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Hematology-Oncology Exam 2 > Ortoski Objectives > Flashcards

Ortoski Objectives Flashcards

1
Q

What are the 3 conditions for transmission of HIV?

A

HIV must be present in…

  1. Body fluid
  2. In sufficient quantity
  3. Portal of entry into bloodstream
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2
Q

What 3 things is transmission of HIV leading to disease progression dependent on?

A
  1. Size of viral inoculin
  2. Virulence of infecting virus (how fit is the virus and what is it’s replication capacity)
  3. Patients cytotoxic lymphocyte response (CD8)
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3
Q

What are the 3 basic modes of HIV transmission?

A
  1. Sexual
  2. Blood
  3. Vertical
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4
Q

What is sexual transmission associated with?

A

Traumatic sex (anal), multiple partners, and lack of protection

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5
Q

What are some influencing factors with sexual transmission?

A

Oral/vaginal/anal receptive, no condom, genital ulcer (syphilis, active herpes)

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6
Q

What is associated with blood HIV transmission?

A

Transfusion/transplant before 1985, drug use, occupational exposure

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7
Q

What can reduce the risk of vertical transmission during pregnancy?

A

AZT

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8
Q

There are 14 AIDS defining conditions listed… name as many as you can.

A
  1. Candidiasis of respiratory system, esophagus
  2. Cervical cancer – invasive
  3. Coccidioidomycosis
  4. Cryptosporidiosis
  5. CMV (retinitis)
  6. Herpes simplex chronic ulcers (> 1 mo duration)
  7. HIV related encephalopathy
  8. Isorporiasis (chronic intestinal)
  9. Kaposi’s sarcoma (HHV8)
  10. Lymphoma
  11. MAC complex, mycobacterium TB, PCP, toxoplasmosis
  12. Recurrent pneumonia (>2 infections in 12 mo)
  13. Progressive multifocal leukoencephalopathy (PML)
  14. Salmonellosis
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9
Q

What are main general categories of HIV testing?

A

Antibody testing and viral assays

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10
Q

When can antibody testing be done for HIV?

A

6 month waiting period exists after infection (the time needed for the immune system to make Antibodies

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11
Q

What are 6 tests for HIV that are antibody tests?

A
  1. ELISA
  2. Western blot
  3. OraSure OraQuick Advance
  4. Unti-Gold Recombigen and Reveal G2
  5. Multispot
  6. P24 Antigen Capture Assay
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12
Q

What antibody test is a screening test that is non-specific?

A

ELISA

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13
Q

What antibody test is a confirmatory test with decreasing false results?

A

Western Blot

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14
Q

What antibody test detects Ab to HIV1 and HIV2 in whole blood, oral fluids, and plasma with results in 20 minutes?

A

OraSure, OraQuick Advance

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15
Q

What antibody test detects antibodies to HIV1 in serum and plasma?

A

Uni-Gold Recombigen and Reveal G2

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16
Q

What antibody test detects antibodies to HIV1 and HIV2 in serum and plasma?

A

Multispot

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17
Q

What antibody test measures the chief component of nucleocapsid?

A

P24 antigen capture assay

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18
Q

What is a vrial RNA Assay?

A

Measures the viral load of HIV…HIV RNA by PCR and HIV branched DNA

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19
Q

When is a DNA PCR assay used?

A

In newborns and needle exposure patiens

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20
Q

When can you say HIV+?

A

Multiple antibody results or a single viral load assay

Ex. 2 ELISAs and 1 Western Blot

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21
Q

What will be positive with an acute retroviral infection symptoms in a primary HIV infection?

A

1 Viral Load Assay

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22
Q

ACTG

A

AIDS clinical trials group

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23
Q

ADAP

A

AIDS drug assistance program

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24
Q

AMfar

A

American foundations of AIDS research

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25
Q

CD4 cells

A

T-Helper Cells

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26
Q

CD8 cells

A

Cytotoxic Cells

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27
Q

Discordant couples

A

Those sexually active partners where one is HIV+ and the other is HIV-

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28
Q

Expanded Acess

A

Initial monitored access to medications prior to public access

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29
Q

HAART/ART

A

High active antiretroviral therapy (the cocktail)

