HIV Infection

Question 1

Presumed severe HIV disease diagnostic factors x3

Answer 1

Infant with positive rapid antibody test and:
Combination of 2 : oral thrush, pneumonia, severe sepsis
OR
At least 1 : severe unexplained wasting, pneumocystis pneumonia, candidiasis

Question 2

Comorbidities associated with HIV infection in children x7

Answer 2

Pneumonia
Malnutrition
Septicaemia
Meningitis
Chronic lung disease
Skin diseases
Malignancy

Question 3

Organisms that cause septicemia in HIV infection x3

Answer 3

Gram negatives
Pneumococcus
Non typhoidal salmonellae

Question 4

Treatment of pneumocystitis x2

Answer 4

Oxygen therapy
Cotrimoxazole

Question 5

Clinical features of HIV encephalopathy x3

Answer 5

Developmental delay
Behavioral alterations
Loss of developmental milestones

Question 6

What are the CT findings of HIV encephalopathy x3

Answer 6

Brain atrophy
Increased ventricular size
Calcifications in basal ganglia and frontal lobes

Question 7

Characteristics of lymphoid interstitial pneumonitis x2

Answer 7

Diffuse bilateral reticulonodular infiltrates
Finger clubbing

Question 8

Strategies to prevent mother to child transmission x4

Answer 8

HIV testing during pregnancy
ART therapy to reduce viral load
Intrapartum care
Postpartum ART for the infant

Question 9

Elimination of MTCT x2

Answer 9

6 weeks of prophylaxis to high risk HIV exposed infants
6 weeks nevirapine to low risk infants

Question 10

Causes of poor adherence to treatment x5

Answer 10

Stigma
Illness in caregivers
High pill burden
Lack of disclosure of mothers status
Difficulties with access to care
Not accepting the need for medication in a child that seems well
Denial in older children and adolescents

Question 11

Factors that increase risk of vertical transmission x5

Answer 11

High viral load (maternal) and in breast milk
Vaginal delivery, chorioamnionitis
Mastitis or cracked nipple
Prolonged rupture of membranes
Baby with mouth sore or oral thrush

Question 12

State the 4 WHO HIV clinical stages

Answer 12

1. Asymptomatic
2. Mild
3. Advanced
4. Severe

Question 13

Characteristics of stage 2 HIV x5

Answer 13

Angular cheilitis
Herpes zoster
Hepatosplenomegaly
Linear gingival arythema
Papular pruritic eruptions

Question 14

Characteristics of stage 3 HIV x5

Answer 14

TB, Pneumonia
Anemia, Thrombocytopenia
Oral candidiasis
Oral hairy leukoplakia

Question 15

State 5 characteristics of stage 4 HIV

Answer 15

Pneumocystis pneumonia
Extrapulmonary TB
Disseminated non tb mycobaterial infection
Invasive cervical cancer
HIV encephalopathy

Question 16

Causes of meningitis in HIV positive children x3

Answer 16

MTB
Pneumococcus
Non typhoidal salmonella

Question 17

Causes of persistent lung disease in HIV x4

Answer 17

Tuberculosis
Bronchiectasis
Recurrent pneumonia
Lymphocytic interstitial pneumonitis