemonia, H. influenza
capsules
stool rule out 2
entercolitis, dysentery (bloody diarrhea)
stool: hey select pathogens (4)
sigella, salmonalla, campylobacteri, E. coli
what causes watery stool
viruses or toxins (tx could cause collitis, dont treat)
urine rule out (2)
cystitis, pyelonephritis
urine key select pathogenes (4)
E. COLI
enterobacter, proteus, e. faecalis
genital rule out (3), how are they categorized
gonorrhea
chlamydia and syphilis – non-gonococcal urethritis. not culturable so cultured for gonorrhea and got nothing.
genital key select pathogens (3)
gonorrhea (culturable)
chalydophilia trachomatis
treponema pellidum
how do you know it is sputum and not spit
WBC > epithelial cells
WBC >10
epithelial cells <10
when do you get the best sputum sample
morning
what is the number one community acquired pneumonia
strep
what is the number one hospital acquired pneumonia
pseudomonas
ichinella crodens infection: how do you get it, how is it identified
seen in human bite
smells like bleach
corrodes agar
automated E test: how does it work
new test, better than kirby, no key needed

wuantative

line on strp shows susceptability

what is the life cycle of neutrophils, 6 steps
blast
promyelocyte
myelocyte
metamyelocyte
band
segmented and polymononuclear
explain the 5 steps in RBC life
pluripotential stem cells > normoblast > nucleated erythocyte > reticulocyte > erythrocyte
what are part of the myelolytic cell line
neutrophils
myeloblast should make you think
blast abnormal in the blood
myeloblast leukemia
how do you differentiate what type of cell a blast is
you dont, its hard. almost undifferentiated. there are some markers than can be stained
what are the three steps in a platelet life
pluripotential stem cell > megakaryoblast > platelet
define pancypenia
all WBC are low, leukemia
define anemia
low RBC, Hb, HCT
define polycythemia
high RBC, Hb, HCT
how is a CNS disease diagnosed, two methods and how to do them
brudizinski’s neck sign: flexing the pt neck causes flexion of the hips and knees
kernig’s knee sign: flex kips to 90 deg and extend knee causes pain
what used to be the trigger to test for HIV
patient with PCP infection
what does CSF look like, how much needs to be collected, why
colorless clear fluid with no WBC

2 tubes to go to microbe study for gram stain and culture, chemistry for glucose and protein, cell count and differential

how is a direct ELISA done
antignic sites are labeled by antibodies and a colored substrate is added that binds to antigen antibody complex
how does a sanwhich ELISA work
unknown antibody is taken from the person
anti-HCG on a strip. HCG antigen will be captured by antibodies. another anti-HCG will then be added that has a reporter enzyme on it. substrate will be added that changes color when bound to sandwhiches
aggultination two definitions definition
taking particulate antigen and add antibody (can test for antibody or antigen)

soluble antigen + antibody bound to particulate leads to agglutination

what areas can be tested via agglutination
blood, CSF, feces, throat
what is the BEST way to claculate CrCl
((urine Cr) / (serum Cr)) x flor rate

flow rate = (mL of urinein 24h)/(1700 ml/day)

is there any other indicator for kidney function other than Cr, is it better or worse?
inulin, better
what is the normal color of urine, what 6 colors or combinations could urine be
normal: straw yellow amber and clear or cloudy

red, black, white (albinuria), orange, brown, blue/green

what medication can turn the urine colors, what is two names for it, what two colors
phenazopyridine/ piridum

red or orange

what two things can turn urine blue
methlyene blue, amitriptyline (antidepressant)
so your patient is on a medication that turns their urine a strange color, what does this mean for your chemical tests
dont trust dip stick results
how can urine color indicate hydration
ligher = dilute = hydrated
dark = concentrated = dehydrated
what are the normal values for all the parts of a dip stick urine test
all negative except specific gravity (1-1.035) and pH (5-8)
how do you physically do a dip stick test to get the best result
run it on the side and blot it so chemicals dont run together
significance of a glucose urine test (2)
tells if there is hyperglycemia or rengal glucosuria
what 4 conditions can cause hyperglycemia that shows in the urine
diabetes mellitus, thyrotoxicosis, cushing syndrome, severe anxiety
what condition can cause glycosuria, why
pregnacy because kidney threashold drops
what would interfere with a urine glucose test, give an example
reducing agents (ascorbic acid)
what is the normal renal threashold, what is a renal threashold
concentration in the blood where you have to spill over into the urine
160-180 mg/dl
what is the significance in a bilirubin urine test
increased direct bilirubin correlates with serum urobilinogen and serum bilirubin and tells about liver function
what can mess up a bilirubin urine test
prolonged exposure of the sample to light
what is the differnce between direct and indirect bilirubin, explain the process of production
indirect bilirubin must travel on albumin because it isnt water soluble. it is taken to the liver where is conjugated with glucronic acid making it water soluble and puts it into a form that can be directly assayed