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30
Q

HIV1

A

Virus that causes AIDS/ HIV2 most prevalent in Africa

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31
Q

IDU

A

Intravenous drug user

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32
Q

Immune Reconstitution

A

Ability of immune system cells to replenish themselves with memory

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33
Q

Index (source) patient

A

The individual known to have been the source of the infection

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34
Q

MAC/DM Avium

A

Mycobacterium Avium Complex/ Disseminated Mycobacterium Avium

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35
Q

MSM

A

Men who have sex with men

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36
Q

Entry Inhibitor

A

Inhibits HIV entry into the host cells

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37
Q

Integrase

A

Inhibits integrase within the host nucleus

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38
Q

Inhibitor

A

Inhibits maturation of virion at exit from host cell

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39
Q

Maturation

A

Nucleoside reverse transcriptase inhibitors

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40
Q

Inhibitor

A

Necleotide reverse transcriptase inhibitor

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41
Q

NRTI

A

Non-nucleoside reverse transcriptase inhibitors

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42
Q

NtRTI

A

Protease Inhibitors

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43
Q

NNRTI

A

D4t, ddl, ddC, AZT

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44
Q

Mutations

A

Amino acid changes that occur within the genome of the virus

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45
Q

Nadir CD4

A

Lowest number reached

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46
Q

Naive

A

No prior exposure to a certain drug

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47
Q

OIs

A

Opportunistic infections, AIDS defining illness

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48
Q

PHI/Acute Retroviral Syndrome

A

Primary HIV infection: Flu-mono-like symptoms associated with acute infection

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49
Q

Reverse Transcriptase/Protease/Integrase

A

Viral enzymes, proteins, needed for viral replication

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50
Q

Sequestered virus/mutations

A

Those viruses or viral mutations that are in the minority and not detectable

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51
Q

Sexual Exposure

A

Passive versus active/Receptive versus insertive

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52
Q

VL

A

Viral load- Estimated amount of virus in the blood stream

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53
Q

VL set point

A

Highest viral load without HAART

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54
Q

Viral Fitness

A

Ability of virus to replicate in a defined environment

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55
Q

Replication capacity

A

Reasonable proxy for viral fitness

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56
Q

Viral Reservoir

A

Areas where virus is maintained and not read into serum viral load assay

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57
Q

Wild Type Virus

A

Original virus without mutations

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58
Q

Quasi Species

A

Multiple mutations in the virus of one host

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59
Q

What should be done on examination for HIV infected individual?

A
  1. Weight
  2. LN Enlargement
  3. CMV retinitis
  4. Oral Lesion
  5. Hepatosplenomegaly
  6. Abdominal masses
  7. Genital sores/warts/STD lesions
  8. DRE or anal cancer (caution/not done in severely immunocompromised patients)
  9. Neuro
  10. Joint and muscle pain
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60
Q

What serial tests should be done every 3 months and when needed for HIV patients?

A
  1. CBC and Plts – leucopenia, anemia, thrombocytopenia (can be due to HIV or meds)
  2. Chemical profile - Liver enzymes, elevated globulin fraction of total protein, serum albumin, amylase and lipase, renal function (creatinine clearance can dec due to meds, urinalysis shows positive proteins in renal damage)
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61
Q

What are 2 HIV related lab tests done on patients with HIV?

A
  1. CD4 absolute count and percent

2. Viral load assays: PCR (bDNA, NASBA)

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62
Q

What are 2 examinations that are done on a different schedule in HIV patients?

A
  1. Cervical/Rectal Pap (more frequently done)

2. PSA/Prostate (earlier)

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63
Q

What testing should be done yearly as indicated?

A
  1. PPD Mantoux
  2. STD Testing (GC/CT, RPR)
  3. Urine Protein (especially for those on tenofovir)
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64
Q

What testing should be done initially and at intermittent screening? (5 things)

A
  1. HLAB 5701: For hypersensitivity reaction with abacavir
  2. Hepatitis A/B/C
  3. Toxoplasmosis and CMV: Requires baseline IgG
  4. Free testosterone levels: For wasting/depression in men
  5. Lactic acid levels: W/ use of D drugs and for unexplained pain
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65
Q

What are 6 vaccines given to HIV patients?

A
  1. Hepatitis A/B
  2. Influenza (yearly)
  3. MMR
  4. Tdap
  5. Pneumococcal
    6, HPV (females 9-26)
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66
Q

What vaccines are contraindicated in HIV patients?

A

LIVE ONES

  • Varicella Zoster
  • MMR (Only if patients CD4 count is under 200)
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67
Q

What can assess relative risk of disease progression and time of death along with providing an assessment of efficacy of antiretroviral therapies for HIV patients?

A

Viral Load Assays

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68
Q

What are 3 things that a viral load assay can do?

