b Has had AIDS defining illness at ANYTIME c Can be symptomatic of

B has had aids defining illness at anytime c can be

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b.Has had AIDS defining illness at ANYTIME.c.Can be symptomatic of opportunistic infx. or asymptomatic.i.Ex- PCP, toxoplasmosis, progressive multifocal leukoencephalopathy, disseminated MAC, Kaposi’s sarcoma, lymphoma, TB, CMV.7.S/S of pt with compromised immune systems in person with HIV.a.Fever, fatigue, muscle aches, and headache.b.Early stage HIV (clinical latency)i.Usually asymptomatic
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ii.Can last as long as 10 years while CD4 cells decrease.c.Opportunistic infx arise, and indicate immunocompromisedpti.Thrush, cervical dysplasia, cervical carcinoma in situ, fever of >38.5 x1 month, oral hair leukoplakia, herpes zoster, PID, neuropathy, frequent yeast inf. With poor response to meds, Kaposi sarcoma, any other opportunistic infx.8.Diagnostic Test for HIVa.HIV EIA (3rdgen)-ELSIAi.Western blot confirmation if +ii.Asses for HIV antibodiesiii.Via urine, saliva, or Serum (most accurate)iv.Can take 12 weeks before antibodies are presentb.Oraquicki.Rapid test, 20 minsii.Via bloodiii.Additional testing required if positive.c.HIV P24 Antigen (4thgen)i.GOLD STANDARDii.Detects antibodies to HIV and presence of p24 antigen. (part of HIV proteins)iii.Detected early as 10 days post infectioniv.If + HIV1/HIV2 differentiation immunoassayv.If HIV1/HIV2 negative or indeterminate, HIV viral load is performed to clarify diagnosis.iii.Differentiate between the etiology, clinical manifestations and pathophysiology of the following opportunistic infections common in AIDS:Type of InfectionEtiologyClinical ManifestationsPathophysiology pneumocystis jiroveci pneumonia (PCP)Butterfly chest xray.Center of chest outBactrim for treatmentPCP FungusSlow and progressiveDyspnea with gradualonset that increases over time. Fatigue, night sweats,weight loss, poor appetite.Organisms multiplies in alveoli.Alveoli fill with exudates, type 2 pneumocyte hyperplasia and mononuclear cells infiltrate lung.AIDS=larger number of pneumocystis organisms in lungs and fewer
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inflammatory cells vssomeone who is HIV negative.mycobacterium avium complex (MAC)Clarythromycin and ethambutol for 6-12 months.Acid fast bacillus resulting in systemic infx.FeverNight sweatsWeight lossAnorexialymphadenopathyBacteria found in soil, water, and animals.The cell wall which contains long chainedglycolipids(which make the cell wall thick) protect bacteriafrom lysosomal attach.90-95% of diseases inAIDS pts.Grows slowly (thick cell wall) and nutrients can’t get in as easy.cytomegalovirus (CMV)Resistant to meds, no prevention.Herpes, opportunisticin natureInfects retina and causes CMV retinitis and eventually blindnessMost at risk- CD4<50-need routine eye exams.Protected from t cellsand nk cells due to MCH expression.-Inhibits cellular dna,rna, protein synthesis,ect resulting in release of digestive enzymes.
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