indirect = unconjungated
direct = conjugated

what form of bilirubin do we test in urine chemistry, why
direct because it is conjugated and dosen’t stick to albumin and thus can be transferred to urine
what is the significance of a ketone urine test (2)
shows prolnged fasting
shows ketoacidosis (diabetic)
when is ketoacidosis an emergency, what qualifies it
diabetic ketoacidosis is an emergency, you can tell it is diabetic because there will be ketones and glucose in the urine. confirm with blood gas showing acidosis
what limits the accuracy of a urine ketone test
it only picks up acetoacetate and not the other ketone bodies
what can cause metabolic acidosis, what type of anion gap (7)
methanol poisoning
uremia
DKA
p-
iron ischemia
lacric acidosis
ethylene glycol (antifreeze)
silislate poisoning

positive anion gap

what is the significance of specific gravity testing (2)
hydration index
diabetes insupidus testing
what causes a change in specific gravity in diabetes insipidus (2)
vasopressing or ADH acting on the kidney
what can interfere or cause error in a specific gravity test (2), give an example
alkaline urine can mess it up
does not measure ionized solutes
what test is simillar to a specific gravity test, is it better
refractory test
yes
what is the significance of urine blood test (4), give a cause of each
hematuria – nephritis, trauma
hemoglobinuria – hemolysis
myoglobinuria – rhabdomyolysis
myoglobin shows as blood – comes from trauma / crush injury
what can mess up the results to a urine blood test (3)
reducing agents
microbial peroxidase (bleach)
cannot distinguish between diseases
what is better than a urine blood dip stick test
urine microscopic examination
what are two things that can cause acidic urine
metabolic acidosis
high protein diet
what can cause alkaline urine, what about VERY alkaline urine
bacterial overgrowth causes alkaline urine
very alkaline urine has been left out too long (>8)
what is the significance of a urine protein test (4)
shows proteinurie and nephrotic syndrome
shows if there is inflammation of the bladder or kidney
increases in Ig disease
what can interfere with the results of a urine protein test (3)
trace amounts can be misleading – they dont nessesicarly mean disease
alkaline urine can mess it up
ultra sensitive to albumin which messes up urine protein electrophoresis
what is a warning sign (pre-eclampsia) for eclampsia, when does this condition occur
protein in urine and HBP, pregnacy
define proteinuria. what are the 4 categories of causes
excess protein in urine
functional, renal, pre-renal, post-renal
what are three causes of functional proteinuria
severe muscular exertion
pregnacy
orthostatic proteinuria
what are the three renal causes of proteinuria
glomerulonephritis
nephrotic syndrome
renal tumor or infection
what are the three causes of pre-renal proteinuria
fever, renal hypoxia, hypertension
what are the three causes of post-renal proteinuria
cystitis
urethritis/prostatitis
contamination with vaginal secretions
how is urobilinogen made
bilirubin is altered by bacteria into urobilinogen, it should not be in the urine
what is the significance of high urine urobilinogen
increased hepatic processing of bilirubin
what is the significance of low urine urobilinogen
bile obstruction – it never got to the gut to be turned into urobilinogen
what can interfere with a urine urobilinogen test, what is a down side to the test
prolonged urine exposure to oxygen converts urobilinogen to urobilin

