HIV Opportunistic Infections - Grinn

Question 1

CNS Toxoplasmosis is seen when pts CD4 is lower than

Answer 1

100

-Can be reactivated via prior infection

Question 2

If CD4+ Count is less than 200 then how does Tb present?

What organs are commonly affected

Answer 2

1) Disseminated Disease with miliary pattern

2) GI, Bone, Brain, LN

Question 3

When is CMV typically seen

Answer 3

<50

Question 4

How would you get a definitive diagnosis of Toxo

Answer 4

Brain Biopsy

Question 5

Oropharyngeal Candidiasis (Thrush) Signs

Answer 5

White plaques on erythematous mucosa

Question 6

HIV+ pts may have a reactivation or new infection of ___ when their CD4+ count is less than 500.

Answer 6

Mycobacterium Tb

Question 7

How is retinitis Dx

Answer 7

Retinal Exam by ophthalmologist

Question 8

How do you Dx Primary CNS Lymphoma

Answer 8

1) Brain Biopsy for Definitive Diagnosis

2) CSF presents with malignant lymphoid cells

Question 9

MRI catches ___ in a pt who has CNS toxoplasmosis

Answer 9

1) Multiple ring enhancing lesions

Question 10

Sx of Colitis

Answer 10

1) Diarrhea
2) Abdominal Pain
3) Weight Loss

Question 11

Sx of Mycobacterium Tb

Answer 11

1) Fever
2) Cough
3) Dyspnea
4) Weight Loss
5) Night Sweats

Question 12

How would you treat a Toxo infection

Answer 12

Empirically and Monitor for Improvement

Question 13

Sx of Cryptococcal Meningitis

Answer 13

1) Fever
2) Altered Mental Status
3) Headache

** Focal Deficits are less common

Question 14

What bacteria normally causes Community acquired pneumonia

Answer 14

1) Strep. Pneumonia

2) H. Influenza

Question 15

Dx of Colitis

Answer 15

Colonoscopy w. mucosal ulcerations

- owls eye - cytoplasm inclusion bodies

Question 16

Mycobacterium avium intracellular infection (MAI) is seen in pts with a CD4 less than ___ but normally less than ___

Answer 16

1) 50

2) 10

Question 17

Location of Oral Hairy Leukoplakia

Answer 17

Lateral Tongue

Question 18

Imaging indications of Tb

Answer 18

1) Apical Cavitary Lesion in Upper Lung Lobe

Question 19

Conditions of CMV in an AIDS pt

Answer 19

1) Retinitis

2) Colitis

Question 20

What is the leading cause of meningitis in AIDS pts

Answer 20

1) Cryptococcal Meningitis

Question 21

Sx of retinitis

Answer 21

1) Floaters
2) Scotomas (Flashing lights)
3) Visual Field Cut

Question 22

What prophylaxis is used for PJP and Toxo

Answer 22

Trimethoprim-sulfamethoxazole (TMP-SMX) Daily

Question 23

Esophageal Candidiasis Signs

Answer 23

1) Odynophagia

2) Retrosternal pain

Question 24

What is shown on a CXR when a pt has community acquire pneumonia

Answer 24

1) Infiltrate

Question 25

Esophageal Candidiasis can be caused by

Answer 25

1) HSV

2) CMV

Question 26

Candidiasis in HIV can lead to ____ or ___

Answer 26

1) Oropharyngeal Candidiasis

2) Esophageal Candidiasis

Question 27

What is the most common infection with pts who have a CD4 count less than 200

Answer 27

Pneumocystis Jirvoecii Pneumonia

Question 28

CD4+ Count: Immune System is healthy

Answer 28

> 500

Question 29

When a pt has PJP, CXR may be normal, but On a CT what in indicative of PJP

Answer 29

Ground-glass infiltrates

Question 30

What causes Oral Hairy Leukoplakia

Answer 30

EBV

Question 31

MRI shows a single ring enhancing lesion in ___

Answer 31

Primary CNS Lymphoma

Question 32

How to receive the Definitive Diagnosis of PJP

Answer 32

1) Analysis of Sputum

2) Bronchoalveolar Lavage

Question 33

Sx of CNS Toxoplasmosis

Answer 33

1) Fever
2) Headache
3) Focal Neuro Deficits: Seizure, Aphasia, and Hemiparesis

Question 34

CD4+ Count: Weak Immune System

Answer 34

200-500

Question 35

CD4+ Count: <200 or and defining conditions

Answer 35

AIDS

Question 36

PJP is common when the CD4+ count is less than ___

Answer 36

200

Question 37

Indications of PrEP

Answer 37

1) Sex with untreatedHIV
2) Hx of recent condomless sex (anal)
3) Hx of recent bacterial STI
4) Multiple sex partners of unknown HIV status

Question 38

Primary CNS Lymphoma is seen when CD4 count drops lower than ___

Answer 38

50

Question 39

Sx of Mycobacterium Avium Intracellular Infection

Answer 39

1) Constitutional Sx
- Fever
- Weight Loss
- Night Sweats
2) Abdominal Pain
3) Lymphadenopathy

Question 40

Clinical Sx of PJP

Answer 40

1) Fever
2) Non-productive cough
3) Pleuritic Chest Pain
4) Dyspnea

Question 41

An HIV+ pt is at risk for ___ at any CD4 count

Answer 41

Community Acquired Pneumonia

-Most common pulm infection

Question 42

CD4 count for Cryptococcal Meningitis

Answer 42

<100

Question 43

Lab abnormalities in PJP

Answer 43

Increased LDH

Hypoxemia on ABG

Question 44

After a Bronchoalveolar Lavage in order to receive a Definitive Diagnosis you must do a: ___ or ___

Answer 44

1) Wright-Giemsa Stain

2) PCR

Question 45

Physical Findings in Pneumocystis J Pneumonia

Answer 45

Exertional Hypoxia

Question 46

How is MAI Dx

Answer 46

Mycobacterium Blood Cultures

Question 47

Dx of Cryptococcal Meningitis

Answer 47

1) CSF lumbar puncture shows elevated opening pressure

2) Cryptococcal antigen +

Question 48

Candidiasis in HIV occurs with a CD4 count less than ___

Answer 48

200

Question 49

Sx of Community Acquired Pneumonia

Answer 49

1) Fever
2) Cough
3) SOB