HIV

Question 1

What 3 conditions are necessary for HIV transmission

Answer 1

Present in Body Fluid
In sufficient quantity
Needs a portal of entry into the bloodstream

Question 2

What are the 3 modes of HIV transmission

Answer 2

Sexual
Blood (transfusion/transplant, needle use)
Vertical

Question 3

What is the AIDS defining illness with a CD4 level of less than 200cell/uL?

Answer 3

Pneumocystis jiroveci (PCP)

Question 4

What is the AIDS defining illness with a CD4 level of less than 50cells/uL?

Answer 4

Mycobacterium Avium Complex (MAC)

Question 5

What is the procedure for testing an adult patient for HIV?

Answer 5

Must have 2 (+) ELISA tests that look for the p24 Antigen

Then a positive Western Blot analysis

(There is a 6 month window after the infection that all the tests will be negative because not enough time has passed for the body to make Abs)

Question 6

What is the procedure for testing a newborn for HIV?

Answer 6

Must do 2 DNA PCR analyses once the baby reaches 18 months

-since the mother is HIV(+) any ELISA or Western blot will definitely come back positive because the baby will have the mother’s Abs. False positive test.

Question 7

When is the AIDS diagnosis made?

Answer 7

An HIV(+) patient that acquires an AIDS defining illness

or

An HIV(+) patient with CD4 count less than 200cells/uL

Question 8

In management for HIV patients, what two screenings should be performed?

Answer 8

1. HLAB5701 antigen screen to check for abacavir hypersensitivity reaction, this will kill them if it is missed
2. Viral load screen, if Viral load does not decrease to less than 47/uL then resistance to the medication’s may have occurred.

Question 9

When should HIV patients start HAART therapy?

Answer 9

Any HIV(+) patient should start therapy right away. They should start all 3 medications together and stop all 3 together.

Question 10

What is the only condition where HIV monotherapy is used?

Answer 10

When AZT is given to the an HIV(+) mother to reduce transmission vertically to the fetus and then given to the newborn for prophylaxis.

Question 11

Drug that causes Hyperchromic Macrocytic Anemia

Answer 11

AZT

Question 12

Drug that causes nephrotoxicity

Answer 12

Tenofovir

Question 13

Drug known to cause neuro adverse effects

Answer 13

Efaviranz

Question 14

Drug that can raise bilirubin levels and what drug class should be avoided with this drug?

Answer 14

Atazanavir

-don’t give PPIs

Question 15

Drug that causes renal lithiasis

Answer 15

Indinavir

Question 16

Drug that causes GI adverse effects

Answer 16

Lopinavir

Question 17

Drug that is merely used as a boosting agent.

Answer 17

Ritonavir

Question 18

What is a “crix belly” and “protease paunch”?

Answer 18

Side effects of HIV therapy. Fat redistribution, loss of fat in face, chest buttocks, legs. Accumulation of fat around visceral organs.

Question 19

Which two lipid drugs are constraindicated in patients on HIV therapy?

Answer 19

Sinvastatin

Lovastatin

Question 20

Prophylactic treatment for Pneumocystis and MAC opportunistic diseases.

Answer 20

Pneumo: TMP-SMZ
MAC: biaxin, zithromax

Question 21

Drug that can cause myelosuppression.

Answer 21

AZT

Question 22

Drug used in post exposure prophylaxis (mainly for health care workers)

Answer 22

Tenofovir