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USMLE Secrets Step 3- ch13-15 > HIV Management Chart > Flashcards

HIV Management Chart Flashcards

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USMLE® Step 1 flashcards
1
Q

After HIV dx, freq of CD4 count

A

q3-4 mo;

q6 mo if pt adheres to protocols and have stable status fo 2-3 yrs

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2
Q

When do you start antiviral therapy in HIV?

A 
When CD4 <350cells/ml OR
If Hx of AIDS defining illness
Also pregnant women, 
HIV assoc nephropathy, and
Hep B coinfection
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3
Q

What are AIDS defining illnesses?

A 
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
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4
Q

When do you start PCP prophylaxis in HIV?

A

CD4 <200

Or hx of oropharyngeal candidiasis

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5
Q

Drug of choice for PCP ppx

A

Trimethoprim-sulfamethoxide

TMP-SMX (Bactrim)

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6
Q

PCP ppx with Bactrim allergy

A

Dapsone
Aerosolized pentamidine
Atovaquone

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7
Q

When to start MAC ppx in HIV

A

CD4 <50

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8
Q

Drugs for MAC ppx

A

Clarithromycin or
Azithromycin

Alternative: rifabutin

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9
Q

T or F:

Once theCD4 count <200, pt is immediately considered to have AIDS even without an opportunistic infection?

A

True

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10
Q

T or F: give the MMR vaccine

A

True

CD4 must be >200

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11
Q

T or F: give the Varicella vaccine

A

True

CD4 count must be >200

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12
Q

T or F: Do not give the Influenza vaccine

A

False

Give flu vaccine every year to HIV pts

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13
Q

T or F: Pneumococcal vaccine should be given.

A

True
Given to all HIV pts
Consider revaccination q5 yrs

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14
Q

T or F: give the Hep A vaccine

A

True if pt has increased risk of Hep A

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15
Q

T or F: give the Hep B vaccine

A

True

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16
Q

T or F: PPD testing should be done annually

A

True if initial test negative and pt is at risk

17
Q

T or F: oral polio vaccine should be given to HIV pt at risk of exposure through travel or work

A

False

Use inactive polio injection

18
Q

The risk of which cancer is increased on skin and in the mouth?

A

Kaposi sarcoma

19
Q

The risk of which blood cell cancer is increased?

A

Non-hodgkin lymphoma

Usually primary B-cell lymphomas of the CNS

20
Q

What do positive india ink preparations of cerebrospinal fluid indicate?

A

Cryptococcus neoformans meningitis

21
Q

What do ring enhancing lesions in the brain CT or MRI indicate

A

Toxoplasmosis
Cystocercosis/Taenia solium Or
Lymphoma

22
Q

T or F: HIV may cause thrombocytopenia

A

True

23
Q

T or F: HIV may cause dementia

A

True

24
Q

T or F: HIV protects against peripheral neuroparhies

A

False

Can cause them

25
Q

T or F: HIV-positive mothers may breastfeed their infants

A

False

Breastfeeding can transmit the virus

26
Q

What is the first choice agent for CMV retinitis?

A

Valganciclovir

27
Q

What is the second choice agent for CMV retinitis?

A

Ganciclovir
Foscarnet and
Cidofivir

28
Q

T or F: pregnant patients should receive antiviral therapies.

A

True

3 drug HAART

29
Q

T or F: infants born to HIV positive mothers should take zidovidine (ZDV)

A

True

For at least 6 wk after delivery

30
Q

T or F: cesarean section increases transmission risk of HIV.

A

False

It may decrease transmission

31
Q

What is the most likely agent of pneumonia in HIV positive patients?

A

Strep pneumo

32
Q

Name a stain used on sputum to detect PCP.

A

Silver (Wright-Giemsa or Giemsa)

33
Q

Name two pathogens that cause chronic diarrhea only in AIDS.

A

Cryptosporidium and Isospora spp

34
Q

T or F: Herpes zoster infection in young adults represents possible HIV infection.

A

True

Suggests immunodeficiency

35
Q

T or F: Thrush in young adults may mean HIV.

A

True

Also associated with diabetes, leukemia, ands steroids

36
Q

T or F: A positive HIV antibody test in a newborn is unreliable.

A

True.

Maternal antibodies in the neonate can give a false positive result for first 6 mo.

USMLE Secrets Step 3- ch13-15 (4 decks)

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