Ex2 HIV

Question 1

Common adverse effect of HIV

Answer 1

Pneumocystis jirovecci pneumonia

Question 2

Defining characteristics of Pneumocystis jirovecci pneumonia

Answer 2

CD4 count < 200

Ground glass opacities on X-ray

Question 3

Rx for Pneumocystis jirovecci pneumonia

Answer 3

Bactrim

+ maybe steroids

Question 4

NRTI Unique effects

Answer 4

Lactic Acidosis w/ mitochondrial dysfunction
Peripheral Neuropathy (Didanosine, Stavudine)
Bone marrow suppression (Zidovudine)
Distributive Shock - Human Leukocyte antigen B*5701 (Abacavir)

Question 5

Unique adverse effects of NNRTI

Answer 5

Hypersensitivity (etravirine)

Lactic acidosis w/ hepatic steatosis (tenofovir)

Question 6

Common adverse effect of protease inhibitors

Answer 6

GI intolerance

Question 7

Unique adverse effect of protease inhibitors - Atazanavir

Answer 7

Heart block

Question 8

Unique adverse effect of protease inhibitors - Tipranavir

Answer 8

Intracranial hemorrhage

Question 9

Unique effect of fusion inhibitors

Answer 9

Hypersensitivity Rxn at inj site

Pneumonia

Question 10

Integrate inhibitors - unique adverse effect

Answer 10

Creatinine kinase elevation/rhabdomyolysis

Question 11

NNRTIs Intxns with anesthetic drugs

Answer 11

Induces CYP3A4 — all anesthetic drugs will decrease in concentration

Question 12

PI Intxns with anesthetic drugs

Answer 12

Inhibit CYP3A4 — all anesthetic drugs will increase in concentration

Question 13

Drugs that will increase levels of anesthetics d/t _____ of CYP3A4

Answer 13

Cobicistat
Ritonavir
*inhibit

Question 14

Patients with myalgia - anesthetic use of ____ should be cautioned

Answer 14

Succinylcholine

Question 15

Patient is presenting as hemodynamically unstable, neurogenic shock, what may be occurring?

Answer 15

Autonomic neuropathy

Question 16

CVS considerations in anesthetics for HIV patients

Answer 16

Myocarditis is common - make sure to have TTE

Adrenal insufficiency - may cause refractory hypotension

Question 17

HIV patients should not receive what?

Answer 17

Excessive blood transfusions

Question 18

Management of current meds in periop

Answer 18

All or Nothing Model — implemented

Never hold or only continue partial regimen, hold all if absorption is limited