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Viral Infections- PSD B14
Terms in this set (26)
What is AIDS defined as?
AIDS is defined as when the CD4 count falls below 200 or when the patient has an acquired systemic infection.
How is HIV/AIDS transmitted?
Sexual intercourse, contaminated blood/needles, transplacentally, or via breast milk.
What systemic symptoms does a person with acute seroconversion illness appear with? When does that generally occur after HIV exposure?
Fever, headache, and malaise generally develop a few weeks after initial exposure to the virus. Anti-HIV antibodies appear soon afterward.
True or false- HIV retinopathy/microangiopathy correlates with the clinical severity of systemic infection.
False- it does NOT correlate with the clinical severity of systemic infection. It is probably due to immune complex deposition.
What are retinal findings seen in HIV retinopathy/microangiopathy?
Cotton wool spots, intraretinal hemorrhages, and capillary abnormalities
If a 25 year old patient presents to you in clinic with cotton wool spots, intraretinal hemorrhages, and vasculature abnormalities with normal blood pressure and no diabetes, what condition should be suspected?
What ocular treatment is required for HIV retinopathy?
No ocular treatment is required for HIV retinopathy. However, retinal findings do improve with anti-retroviral (HAART) treatment.
What secondary "opportunistic" infections may occur with AIDS? (Viral, Protozoa, fungi, and neoplasms)
Viruses- cytomegalovirus retinitis (CMV retinitis), Progressive retinal necrosis (PRN)
Fungi- choroidal pneumocystosis, etc.
Secondary neoplasms- B-cell intraocular lymphoma
What is the most commonly seen ocular opportunistic infection in those with AIDS?
Cytomegalovirus retinitis (CMV retinitis)
What symptoms do patients with CMV retinitis experience?
new onset of floaters and blurred vision
What condition is characterized by slowly expanding granular opacification of peripheral retina WITHOUT vitritis (indolent), confluent retinal whitening with associated hemorrhages and vascular sheathing (fulminant), and fibroglial scarring with mottling of the RPE (healed)?
What is the most common treatment of CMV retinitis?
Appropriate oral antivirals (often multiple); IV and intravitreal antivirals may be used as well. Most respond to initial treatment, however recurrences are common. In the case of recurrences, the patient may require maintenance treatment or a different combination of medications.
What is an ocular complication that may occur late in CMV retinitis?
What systemic condition is progressive retinal necrosis associated with?
Herpes (usually zoster) seen in those who are immunocompromised (ex. AIDS patient or someone with drug-induced immune suppression)
What ocular condition is characterized by yellowish-white retinal infiltrates, rapid progression of infiltrates and necrosis with frequent early involvement of macula, and little or no vitreous inflammation until late?
Progressive Retinal Necrosis (PRN)
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