Opportunistic Infections

Question 1

IMMUNOCOMPROMISED STATES (5)

Answer 1

HIV WITH CD4 < 200 (AIDS)
STEROID USE FOR > 14 DAYS AT A PREDNISONE DOSE > 20MG/DAY AND >2 MG/KG/DOSE
ASPLENIA
IMMUNOSUPPRESSANTS FOR AUTOIMMUNE CONDITIONS OR TRANSPLANTS
CHEMOTHERAPY WITH ANC < 500

Question 2

IN HIV, WHICH PRIMARY PROPHYLAXIS IS RECOMMENDED

Answer 2

PNEOMOCYSTITIS JIROVECII PENUMONIA (PJP OR PCP)
TOXOPLASMA GONDII ENCEPHALITIS
MYCOBACTERIUM AVIUM COMPLEX

Question 3

WHAT IS THE CRITERIA FOR STARTING PRIMARY PROPHYLAXIS IN HIV FOR PJP

Answer 3

CD4 < 200
OR AIDS DEFINING ILLNESS

Question 4

WHAT IS THE CRITERIA FOR STARTING PRIMARY PROPHYLAXIS IN HIV FOR TOXOPLASMA GONDII ENCEPHALITIS

Answer 4

TOXOPLASMA IGG POSITIVE AND CD4 COUNT < 100

Question 5

WHAT IS THE CRITERIA FOR STARTING PRIMARY PROPHYLAXIS IN HIV FOR MAC

Answer 5

NOT RECOMMENDED IF ART IS STARTED IMMEDIATELY
INITIATE IF NOT TAKING ART AND CD4 < 50

Question 6

WHAT IS THE CRITERIA FOR DC’ING PRIMARY PROPHYLAXIS IN HIV FOR PJP

Answer 6

CD4 > 200 FOR > 3 MONTHS ON ART

Question 7

WHAT IS THE CRITERIA FOR DC’ING PRIMARY PROPHYLAXIS IN HIV FOR TOXOPLASMA GONDII ENCEPHALITIS

Answer 7

CD4 COUNT > 200 FOR > 3 MONTHS

Question 8

WHAT IS THE CRITERIA FOR DC’ING PRIMARY PROPHYLAXIS IN HIV FOR MAC

Answer 8

TAKING FULLY SUPPRESSIVE ART

Question 9

OI TREATMENT: OROPHARYNGEAL CANDIDIASIS

Answer 9

FLUCONAZOLE
ALT: ITRACONAZOLE

Question 10

OI TREATMENT: CRYPTOCOCCAL MENINGITIS

Answer 10

AMPHO B + FLCYTOSINE
ALT: FLUCONAZOLE ± FLUCYTOSINE

Question 11

OI TREATMENT: CMV

Answer 11

VALGANCICLOVIR OR GANCICLOVIR
ALT: FOSCARNET OR CIDOFOVIR

Question 12

OI TREATMENT: MAC

Answer 12

(CLARITHROMYCIN OR AZITHROMYCIN) ± ETHAMBUTOL

Question 13

OI TREATMENT: PJP

Answer 13

SMX/TMP
ALT: ATOVAQUONE OR PENTAMIDINE IV

Question 14

OI TREATMENT: TOXOPLASMOSIS GONDII ENCEPHALITIS

Answer 14

PYRIMETHAMINE + LEUCOVERIN + SULFADIAZINE
ALT: AMX/TMP

Question 15

OI PRIMARY PROPHYLAXIS: PJP

Answer 15

SMX/TMP
ALT: DAPSONE ± (PYRIMETHAMINE + LEUCOVORIN) OR ATOVAQUONE

Question 16

OI PRIMARY PROPHYLAXIS: TOXOPLASMOSIS

Answer 16

SMX/TMP
ALT: (DAPSONE + LEUCOVORIN + PYRIMETHAMINE) OR ATOVAQUONE

Question 17

OI PRIMARY PROPHYLAXIS: MAC

Answer 17

AZITHROMYCIN 1200MG PO WEEKLY

Question 18

OROPHARYNGEAL CANDIDIASIS
SECONDARY PROPHYLAXIS RECOMMENDED? IF SO WHAT IS THE REGIMEN?

Answer 18

NO

Question 19

CRYPTOCOCCAL MENINGITIS
SECONDARY PROPHYLAXIS RECOMMENDED? IF SO WHAT IS THE REGIMEN?

Answer 19

YES
LOW DOSE FLUCONAZOLE

Question 20

CMV
SECONDARY PROPHYLAXIS RECOMMENDED? IF SO WHAT IS THE REGIMEN?

Answer 20

NONE
GOAL: MAINTAIN CD4 > 100

Question 21

MAC
SECONDARY PROPHYLAXIS RECOMMENDED? IF SO WHAT IS THE REGIMEN?

Answer 21

SAME AS TREATMENT REGIMEN

Question 22

PJP
SECONDARY PROPHYLAXIS RECOMMENDED? IF SO WHAT IS THE REGIMEN?

Answer 22

SAME AS PRIMARY PROPHYLAXIS

Question 23

TOXOPLASMOSIS
SECONDARY PROPHYLAXIS RECOMMENDED? IF SO WHAT IS THE REGIMEN?

Answer 23

SAME AS TREATMENT BUT LOWER DOSES