A
  1. Measure HIV
  2. Study pathogenesis
  3. Determine HIV Kinetics (replication)
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69
Q

With respect to a viral load assay, equilibrium is established between what?

A

Viral replication and immune response

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70
Q

True or False: Viral load assays can show viremia when culture reveals none

A

TRUE

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71
Q

How fast should HIV RNA decrease upon starting treatment?

A

With in days

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72
Q

If you have an adherent patient, how long until Nadir (or lowest possible viral load count) is reached in a HIV patient after starting treatment?

A

16-24 weeks

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73
Q

What can increases of RNA viral load reveal?

A

Outgrowth of drug-resistant HIV-variants or non-adherence to drugs

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74
Q

What RNA level change is associated with a biologically and clinically relevant change?

A

Over 0.5log10

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75
Q

What are viral blips?

A

Insignificant low level rises

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76
Q

True or False: Undetectable means eradication

A

FALSE: Undetectable doesn’t mean eradication…this is not possible with today’s drugs

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77
Q

What are some viral reservoirs?

A

Lymphoreticular system, GALT (GI Lymph Tissue), CNS, Gential tract

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78
Q

What are 3 uses of CD4 counts?

A
  1. Assess extent of immune system damage
  2. Assess relative risk of disease progression and time of death
  3. Provide assessment of risk of developing opportunistic infections
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79
Q

What is done with regards to CD4 number?

A

Prophylactic medication is given

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80
Q

True or False: With immune reconstitution, discontinuation of meds is possible

A

TRUE

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81
Q

With a CD4 count under 200, what do you give for prophylaxis?

A

TMP-SMX for pnuemocystis jiroveci (PCP)

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82
Q

With a CD4 count under 100, what do give for prophylaxis?

A

TMP-SMX for toxoplasma gondii

83
Q

With a CD4 count under 50, what do you give for prophylaxis?

A

Biaxin and azithromycin for Mycobacterium avium complex

84
Q

What is the significance of CD4 Nadir?

A

When ART is stopped…they body will easily return to the CD4 nadir level

85
Q

Who should CD4 levels be performed on?

A

All new diagnosed patients

-Levels can vary up to 30%- Monitoring levels over time is important

86
Q

True or False: Levels must be monitored (even in untreated patients) to check disease progression and degree of immunodeficiency

A

True

87
Q

What % of newly infected patients and resistant to at least 1 drug?

A

15%- Transmitted drug resistance (some persists in absence of treatment)

88
Q

What is clinical resistance?

A

Lack of clinical benefit from antiretroviral agents

89
Q

Where is the mutation/resistance located at in viral resistnace?

A

The codon of the enzyme genome

90
Q

What reveals changes in viral genome that appear as consequence of drug exposure and natural replication?

A

Genotype testing for genotype resistance

91
Q

What is the interpretation for genotype testing for gentypic resistance?

A

For each list of mutations, which drugs will still work in the patient

92
Q

What reveals the ability of virus to grow in culture despite persistance of antiretroviral agent?

A

Phenotype testing for phenotypic resistnace

93
Q

What is the interpretation of phentotype testing for phenotypic resistance?

A

For each drug, how large a fold change makes the drug no longer work

94
Q

What does a virtual phenotype reveal?

A

The % of drugs responses as seen in database of known mutations

95
Q

What is a trofile?

A

Tropism test- a specific phenotypic assay

96
Q

What are the 2 HIV trophisms?

A
  1. M-tropic

2. T-Tropic

97
Q

What virus is M-tropic associated with and what is it attracted to and what is the timeline?

A

R5 Virus
CCR5 co-receptors (macrophages)
EARLY

98
Q

What virus is T-Tropic associated with and what is it attracted to and what is the timeline?

A

X4 Virus
CXCR4 co-receptors (T-cell)
LATE

99
Q

What does T-tropic X4 virus correlate to?

A

Rapid progression to AIDS

100
Q

What does resistance analysis require?

A

A sample of greater than 1000 viral load copies

101
Q

What does resistance analysis measure?

A

Majority variants (20% or more of the viral population)

102
Q

What can false positives with resistance analysis result from?

A

Amplification

103
Q

What is the availability of resistance analysis for genotypes and phenotypes?

A

Genotypes: Many labs (2-4 weeks for results)
Phenotypes: 2 labs in the world (SF and Ireland) (4-6 weeks for esults)

104
Q

Nomenclature on reported mutations….what do the 3 components stand for?

