Other Conditions

Question 1

ALL patients with a Dx of cancer are strongly encouraged to what?

Answer 1

Be seen and co-managed by an oncologist

Question 2

If a pt with cancer refuses to be seen by an oncologist, what must they sign?

Answer 2

Refusal of medical Tx form

Question 3

When does a pt with HIV need immediate referral to HIV specialist?

Answer 3

Peds, Pregnant
CD4 T-cells <350
Opportunistic infx
Con-com Hep B/C
Other HIV co-morb: HIV-nephro, cvd, neuro dz

Question 4

What should each HIV infx pt entering care receive?

Answer 4

Hx (substance abuse, social/psych issues, PMHx, social support, med insurance, factors that may inhibit Tx)
Exam

Question 5

What labs should each HIV infx pt entering care receive?

Answer 5

HIV Ab testing (if no documentation or HIV RNA below assay’s limit of detection)
CD4 t-cell count (f/up test q3-4 mo)
Plasma HIV RNA (viral load)
CBC, CMP, lipids (transaminase lvls, BUN, creatinine, fasting glucose), UA
Hep A, B, C serology
Genotype resistance testing
STIs PRN

Question 6

When should anti-retroviral therapy be initiated? Who should manage this?

Answer 6

ALL pts with Hx of AIDS defining illness
CD4 count <350
Pregnant pts, pts with nephropathy d/t HIV, Hep B co-infx

Infx dz specialist