TB-HIV-PBL

Question 1

Cause of pulm infx in HIV pt with normal CD4 count:

Answer 1

Strep pneumo

Question 2

Pulmonary infx in HIV pt with CD4

Answer 2

1. Pneumocystis jirovecii pneumonia
2. Histoplasmosis
3. Toxoplasmosis
4. Invasive Aspergillosis

Question 3

Pulmonary infx in pts with CD4

Answer 3

1. Mycobacterium avium

2. CMV – interstitial pneumonia

Question 4

Positive predictive value = ?

Answer 4

true positives / (true positives + false positives)

Question 5

Used to treat TB

Decreases mycolic acid synthesis

Answer 5

Isoniazid

Question 6

Used to treat TB

inhibits DNA-dependant RNA-polymerase

Answer 6

Rifamycins

Ramps up p450

Red body fluids

Rapid resistance

RNA pol inhibitor

Question 7

Treats TB

blocks arabinosyltransferase –>

decreases carbohydrate polymerization

Answer 7

Ethambutol

Question 8

Vit B6 supplement

Answer 8

Pyridoxine

Question 9

What to give with Isoniazid?

Why?

Answer 9

Pyridoxine

prevents neurotoxicity

Question 10

HIV drugs

Protease inhibitors:

Answer 10

“navir’s”

Ritanovir

Indinavir

Amprenavir

Saquinavir

Lopinavir

Tipranavir

Atazanavir

Question 11

Why would you add low dose ritanovir to an HIV regimen?

Answer 11

CYP3A4 inhibitor –> “boosts” concentration of other drugs

Question 12

Immigrant TB screening in child less than 2:

Answer 12

none unless symptomatic or known contact

Question 13

Immigrant TB screening for ages 2-14:

Answer 13

TST/QuantGold, if + –> CXR, if + –> sputum smear/cx, if + –> drug sensitivity testing –> Daily observed therapy

Question 14

Immigrant TB screening fro ages 15 and older:

Answer 14

CXR, if + –> sputum smear/cultures, if + –> DST –> DOT

Question 15

Pts with HLA-B*5701 have delayed type hypersensitivity to which drug?

Answer 15

abacavir