HIV associated conditions

Question 1

PJP pneumonia management

Answer 1

High dose co-trim with maybe steroids

Question 2

PJP prophylaxis

Answer 2

Low dose co-trimoxazole if CD4 count <200

Question 3

What is the screening for CMV in HIV?

Answer 3

Ophthalmic screening if CD4 <50

Question 4

Below what CD4 count does someone with HIV begin to get opportunistic infections?

Answer 4

200

Question 5

What is the CXR appearance of PJP pneumonia?

Answer 5

Looks like heart failure:
May be normal
Interstitial infiltrates
Reticulonodular shadowing

Question 6

PJP diagnostic investigation

Answer 6

Bronchial alveolar lavage with immunofluorescence and PCR

Question 7

What virus will be found in progressive multifocal leukoencephalopathy in HIV and what will the CD4 count be?

Answer 7

JC virus

<100

Question 8

CMV infection in HIV presentation and what will their CD4 count be?

Answer 8

Reduced visual acuity
Floaters
Abdominal pain
Diarrhoea
PR bleeding

Question 9

Progressive multifocal leukoencephalopathy

Answer 9

Rapidly progressing
Focal neurology
Confusion
Personality change

Question 10

Presentation of HIV-associated neurocognitive impairment

Answer 10

Reduced short term memory

Maybe motor dysfunction

Question 11

What organism causes Kaposi’s sarcoma and what is the CD4 threshold for this condition?

Answer 11

Human herpes virus 8

Any CD4, but increased risk at lower counts

Question 12

Management of Kaposi’s sarcoma.

Answer 12

HAART
Local therapies
Systemic chemotherapy (for visceral disease)

Question 13

What type of lymphoma occurs in HIV and what organism causes this?

Answer 13

Non-hodgkins (Burkitt’s, primary CNS lymphoma)

EBV

Question 14

How does HIV associated lymphoma differ from someone who does not have HIV?

Answer 14

More advanced disease

Increased CNS involvement

Question 15

Management of HIV associated lymphoma

Answer 15

Treat the HIV

Question 16

What are the conditions that patients with HIV will get more often even if they are not immunosuppressed?

Answer 16

Mucosal candidiasis (particularly oral)
Seborrhoeic dermatitis
Diarrhoea
Fatigue
Worsening psoriasis
Lymphadenopathy
Parotitis
Epidemiologically linked conditions:
STIs
Hepatitis B
Hepatitis C

Question 17

What haematological problems can HIV cause other than cancer?

Answer 17

Anaemia

Thrombocytopaenia