A

M184V
M: AA found in wild type
184: AA position
V: AA substitution

105
Q

What 3 circumstances do you order resistance testing?

A
  1. Acute HIV infection
  2. All chronically infected patients prior to therapy initiation
  3. Virologic failure
106
Q

What is virologic failure?

A

Failure to achieve or sustain a viral load under 50c/ml after 16-24 weeks of HAART and within 4 weeks after therapy discontinuation

107
Q

What does it mean for a drug to have a low genetic barrier to resistance?

A

It is easy for these drugs to obtain resistance after certain mutations

108
Q

What are 2 drugs that have a low barrier to resistance and don’t kill the virus after a 184V mutation?

A

Lamivudine and emtricitabine

109
Q

What is a drug that has a low carrier to resistance and is ineffective with 103 mutation?

A

Efavirenz and other NNRTIs (Whole class really?)

110
Q

How many approved agents are there and with how many fixed dose combination medications?

A

27 approved agents with 7 fixed dose combination medications

111
Q

What are 5 examples of classes of drugs for HIV?

A
  1. Reverse transcriptase inhibitors: Nucleoside, nucleotide, non-nucleoside
  2. Protease inhibitors: Attachment, CCR5, CXCR4, Fusion, T-20
  3. Integrase inhibitors
  4. Entry inhibitors
  5. Maturation inhibitors
112
Q

What is important for AIDS patients with regards to opportunistic disease?

A

Prophylaxis

113
Q

What is the treatment for wasting syndrome?

A

-Anabolic steroids, testosterone replacement, appetite stimulants, growth hormone injections, Egrifta, GH-releasing factor analog

114
Q

What 3 things constitute HIV related illness?

A

Anemia, dementia, opportunistic diseases

115
Q

What is one big SE of antiretrovirals?

A

Lipodystrophy syndrome (fat redistribution and metabolic complications)

116
Q

What is HAART used for?

A

Long term management of chronic infection

117
Q

What are some general guidelines for beginning antiretroviral therapy? (9)

A
  1. Acute HIV infection?
  2. Symptomatic HIV disease
  3. AIDS defining illness
  4. Severe symptoms of HIV infection
  5. CD4 100,000 (treatment may be considered)
  6. Pregnant women
  7. Pts w/ HIV-associated neuropathy
  8. Hepatitis B virus co-infection
118
Q

What is the goal of therapy?

A

To get HIV RNA to undetectable levels

-THIS DOES NOT MEAN ERADICATION…virus reservoirs like CNS, lymph, ect.

119
Q

True or False: Mutated virus can be given to an infected patient by the index/source patient

A

TRUE

120
Q

Why shouldn’t monotherapy be used for patient treatment?

A

Drug resistance and cross-resistance

121
Q

What is the 1 exception where monotherapy can be used for HIV?

A

ACTG 076 where AZT alone is given to mother and newborn–> TREATMENT IS AIMED TOWARDS FETUS

122
Q

When initiation combination treatment, are all drugs started at once?

A

YES

123
Q

After initiation, what does the patient have to take their meds at?

A

THE RECOMMENDED DRUG DOSE

124
Q

Antiretroviral rug resistance is less likely under what circumstance?

A

If all therapy is temporarily stopped versus dose-reduction or one component being withheld

125
Q

Patient education on what is mandatory?

A

COMPLIANCE

126
Q

What are the HIV drug interactions due to?

A

Liver metabolism

127
Q

NNRTIs decrease the level of what?

A

PIs

128
Q

What drugs require dosage adjustment in renal dysfunction?

A

NRTIs

129
Q

What drugs can cause liver damage or dysfunction?

A

AZT, NNRTIs, PIs

130
Q

What do ED agents like VIagra do to HIV meds?

A

Increase concentration when given with a bunch of drugs, but NO EFFECT on PIs

131
Q

Can you use a PPI with a PIs?

A

NEVER USE PPI with ATAZANAVIR

132
Q

What are some other drugs that have interactions with antiretrovirals?

A

-Anticonvulsants, antifungals, anti-mycobacterials (TB drugs), benzodiazapines, cardiac drugs (CCBs), statins, macrolides, methadone (IV drug use), oral contraceptives, grapefruit juice, theophylline, disipramine, st. john’s wort, vitamin E

133
Q

What does nevirapine cause?

A

Hepatic necrosis

134
Q

WHat does abacavir cause?

A

HS reaction

135
Q

What causes lactic acidosis (mitochondrial toxicities)?

