Infectious

Question 1

vaccines contraindicated in severe HIV

Answer 1

MMR, varicella, herpes

Question 2

prophlaxis against …. if CD4 <….
<200
<100
<50

Answer 2

<200 pneumocystis pneumonia-TMP-SMX or alternative - dapsone, atovaquone, pentamidine
<100 toxoplasmosis - TMP-SMX, dapsone if sulfa allergy or alternative - atovaquone + pyrimethamine and leucovorin
<50 MAC - azithromycin, if starting ART no prophylaxis needed - alternative - clarithromycin, rifabutin

Question 3

SIRS criteria versus sepsis versus severe sepsis

Answer 3

HR> 90
RR >20
T > 38 or < 36
WBC > 12, <4 or bandemia >10%

SIRS + source of infxn
sepsis + organ dysfxn (elevated lactic acid, reduced systolic, other organ injury)