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BCACP > Infectious Diseases I > Flashcards

Infectious Diseases I Flashcards

1
Q

What types of HPV cause cervical, penile, vulvar, vaginal, anal, and oropharyngeal cancers?

A

Oncogenic types 16 and 18

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2
Q

What types of HPV cause genital warts?

A

Nononcogenic types 6 and 11

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3
Q

For who is the HPV vaccine recommended?

A

9-26 years (who have not completed the series)

Individuals 27-45 years - use shared decision-making

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4
Q

What is the HPV vaccine series?

A

If started < 15 years = 2 doses given 6-12 months apart

If started 15-26 years = 3 doses (0, 1-2, and 6 months)

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5
Q

What is the recommended treatment for uncomplicated gonorrhea infection?

A

If < 150 kg = ceftriaxone 500 mg IM x 1

If > 150 kg = ceftriaxone 1000 mg IM x 1

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6
Q

What is an alternative treatment for uncomplicated gonorrhea infection?

A

Gentamicin 240 mg IM x 1
PLUS
Azithromycin 2 g PO x 1

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7
Q

What is the recommended treatment for chlamydia infection?

A

Doxycycline 100 mg PO BID x 7 days

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8
Q

What is an alternative treatment for chlamydia infection?

A

Azithromycin 1 g PO x 1

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9
Q

How long should patients abstain from sexual activity after being treated for chlamydia?

A

7 days after last dose

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10
Q

What is the recommended treatment for primary, secondary, and early latent syphilis?

A

Benzathine PCN G 2.4 million units IM x 1

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11
Q

What alternatives can be used in PCN-allergic patients for treatment of primary, secondary, and early latent syphilis?

A

-Doxycycline 100 mg BID PO x 14 days
-Tetracycline 500 mg QID PO x 14 days
-Ceftriaxone 1 g daily IV/IM for 10 days

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12
Q

What is the recommended treatment for late latent syphilis?

A

Benzathine PCN G 2.4 million units IM once weekly x 3 weeks

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13
Q

What alternatives can be used in PCN-allergic patients for treatment of late latent syphilis?

A

-Doxycycline 100 mg BID PO x 28days
-Tetracycline 500 mg QID PO x 28days

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14
Q

What is the recommended treatment for tertiary syphilis?

A

Benzathine PCN G 2.4 million units IM once weekly x 3 weeks

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15
Q

What is the recommended treatment for neurosyphilis, ocular syphilis, and otosyphilis?

A

Aqueous crystalline PCN G 18-24 millions units/day - given as 3-4 million units IV every 4 hours or as a continuous infusion for 10-14 days

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16
Q

What are recommended treatment options for first episode of genital herpes?

A

-Acyclovir 400 mg TID or 200 mg 5x/day
-Valacyclovir 1 g BID

Duration: 7-10 days

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17
Q

What are recommended treatment options for subsequent episodes of genital herpes?

A

-Acyclovir 800 mg TID x 2 days OR 800 mg BID x 5 days
-Valacyclovir 500 mg BID x 3 days OR 1 g daily x 5 days

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18
Q

What are recommended treatment options for suppression of genital herpes?

A

-Acyclovir 400 mg BID
-Valacyclovir 1 g daily

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19
Q

What is recommended treatment for trichomoniasis?

A

Women: Metronidazole 500 mg BID x 7 days

Men: Metronidazole 2 g as single dose

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20
Q

What patients are at high risk of HIV and should be screened?

A

-MSM
-Multiple sexual partners (men or women)
-Injection drug users

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21
Q

What are symptoms of conversion syndrome (acute HIV infection)?

A

-Fever
-Rash
-Fatigue
-Malaise
-Lymphadenopathy

22
Q

What test should be performed before initiating any antiviral therapy that contains abacavir?

A

HLA-B*5701

23
Q

What medications are considered NRTIs?

A

Nucleoside:
-Emtricitabine
-Abacavir
-Lamivudine
-Zidovudine

Nucleotide:
-TDF
-TAF (lower renal and bone effects)

24
Q

What medications are considered NNRTIs?

A

-Nevirapine
-Efavirenz
-Etravirine
-Rilpivirine
-Doravirine

25
Q

What medications are considered protease inhibitors (PIs)?