A

NRTI or “d drugs”

136
Q

What does Stevens-Johnson Syndrome?

A

NNRTI

137
Q

What does tipranavir cause?

A

Bleeding and intracranial hemorrhage

138
Q

What does zidovudine cause?

A

BM suppression

139
Q

What drug causes hepatotoxicity?

A

ALL OF THEM

140
Q

What 2 drugs cause nephrolithiasis?

A

Indinivir and atazanavir

141
Q

What 2 drugs cause nephrotoxicity?

A

Indinivir and tenofovir

142
Q

What 2 drugs cause pancreatitis?

A

Didanosine and stavudine

143
Q

What are 4 long-term complications of PIs?

A

CV effects, hyperlipidemia, insulin resistnace, osteonecrosis

144
Q

What drug can cause CNS effects?

A

Efavirenz

145
Q

What class of drugs causes fat maldistribution and GI intolerance?

A

PIs

146
Q

What drug causes injection site reactions?

A

Enfuvirtide

147
Q

What does dianosine, stavidine, and “d drugs” cause?

A

Peripheral neuropathy

148
Q

What is the result of HIV associated lipodystrophy syndrome?

A

Fat redistribution

149
Q

This is when there is subQ adipose wasting in face, chest, buttocks, legs and is treated by changing the drug regimen

A

Lipoatrophy

150
Q

This is when there is visceral adipose tissue accumulation and resultant increased abdominal girth (crix belly, protease paunch), bloating, and dyspepsia?

A

Lipohypertrophy

151
Q

What are 2 other sites of fat accumulation in HIV associated lipodystrophy syndrome?

A

Breasts and dosrocervical region (buffalo hump)

152
Q

What are 3 metabolic complications from HIV drugs?

A
  1. Dyslipidemia
  2. Insulin resistance
  3. Mitochondrial dysfunction toxicities
153
Q

What is seem in terms of dyslipiemia?

A

Increase TGs (especially with RTV combinations), increased total cholesterol and LDL, normal HLD

154
Q

Can you treat a person on HIV drugs with Simvastatin or Lovastatin?

A

NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO

155
Q

What drug induces insulin resistance and decreases insulin secretion?

A

Indinivir

-This results in glucose intolerance and diabetes

156
Q

What are some mitochondrial dysfunction toxicities seen?

A

Lactic acidosis (stop NRTI’s if this condition exsists), peripheral neuropathy, pancreatitis, lipodystrophy, myopathy, cardiomyopathy

157
Q

True or False: CAD is more prevalent in HIV patients

A

TRUE

158
Q

What regimen is linked to more MIs than NNRTI regimens?

A

PI regimens

159
Q

Why do you need to order DEXA scans in HIV patients?

A

They have decreased bone mineral density resulting in osteopenia, osteoporosis, and osteomalacia

160
Q

How do you treat decreased bone density in HIV patients?

A

Calcium and Vitamin D

161
Q

What are 4 things that can cause osteonecrosis (avascular necrosis) in an HIV patient?

A
  1. Corticosteroid use
  2. Alcohol abuse
  3. Smoking
  4. Hypercholesterolemia
162
Q

How do you diagnose avascular necrosis?

A

CT or MRI

163
Q

What is given to treat avascular necrosis?

A

ERT, bisphosphates (fosamax or actonel), evista (estrogen replacement), calcitonin

164
Q

What are 5 malignancies associated with HIV?

A
  1. Kaposi Sarcoma
  2. Non-Hodgkin’s Lymphoma
  3. Cervical CA
  4. Primary CNS lymphoma
  5. Anal CA
165
Q

What are the risk factors with Non-Hogkin lymphoma?

A
  1. Duration of HIV
  2. Low CD4
  3. Older age
  4. Chronic B cell stimulation
166
Q

What % of HIV patients with Non-Hodkin’s lymphoma have uncontrolled HIV?

A

75%

167
Q

What 3 things are seen in HIV patients with Non-Hodgkin’s Lymphoma?

A
  1. Frequent CNS disease
  2. Poor prognosis
  3. Survival 6-20 months
168
Q

What is recommended in both genders for HIV patients to look for dysplasia caused by HPV?

A

Annual DRE and Rectal Paps

169
Q

Who is anal cancer more common in in patients with HIV?

A

Patients over 50, women, blacks, and men who have sex with men

170
Q

What is seen in the nervous system with HIV patients?

A

Hepatitis C co-infection and penetration of the BBB

171
Q

What are the secondary HIV complications relating to the nervous system due to?