cannot detect low levels of urobilinogen

what is the significance of a nitrate urine test
shows presence of gram negative bacteria
best show for E. coli
what is the best urine dip stick test for a UTI
leukocyte esterase
what can interfere with a nitrate urine test (2)
bacterial over growth
bacteria that dont convert nutrate to nitrite
what are the 4 ways to test for a UTI
leukocyte esterase
microscopic examination for bacteria
urine culture
nitrites in urine
what is the significance of leukocyte esterase urine test
finds pyuria, acute inflammation (damage), renal calculus, most sensitivt UTI test
what can cause increased WBC without infection
kidney damage, kidney stone
why is it important to alwasy check the WBC microcope test and compare to the leukocyte esterase test
WBC have to lyse to release leukocyte esterase so if they didnt lyse you could have false results
what are two things that can mess up a leukocyte esterase urine test
oxidizing agents
menstural contamination
what 4 things are looked for on a urine how power exam (400x)
>3 erythrocytes
>5 leukocytes
>2 renal rubular cells
>10 bacteria
what 5 things are looked for on a urine low power exam (200x)
>3 hayline casts
>1 granular cast
>1 WBC cast
>1 RBC cast
>10 squamous cells
what crystals are seen on a microscopic exam, which are of concern
AA crystals are not a concern unless its in newborns
uric acid is a concern in all because it causes gout
what kinds of epithelial cells can be found in the urine (2), what is the significance
normal: sloughing of normal tissue. too much suggests contaimination

renal tubular epithelial cells: too many means something is wrong with the kidney – glomerulonephritis?

where are casts made (2)
DCT and CD
what casts are there allowed to be some of
tamm horsfall
what does an increase in WBC, RBC, or granular casts mean
kidney damage
what 4 things are looked for on a urine how power exam (400x)
>3 erythrocytes
>5 leukocytes
>2 renal rubular cells
>10 bacteria
what 5 things are looked for on a urine low power exam (200x)
>3 hayline casts
>1 granular cast
>1 WBC cast
>1 RBC cast
>10 squamous cells
what crystals are seen on a microscopic exam, which are of concern
AA crystals are not a concern unless its in newborns
uric acid is a concern in all because it causes gout
what kinds of epithelial cells can be found in the urine (2), what is the significance
normal: sloughing of normal tissue. too much suggests contaimination

renal tubular epithelial cells: too many means something is wrong with the kidney – glomerulonephritis?

where are casts made (2)
DCT and CD
what casts are there allowed to be some of
tamm horsfall
what does an increase in WBC, RBC, or granular casts mean
kidney damage
what is pyelonephritis, what are 6 signs
kidney infection

bacteria, leukocytes
leukocyte, granular and waxy casts
renal tubular epithelial cast cells

what are the four types of urinary tract infections
urethritis
cystitis
polynephritis
prostatis
what UTI are considered lower
urethritis, cystitis, prostatitis
what UTI are considered upper
polynephritis
what UTI are always complicated
polynephritis
what are the two types of UTI patients, what is the main difference in their care plan
uncomplicated – dip stick test
complicated – culture and dip stick
what is the rank of UTI in common bacterial infections
#2 (respiratory is #1)
what risk factor can increase UTI in a uncomplicated patient, how can this be avoided (2)
sexual intercourse: post coital voidiing, prophylactic antibiotics
how is renal abscess diagnosed (2) and treated
CT with contrast, renal ultrasound

surgical drainage

explain the two cup test, why is this done
fill one cup with urine, massage prostate, fill another.
organisms dont always come out during urinalysis
what are the general symptoms of cystitis (10)
dysuria, urgency, frequency, bladder fullness, suprapubic tenderness, hematuria, painful urination, urethral burning, blood
what conditions cause vaginal discharge (6)
STi, yeast, vaginosis, urethritis, cervicitis, PID
when someone has a UTI what labs will come back positive for sure, which might come back positive (9)
always: leukocyte esterase, microscopic WBC

sometimes: nitrites, blood, protein, microscope RBC, granular or WBC casts

what is a condition that can cause RBC in urine that isnt an infection
acute glomerular nephritis (immunological)
name 4 urine collection methods, who they are used in, which is best
mid stream catch: wash, rinse, dry, void, collect midstream (flushes flora out, wipe away antiseptic)

foley catheter: any bacteria is significant, lean towards yes for infection

suprapubic aspiration – infants. shoulw be no contamination

perineal urine collection bag – infants. worry lots about contamination

what is the timing of culture of a urine sample, what can change this, how can you tell if it sat for too long
>2h changes reuslts unless there is perservitives

