Weeks 8-9

Question 1

What are NTDs?

Answer 1

Neglected tropical diseases

Question 2

Give examples of soil transmitted helminths (nematodes)

Answer 2

Ascaris lumbricoides
Necatar americanus
Acylostoma duodenale
Trichuris trichiura
Strongyloides sterocoralis

Question 3

What is the common name for ascaris lumbricoides?

Answer 3

Roundworm

Question 4

What is the common name for necatar americanus?

Answer 4

Hookworm

Question 5

What is the common name for acylostoma duodenale?

Answer 5

Hookworm

Question 6

What is the common name for tichuris trichiura?

Answer 6

Whipworm

Question 7

What is the common name for strongyloides stercoralis?

Answer 7

Threadworm

Question 8

What immune response increases susceptibility to STHs in HIV disease?

Answer 8

Predominant Th2 response

Question 9

What is the relationship of HIV with strongyloides stercoralis?

Answer 9

Unreliable serological testing
High fatality of SHS
No increased risk

Question 10

Give examples of filaria (nematodes)

Answer 10

Wuchereria bancrofti
Brugia malayi
Onchocerca volvulus
Loa loa

Question 11

What disease does loa loa cause?

Answer 11

African eye worm

Question 12

What is the urogenital schistosoma?

Answer 12

Haematobium

Question 13

Name intestinal schistosomas

Answer 13

Mansoni
Japonicum
Mekongi
Intercalatum

Question 14

Does HIV increase schistosoma risk or does schistosoma increase HIV risk?

Answer 14

Schisostoma increases HIV risk

Question 15

Name cestodes

Answer 15

Taenia solium
Echinococcal granulosus
Echinococcal multiocularis

Question 16

What organism causes neurocystercircosis?

Answer 16

Taenia solium

Question 17

Name the organisms that cause visceral leishmaniasis

Answer 17

Donovani
Infantum

Question 18

Name the organisms that cause cutaneous leishmaniasis

Answer 18

Tropica
Major
Mexicana
Vienna braziliensis

Question 19

Which organisms cause human African trypanosomiasis?

Answer 19

Brucei gambiense
Brucei rhodesiense

Question 20

Which organisms cause Chagas disease?

Answer 20

T. cruzi

Question 21

Name GIT associated protozoa

Answer 21

Entamoeba histolytica
Giardia lamblia
Cryptosporidium hominis
Cyclospora cayetensis
Cystoisospora belli
Microsporidia

Question 22

Does HIV increase susceptibility to leprosy?

Answer 22

No and they tend to develop milder forms

Question 23

Why does EFV have many drug interactions?

Answer 23

CYP450 inducer

Question 24

Name side effects of EFV

Answer 24

CNS
Hepatotoxicity
Rash
Hyperlipidemia
QT prolongation

Question 25

What is the dose of EFV?

Answer 25

600mg daily

Question 26

Name side effects of NVP

Answer 26

Hepatotoxicity Severe cutaneous reactions

Question 27

Which factors increase NVP risk for hepatic necrosis?

Answer 27

Females CD4 >250 Males CD4 >400

Question 28

Which patients is doravirine (DRV) approved for use in?

Answer 28

Treatment naive patients

Question 29

With which medication does doravirine interact?

Answer 29

Rifampicin (lowers DRV doses)

Question 30

What is the most commonly used NNRTI in DR HIV?

Answer 30

Etravirine

Question 31

What is the decision to use etravirine based on?

Answer 31

NNRTI mutation score

Question 32

With which medication does etravirine interact?

Answer 32

DTG

Question 33

Name side effects of etravirine

Answer 33

Rash (SJS)

Question 34

In which patients can we use rilpivirine?

Answer 34

Treatment naive with VL < 100 000

Question 35

With which medication does rilpivirine interact?

Answer 35

All TB treatment

Question 36

Why if TAF superior to TDF?

Answer 36

90% less in plasma -> less bone and renal toxicity However assoc with weight gain

Question 37

What is Fanconi syndrome?

Answer 37

Proximal tubular dysfunction

Question 38

What does TDF increase risk for?

Answer 38

Fanconi syndrome AKI CKD Nephrogenic diabetes insipidus Osteoporosis

Question 39

Name side effects of AZT

Answer 39

Lactic acidosis Lipodystrophy Bone marrow suppression

Question 40

In which patients is abacavir contraindicated?

Answer 40

HLA-B*3701 positive CVS disease

Question 41

When is the risk for flare highest in HBV?

Answer 41

Active HBV HBeAg positive

Question 42

If there is previous INST treatment or resistance, can you use DTG?

Answer 42

Yes, 50mg bd

Question 43

With which mutation must DTG be avoided?

Answer 43

Q148 mutation

Question 44

What are the requirements for VL when switching to DTG?

Answer 44

TLD1 - no VL TLD2 - suppressed VL within 6 months

Question 45

Which INSTI has the most side CNS effects?

Answer 45

DTG

Question 46

How do INSTIs work?

Answer 46

Prevent binding of pro-integration complex to host cell DNA

Question 47

What are contraindications for bictegravir?

Answer 47

Hepatic impairment CrCl<30

Question 48

What is the dose of bictegravir?

Answer 48

<25kg 30mg >25kg 50mg

Question 49

Which INSTIs have the highest resistance barrier?

Answer 49

DTG BIC

Question 50

What were risk factors for virological failure on cabotegravir/rilpivirine injection?

Answer 50

BMI>30 HIV subtype A1/A6 RPV resistance

Question 51

What is the MOA of lencapovir (LEN)?

Answer 51

Inhibits Gag/Gag-Pol and protein subunit production (capsid inhibitor)

Question 52

Can you pick up HIV resistance if you are not on treatment?

Answer 52

No, increased wild type

Question 53

In which HIV subtype is K65R more common?

Answer 53

C>B

Question 54

What must the VL be in order to do drug resistance testing?

Answer 54

VL>400

Question 55

Which mutation is most common in DTG resistance?

Answer 55

R236K

Question 56

What is a major determinant of neurological deficit in TBM?

Answer 56

Vasculitis

Question 57

What are the clinical stages of TBM?

Answer 57

1- alert w/ no focal signs 2 - non-comatose w/ focal signs 3 - comatose

Question 58

Solid, non-enhancing lesion?

Answer 58

PML

Question 59

What is the treatment of CCM?

Answer 59

Initiation - 2 weeks ampho B and fluconazole Consolidation - 8 weeks fluconazole Maintenance - daily fluconazole 200mg until CD4>200

Question 60

What is the treatment of toxoplasmic encephalitis?

Answer 60

Bactrim

Question 61

What is the treatment of CMV?

Answer 61

Gancyclovir

Question 62

Which virus causes PML?

Answer 62

JC virus reactivation

Question 63

What is the treatment of PML?

Answer 63

ART

Question 64

When can you get contrast enhancement in PML?

Answer 64

IRIS

Question 65

Which virus is associated with primary CNS lymphoma?

Answer 65

EBV

Question 66

Which ART is associated with HIV stroke?

Answer 66

PI use

Question 67

What stage of syphilis is meningovascular syphilis?

Answer 67

Secondary

Question 68

Which artery is usually affected by VZV?

Answer 68

Middle cerebral artery ipsilateral to rash on face