A

Immunosuppression

172
Q

What are primary HIV complications of the nervous system?

A

Dementia, encephalopathy, myelopathy, peripheral neuropathy

173
Q

True or False: Patients with psychiatric disorders are more likely to get HIV, get less treatment, and die.

A

TRUE

174
Q

What are 2 renal concerns for patients with HIV?

A
  1. Nephrolithiasis

2. Fanconi syndrome (proximal tubular dysfunction leading to acidosis)

175
Q

Name 8 metabolic issues seen in HIV patients

A
  1. Insulin resistance
  2. DM
  3. Dyslipidemia
  4. Lypodystrophy
  5. Bone Density Loss
  6. Mitochondrial Toxicity
  7. Chronic Inflammation
  8. HTN
176
Q

Name 8 Organ-Related issues seen in HIV patients

A
  1. Liver disease
  2. Kidney disease
  3. Peripheral vascular disease
  4. Cardiovascular disease/MI
  5. Cerebrovascular disease
  6. Osteopenia/osteoporosis
  7. Non-AIDS CA
  8. CA caused by chronic infection (anal, liver, Hodgkins)
177
Q

Name 7 neuropsychiatric conditions seen in HIV patients

A
  1. HIV-associated dementia
  2. HIV encephalopathy
  3. Depression
  4. Mild neurocognitive impairment
  5. Delirium
  6. Depression
  7. Anxiety
178
Q

What CD4 count is TMP-SMZ given to prevent pneumocystis jiroveci?

A

Under 200

179
Q

What is the mm reaction for mycobacterium tuberculosis to give isoniazid prophylaxis?

A

Over 5mm

180
Q

What is required to start TMP-SMZ prophylaxis for toxoplasma gondii?

A

CD4 under 100 and IgG+

181
Q

When is biaxin and zithromax given prophylactically for mycobacterium avium complex?

A

CD4 under 50

182
Q

When is Varicella zoster immune globulin given prophylactically?

A

With significant exposure

183
Q

What CD4 count do you give the pneumococcal vaccine for Strep Pneumo?

A

Under 200

184
Q

Do all HIV patients get 3 doses of Hep B Vaccine?

A

Yes… all that are susceptible

185
Q

Do all HIV patients get influenza vaccine?

A

Yes- Inactivated vaccine

Oseltamivir, Rimantadine, Amantadine

186
Q

Who gets 2 doses of Hep A Vaccine?

A

All susceptible with chronic Hep C

187
Q

When is G-CSF given for an HIV patient?

A

When there is neutropenia

188
Q

What CD4 count if fluconazole given at for cryptococcus neoformans?

A

Uner 50

189
Q

When is itraconazole given for histoplasma capsulatum?

A

CD4 under 100

190
Q

When is oral gancyclovir given for CMV?

A

CD4 under 50 or CMV Ab+

191
Q

What is given to reduce vertical transmission of HIV from mom to baby?

A

AZT

192
Q

What drug is used alone during labor to reduce vertical transmission?

A

Nevirapine

193
Q

What is Mom on throughout pregnancy to prevent HIV transmission?

A

HAART

194
Q

When is AZT given to the baby?

A

At birth…given first 6 weeks of life and discontinued at 6 weeks in the DNA PCR is negative

195
Q

How many DNA PCR positive results are sufficient for newborn HIV diagnosis?

A

2

196
Q

WHat is required for exclusion of HIV in newborn?

A

2 DNA PCR negative results when done at >1 month and >4 months

197
Q

When are 2 positive antibody tests with confirmatories sufficient for diagnosis of HIV in child?

A

After 18 months

198
Q

When may 2 negative antibody tests exclude HIV1 infection?

A

When both are done at >6 months

199
Q

Children who havne’t seroconverted should continue to be monitored until they have what?

A

Negative HIV antibody tests

200
Q

What if given for PCP prophylaxis in newborn to HIV mom?

A

Start bactrim at 6 weeks… if HIV + or is positivity is still unknown or negative

201
Q

What must be given to all HIV-exposed infants?

A

Vaccinations

202
Q

True or False: Breastfeeding is contraindicated in an HIV positive Mom

A

TRUE

203
Q

There is a better outcome if an HIV-infected individual was treated by a clinician that had at least how many patients they were following?

A

5

204
Q

True or False: Clinicians that manage a small number of HIV-infected patients shouldn’t treat without assistance from more expert colleagues

A

TRUE

Hematology-Oncology Exam 2 (15 decks)

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