HIV Management Chart Flashcards
After HIV dx, freq of CD4 count
q3-4 mo;
q6 mo if pt adheres to protocols and have stable status fo 2-3 yrs
When do you start antiviral therapy in HIV?
When CD4 <350cells/ml OR If Hx of AIDS defining illness Also pregnant women, HIV assoc nephropathy, and Hep B coinfection
What are AIDS defining illnesses?
Pneumocystis jirovecii pneumonia Esophageal candidiasis Wasting Kaposi sarcoma Disseminated Mycobacterium avium infxn Tuberculosis Cytomegalovirus disease HIV assoc dementia Toxoplasmosis Immunoblastic lymphoma Chronic cryptosporidiosis Burkitt lymphoma Disseminated Histoplasmosis Invasive cervical cancer Chronic HSV infxns
When do you start PCP prophylaxis in HIV?
CD4 <200
Or hx of oropharyngeal candidiasis
Drug of choice for PCP ppx
Trimethoprim-sulfamethoxide
TMP-SMX (Bactrim)
PCP ppx with Bactrim allergy
Dapsone
Aerosolized pentamidine
Atovaquone
When to start MAC ppx in HIV
CD4 <50
Drugs for MAC ppx
Clarithromycin or
Azithromycin
Alternative: rifabutin
T or F:
Once theCD4 count <200, pt is immediately considered to have AIDS even without an opportunistic infection?
True
T or F: give the MMR vaccine
True
CD4 must be >200
T or F: give the Varicella vaccine
True
CD4 count must be >200
T or F: Do not give the Influenza vaccine
False
Give flu vaccine every year to HIV pts
T or F: Pneumococcal vaccine should be given.
True
Given to all HIV pts
Consider revaccination q5 yrs
T or F: give the Hep A vaccine
True if pt has increased risk of Hep A
T or F: give the Hep B vaccine
True
T or F: PPD testing should be done annually
True if initial test negative and pt is at risk
T or F: oral polio vaccine should be given to HIV pt at risk of exposure through travel or work
False
Use inactive polio injection
The risk of which cancer is increased on skin and in the mouth?
Kaposi sarcoma
The risk of which blood cell cancer is increased?
Non-hodgkin lymphoma
Usually primary B-cell lymphomas of the CNS
What do positive india ink preparations of cerebrospinal fluid indicate?
Cryptococcus neoformans meningitis
What do ring enhancing lesions in the brain CT or MRI indicate
Toxoplasmosis
Cystocercosis/Taenia solium Or
Lymphoma
T or F: HIV may cause thrombocytopenia
True
T or F: HIV may cause dementia
True
T or F: HIV protects against peripheral neuroparhies
False
Can cause them
