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NAPLEX ID > Opportunistic Infections > Flashcards

Opportunistic Infections Flashcards

1
Q

What is the primary prophylaxis regimen for

Pneumocystis jirovecii pneumonia (PJP or PCP)

in HIV

A

Initiation: CD4 count ≤ 200 cells/mm3 or AIDS-defining illness

SMX/TMP DS daily

Discontinuation: CD4 count > 200 cells/mm3 for > 3 months on ART

Alternatives:
Dapsone
Dapsone + pyrimethamine + leucovorin
Atovaquone

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2
Q

What is the primary prophylaxis regimen for

Mycobacterium avium complex (MAC)

in HIV

A

Initiation: if not taking ART and CD4 count < 50 cells/mm3

Azithromycin 1,200 mg weekly

Discontinuation: taking fully suppressive ART

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3
Q

What is the primary prophylaxis regimen for

Toxoplasma gondii encephalitis

in HIV

A

Initiation: toxoplasma IgG positive and CD4 count < 100 cells/mm3

SMX/TMP DS daily

Discontinuation: CD4 count > 200 cells/mm3 for > 3 months on ART

Alternatives:
Dapsone + pyrimethamine + leucovorin
Atovaquone

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4
Q

What is the preferred treatment for

Candidiasis (thrush)
(oropharyngeal/esophageal)

A

Fluconazole

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5
Q

What is the secondary prophylaxis for

Candidiasis (thrush)
(oropharyngeal/esophageal)

A

Not usually recommended

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6
Q

What is the preferred treatment for

Cryptococcal meningitis

A

Amphotericin B (deoxycholate or liposomal) + flucytosine

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7
Q

What is the preferred treatment for

Cytomegalovirus (CMV)

A

Valganciclovir
or
Ganciclovir

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8
Q

What is the secondary prophylaxis for

Mycobacterium avium complex (MAC)

A

(Clarithromycin or azithromycin) + ethanbutol

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9
Q

What is the secondary prophylaxis for

Pneumocystis jirovecii pneumonia (PJP or PCP)

A

SMX/TMP DS daily

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10
Q

What is the secondary prophylaxis for

Cryptococcal meningitis

A

Fluconazole (low dose)

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11
Q

What is the secondary prophylaxis for

Toxoplasmosis gondii encephalitis

Risks: exposure to the parasite via ingestion of undercooked/raw meat or raw shellfish, or contact with cat feces/litter

A

Pyrimethamine + leucovorin + sulfadiazine
(Same as treatment but with reduced doses)

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12
Q

What is the secondary prophylaxis for

Cytomegalovirus (CMV)

A

None

Maintain CD4 count > 100 cells/mm3

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13
Q

What is the preferred treatment for

Mycobacterium avium complex (MAC)

A

(Clarithromycin or azithromycin) + ethambutol

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14
Q

What is the preferred treatment for

Pneumocystis jirovecii pneumonia (PJP or PCP)

A

SMX/TMP (high-dose)

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15
Q

What is the preferred treatment for

Toxoplasmosis gondii encephalitis

Risks: exposure to the parasite via ingestion of undercooked/raw meat or raw shellfish, or contact with cat feces/litter

A

Pyrimethamine + leucovorin + sulfadiazine

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