bacteria will be high but leukocyte esterase wont

what are 6 incidence when the patient’s urine would be cultured
pyelonephritis
repeat uncomplicated UTI
men
children
pregnant women
complicated UTI
what are the two ways for microbes to be introduced into the urine
ascending or hematogenous route
explain the ascending route to a UTI
colonization of vagina
colonization or urethra
entry into the bladder
infection
sepsis?
explain the hematogenous route to a UTI
spread from blood to body
check urine when someone has meningitis
what are common pathogens that cause urethritis, which is #1 (4)
1. chalmydia trachomatis
neisseria gonorrhea, mycoplasma, uroplasma
what are the common pathogens that cause cystitis (6)
E. coli, staph saphrophiticus, proteus mirabilis, klebsiella, enterococcus, adenovirus (hemorrhagic)
what are the common pathogens that cause pyelonephritis (6)
E. coli, staph saphrophiticus, proteus mirabilis, klebsiella, enterococcus, mycoplasma
what are the common pathogens that cause prostatitis (6)
E. coli, staph saphrophiticus, proteus mirabilis, klebsiella, enterococcus, uroplasma
what does schistoma hematobium do when it gets in the body, where can it be acquired
it burrows into the bladder wall and causes a form of cystitis
it deposits eggs and causes inflammatory response via eosinophils

seen overseas

what causes hemorrhagic cystitis
adenovirus
what is the microbe that causes infection in young sexually active women, how can it be identified in the lab
coagulase negative
staphlyococcis saphrophyticus
what is the most common cause of urethritis in men
chalmydia trachomatis
what are the two types of STI
acellular and cellular
what are the acellular STIs (4)
herpes, papilloma, hepb, HIV
what are the three types of cellular STIs
arthropods
bacteria
protozoa
what arthropods cause STIs (2)
public lice, scabes
what bacteria cause STIs (5)
chylamydia, gonorrhea, haemophilus ducreyi, mycoplasmas, syphilis, BV
what STIs cause sores/ulcers (4)
syphilis, genital herpes (HSV1/2), lymphogranuloma venereum, canceroid
crab lice: official name, appearance, how to get
phthirus pubis
pinhead sized light brown insects
intimate contact or fomites (dont jump)
where do crab lice like to go, what do they do with their life
moist coarse hair (pubic, beart, eyebrows, eyelashes)
lay eggs (nits) at the base of the hair
what are the 4 signs of crab lice
itching, burning, irritation, worse at night
what is the treatment for crab lice (2)
wash linnens and clothes in hot water, Rx
why do crab lice itch
they spit and their spit causes an allergic reaction
scabes: official name, appearance, how to get
sarcoptes scabiei
microscopic burrowing insects that lay eggs in skin
intimate contact or fomites (dont jump)
4 signs of scabes
intense itching, often in crevices, worsens at night, small insect bites
how do you diagnose scabes
skin scraping for mites or eggs
how is scabes treated (2)
permethrin, wash hot linnens and clothes
how is HPV spread (2)
sex, other (plantar warts etc)
what are the two types of HPV, which do we have no vaccines against
mucosal
dermal: no vaccines
what are the four most common atypical bacteria, why
require weird growth, have to act like a virus

mycoplasma, ureaplasma, chylmidia, reckittsia

when you treat someone for chlamydia, what do you always do
treat their partner
how do yu diagnose chlamydia (4)
it is unculturable

urethram smear: >5 polymorphic neutrophils

tissue culture: costly, time consuming

nucleic acid hybridization (gen-probe): tests for gonorrhea and chlamydia

DNA amplication test (NAT)

what are the symptoms of PID (5)
uterine adnexal tenderness, cervical motion tenderness, endocervical discharge, fever, lower abdominal pain
what are the complications of PID (3)
chronic pelvic pain in 18%
7x risk of ectopic pregnacy with 1 PID episode
15% risk of infertility with 1 PID episode
how do we categorise STIs that cause sores
painful or painless
what are the three types of STI that cause painless sores, what are their full names
syphilis: treponema pallidum
lymphogranumoma venereum (clymatic bubo): chlamydophila trachomatis
granuloma inguinale: klebsiella granulomatis
what two things cause painfil genital sores, what are their full names
canceroid: hamophlius ducreyl (soft cancer)

