Chapter 25: ID IV - Opportunistic Infections Flashcards

1
Q

What are opportunistic infections

A

Infections that occur when the immune system is unable to respond normally, typically in immunocompromised patients

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2
Q

Immunocompromised states include:

A
  • HIV with CD4+ T lymphocyte count < 200 cells/mm3
  • Systemic steroids for 14 days or longer at a prednisone dose >/= 20 mg/day or >/= 2 mg/kg/day
  • Asplenia
  • Use of immunosuppressants
  • Use of cancer chemotherapy agents
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3
Q

OIs can be prevented with antibiotics, antifungals or antivirals . This is known as

A

Chemoprophylaxis

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4
Q

T/F: Prophylaxis for Candida infections in the mouth/esophagus is not usually recommended

A

True

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5
Q

Severe neutropenia is another major risk factor for developing infections and is determined by an ANC < ___ cells/mm3

A

500

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6
Q

Which drugs are used as alternatives in OI if a patient has a sulfa allergy

A

Atovaquone, dapsone, pentamidine

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7
Q

Which drugs are used as alternatives in OI if a patient has G6PD deficiency

A

Atovaquone & pentamidine

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8
Q

PCP or PJP infection in HIV is indicated by CD4+ count < ___ cells/mm3

A

200

remember, PCP and PJP have 2 Ps in them

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9
Q

Toxoplasma gondii encephalitis (aka Toxo) in HIV is indicated by CD4+ count < ___ cells/mm3

A

100

remember: Ghandi lived to be 100 years old

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10
Q

Mycobacterium avium complex infection in HIV is indicated by CD4+ count < ___ cells/mm3 & treatment should be initiated if:

A

50

not taking ART

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11
Q

In PCP or PJP, primary ppx in HIV should be discontinued when CD4+ count >/= ___ cells/mm3 for >/= __ months on ART

A

200

3 months

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12
Q

In Mycobacterium avium complex, primary ppx in HIV should be discontinued when

A

taking fully suppressive ART

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13
Q

Preferred ppx regimen for PCP or PJP (including frequency)

A

Bactrim daily

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14
Q

Alternative ppx regimens for PCP or PJP

A
Dapsone 
OR
Dapsone + pyrimethamine + leucovorin
OR
Atovaquone
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15
Q

Preferred ppx regimen for Toxoplasma gondii encephalitis

A

Bactrim

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16
Q

Alternative ppx regimens for Toxoplasma gondii encephalitis

A

Dapsone + pyrimethamine + leucovorin
OR
Atovaquone

17
Q

Preferred ppx regimen for Mycobacterium avium complex (including dose)

A

Azithromycin 1,200 mg PO weekly

Think of MAC & Z-pak

18
Q

Candidiasis preferred treatment

A

Fluconazole

19
Q

Candidiasis alternative treatment

A

Itraconazole

20
Q

Cryptococcal meningitis preferred regimen

A

Amphotericin B (dexycholate or liposomal) + flucytosine

21
Q

Cryptococcal meningitis alternative regimen

A

Fluconazole

22
Q

Cytomegalovirus preferred treatments

A

Valganciclovir or ganciclovir

23
Q

Cytomegalovirus alternative treatments

A

Foscarnet or cidofovir

24
Q

Mycobacterium avium complex preferred treatment regimen

A

(Clarithromycin or azithromycin) + ethambutol

25
Q

PCP preferred treatment regimen

A

Bactrim

26
Q

PCP alternative treatment regimen

A

Atovaquone or pentamidine IV

27
Q

Toxoplasmosis gondii encephalitis preferred treatment

A

Pyrimethenamine + leucovorin + sulfadiazine

28
Q

Toxoplasmosis gondii encephalitis alternative treatment

A

Bactrim