A

-Darunavir
-Atazanavir
-Ritonavir (only used as a booster)

26
Q

What medication is considered a fusion inhibitor?

A

Enfuvirtide

27
Q

What medication is considered an attachment inhibitor?

A

Fostemasavir

28
Q

What medication is considered a co-receptor antagonist?

A

Maraviroc

29
Q

What medications are considered integrase strand transfer inhibitors (INSTIs)?

A

-Raltegravir
-Dolutegravir
-Elvitegravir
-Bictegravir
-Cabotegravir

30
Q

What medication is a pharmacokinetic booster?

A

Cobicistat

31
Q

What HIV treatment regimens are considered first-line for most patients?

A

INSTI-based regimens:
-Dolutegravir/abacavir/lamivudine
-Dolutegravir + TDF/emtricitabine
-Dolutegravir + TAF/emtricitabine
-Bictegravir/TAF/emtricitabine

32
Q

What HIV treatment regimen is recommended for patients who received cabotegravir for PrEP who do not undergo integrase inhibitor resistance testing?

A

Boosted darunavir + TDF or TAF + emtricitamine or lamivudine

33
Q

When is antiviral treatment for HIV considered a failure?

A

Viral load fails to become undetectable within 24 weeks of therapy
OR
When a previously undetectable viral load becomes detectable

34
Q

What vaccines are recommended for patients with HIV?

A

-MMR (if CD4 > 200)
-Varicella (if CD4 > 200)
-Hep A
-Hep B
-Pneumococcal
**If received a dose of PCV13, can use either PPSV23 or PCV20
-Tdap
-Influenza
-HPV
-Zoster

35
Q

How often should patients w/ HIV be screened for TB?

A

Annually

36
Q

When is primary prophylaxis for PJP indicated?

A

CD4 < 200 or < 14% of total lymphocyte count
OR
CD4 200-250 if ARV therapy initiation must be delayed and routine Cd4 monitoring is not possible

Can discontinue when CD4 > 200 for at least 3 months

37
Q

What is the recommended regimen for primary prophylaxis of PJP?

A

Trimethoprim/sulfamethoxazole 1 DS tablet daily (preferred) or 1 SS tablet daily or 1 DS tablet three times weekly

*Alternatives: dapsone, atovaquone, nebulized pentamidine

38
Q

What is the recommended regimen for treatment of PJP?

A

Trimethoprim/sulfamethoxazole 15-20 mg/kg IV for 21 days

39
Q

When is primary prophylaxis for toxoplasmosis indicated?

A

CD4 < 100

40
Q

What is the recommended regimen for primary prophylaxis of toxoplasmosis?

A

Trimethoprim/sulfamethoxazole 1 DS tablet daily

Can discontinue when CD4 > 200 for at least 3 months

41
Q

When is primary prophylaxis for MAC indicated?

A

CD4 < 50

42
Q

What is the recommended regimen for primary prophylaxis of MAC?

A

Azithromycin 1200 mg once weekly or 600 mg twice weekly

Can discontinue when CD4 > 100 for at least 6 months

43
Q

How soon should treatment be used following occupational exposure to HIV?

A

ASAP but at least within 72 hours

Regimen: TDF/emtricitabine + raltegravir for 28 days

44
Q

What regimens are available for PrEP?

A

-TDF 300 mg + emtricitabine 200 mg daily (Truvada)
-TAF 25 mg + emtricitabine 200 mg daily (Descovy)

45
Q

What is the time to protective effects for oral PrEP?

A

7 days for anal tissue

21 days for vaginal tissue

46
Q

How often should patients be screened for HIV when on PrEP

A

Every 3 months

47
Q

What patients should influenza treatment be considered for?

A

-High risk of complications w/ persistent illness and a positive test result > 48 hours after symptom onset
-Confirmed or highly suspected influenza within 48 hours of symptoms onset who wish to shorten duration of illness or who are in contact with high-risk individuals

48
Q

Which influenza vaccines are recommended for patients 65 years+?

A

-HD-IIV
-RIV
-aIIV

49
Q

What is the recommended treatment for uncomplicated herpes zoster infection?

A

Acyclovir 800 mg PO five times daily for 7-10 days

50
Q

What is recommended for all patients when they begin to receive HIV care, regardless of initiation of ART?

A

Genotype testing

BCACP (20 decks)

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