genital herpes simplex

what is the initial test done for syphilis, how is it done, what is the concern
RPR/VDRL (prodrome): non trepinemal antigen used for agglutinating tests

you can have lots of antibody and get a negative test. cannot detect positive until you dilute the antibody way down

what is the conformation test for syphilis
FRA-ABS (floursecent treponimal antigen)
how do you get genital herpes (2)
asymptomatic shedding, sexual contact
how is herpes diagnosed (2)
culture, serology, PCR
what are some outdated ways to say HIV
gay related immunodeficiency disease
lymphadenopathy associated virus
human t lymphocyte virus III
what is the centraldogma of biology
dna is transcribed into rna which is translated into protein
what is the central dogma in HIV
reverse transcriptase turns RNA into DNA
DNA is transcribed into RNA which is translated into protein
what is the difference between HIV1 and HIV2
HIV1 is more prevalent and virulent
HIV2 isnt as bad but can cause AIDS of untreated
after HIV attaches what does it do in the cell
reverse transcriptase turns viral RNA into DNA

integrase puts the DNA into the genome (makes a provirus)

DNA is transcribed into RNA which is translated into protein (viral particles)

baby HIV buds out

begining with the primary infection explain the timeline or HIV
primary infection
acute HIV syndrome: dissemination and arrival at lymphoid organs
clinical latency
constitutional symptoms
opportunistic diseases
death
how long is the clinical latency of HIV
can be 10 years if not injected into the blood (2 years)
what are some of the constitutional symotoms of HIV (5), what is the CD4 count
CD4 500
oral candidiasis, shingles, oral thrush, vaginal thrush, HSV-1
before the constitutional symptoms, what symptoms are there of HIV in the latency or acute HIV syndrome phases (4)
acute pharyngitis, bronchitis, sinusitis, pulmonary TB
what are the opportunistic infections of HIV, when do they appear
CD4 400 kaposkis sarcoma (HSV8)
CD4 300 oral hairy leukoplakia, EBV, disseminated TB
CD4 200 PCP, cryptococcus, toxoplasmosis
CD4 50 MAC, CMV, lymphoma
when is AIDS diagnosed
CD4 <200 or AIDS asociated illness along with a positive HIV test
what is standard percuation
assume everyone is infected, if you glove for someone with HIV then you glove for everyone
what is the treatment for HIV (2)
no cure
HAART
what does HAART stand for, what is the 4 ways it helps
highly active antiretroviral therapy
combination drug therapy that slows the replication, reduces viral load, improves immune function, delays progression
what is the success of HAART dependent on (2)
compliance despite…
complex redigmen
adverse side effects
when on HAART what is HIV doing
latent/silent
why does presence of other STD increase risk of HIV (2)
displays risk behavior
increases susceptability (sores give route for contamination)
what is the best solution for HIV (7)
avoid sex especially with sex workers, multiple partners, high risk people, anal intercourse

use condoms
dont share needles
do not share razor bladers/toothbrushes

explain the new ag/ab combo test
helps close the viral window a little. if they have enough antibody the antigen load drops a lot so their HIB test may not detect the antigen. this test accounts for both
what are the three parts of the western blot stip, what are they coding for
ENV: viral envelope

POL: polymerase, protease (cuts viral particles), integrate (integrates DNA into genome forming provirus), RT

Group specific antigen: capsid, matrid

what is a low budget way to test for HIV/disease progress, explain how it works
candidal skin test: everyone should have a positive test. if you do it on a HIV person and they are positive than their type 4 (T cell mediated) hypersensitivity is still good enough to work. when it becomes negative they have the disease and their CD4 is relativly low (anergic sign)
what are the three clinical categories of HIV, what defines them
A: asymptomatic: Acute HIV (POL)

B: symptomatic

C: AIDS

what puts someone into category B HIV (10)
persistant PID
hairy leukoplakia oral
recurrant shingles
cervical dysplasia/carcinoma
idiopathic thrombocytopenic purpura
fever/diarrhea > 1mo
neuropathy
oropharyngela candidiasis
bacillary angiomatosis

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