HIV/AIDS and opportunistic infections

Question 1

US populations most at risk for HIV contraction

Answer 1

african american and hispanic gay and bisexual men

Question 2

Area of the world that bears heaviest burden of HIV/AIDS

Answer 2

subsaharan Africa

Question 3

Clinical signs of HIV

Answer 3

asymptomatic, often for years

Question 4

Mean time between infection of HIV and AIDS development

Answer 4

10 years

Question 5

Clinical PE findings specific for HIV

Answer 5

hairy leukoplakia, disseminated Kaposi sarcoma, cuteaneous bacillary angiomatosis

Question 6

HIV initial lab diagnostic test

Answer 6

immunoassay for HIV antibody and HIV p24 ag

Question 7

Test that follows HIV-1/2 Ag/Ab combo assay

Answer 7

HIV-1/2 Ab differentiation immunoassay

Question 8

HIV samples negative on Ab differentiation are tested next with what assay?

Answer 8

HIV-1 nucleic acid amplification test

Question 9

If NAAT is pos with a neg. Ab test, dx is

Answer 9

acute HIV

Question 10

If specimen is positive on combo assay, then negative on Ab differentiation and NAAT, dx is…

Answer 10

false-positive

Question 11

Nonspecific lab findings in patients with HIV

Answer 11

anemia, leukopenia, thrombocytopenia, ESR increased, polyclonal hypergammaglobulinemia, hypercholestrolemia, cutaneous anergy

Question 12

Marker used to guide HIV therapy decisions and prognostics

Answer 12

CD4 count

Question 13

Common side effects/OI of CD4 ct >300

Answer 13

Pneumococcal pneumonia, TB, herpes zoster, oral candidiasis, vaginal candidiasis, fatigue

Question 14

Common side effects/OI of CD4<300

Answer 14

Oral Hairy leukoplakia, thrush, fever, weight loss, diarrhea

Question 15

Opportunistic infections and diseases of CD4<200

Answer 15

P. jirovecii, disseminated histoplasmosis, kaposi sarcoma, extrapulmonary TB, NHL, CNS lymphoma

Question 16

Opportunistic infections of CD4<100

Answer 16

Crypto, esophageal candidiasis, toxoplasmosis

Question 17

Opportunistic infections of CD4<50

Answer 17

Mycobaterium-avium complex, CMV, primary CNS lymphoma

Question 18

How often should CD4 counts be checked?

Answer 18

Every 3-6 months

Question 19

Differential considerations for HIV sxs

Answer 19

Cancer, chronic infections, endocrine diseases; pulmonary, neuro, GI presentations

Question 20

AIDS-defining illnesses

Answer 20

P. jirovecii, Kaposi sarcoma, CMV infection, histoplasmosis, crypto, coccidioidomycosis, TB

Question 21

P. jirovecii pneumonia

Answer 21

most common OI associated with AIDS; fever, cough, SOB, atypical apical infiltrates

Question 22

Dx of P. jirovecii

Answer 22

Wright-Giemsa stain, direct fluorescence ab, bronchoalveolar lavage

Question 23

Lab findings that make P. jirovecii unlikely

Answer 23

normal diffusing cap of CO, CT scan that demonstrates no interstitial lung disease, CD4>250 within 2 mo prior to resp symptoms

Question 24

Most common cause of pulmonary disease in HIV-infected persons

Answer 24

CA-pneumonia

Question 25

Toxoplasmosis clinical findings

Answer 25

HA, fever, focal neuro deficit, AMS, seizures

Question 26

Toxo CT findings

Answer 26

multiple subcortical lesions with predilection for basal ganglia

Question 27

Second most common cause of space-occupying brain lesion in HIV patients

Answer 27

primary CNS lymphoma

Question 28

Primary CNS lymphoma

Answer 28

DLCBcell, often associated with EBV

Question 29

Presentation of primary CNS lymphoma

Answer 29

mass lesion, HA, neuropsych sxs, focal deficits, altered gait, seizures, onset days-weeks

Question 30

Major complications associated with CMV

Answer 30

retinitis, colitis, esophageal ulceration, encephalitis, pneumonitis

Question 31

Kaposi Sarcoma

Answer 31

vascular tumor associated with HHV-8 that often appear on lower extremities, face, oral mucosa, and genitalia

Question 32

Kaposi sarcoma lesion description

Answer 32

papular, mm to cm in diameter

Question 33

Prophylactic treatment P. jirovecii

Answer 33

TMP-SMX, 1 DS tablet daily PO

Question 34

TB prophylaxis

Answer 34

Isoniazid + pyridoxine x 9months

Question 35

T. gondii prophylaxis

Answer 35

TMP-SMX 1 DS tablet PO qd

Question 36

Varicella prophylaxis

Answer 36

acyclovir 800 mg PO 5x day for 5-7 days

Question 37

Immunizations recommended for HIV patients

Answer 37

Hep B, Hep A, influenza, S. pneumoniae, HPV

Question 38

Vaccines for HIV patients to avoid

Answer 38

live vaccines