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RDS Test 2 > B8-082 PrEP > Flashcards

B8-082 PrEP Flashcards

1
Q

oral medications approved for PrEP [2]

A

truvada
descovy

(daily)

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2
Q

IM medication approved for PrEP [1]

A

apretude

(once every 2 months; very difficult to get approved though)

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3
Q

oral PrEP med that is less toxic to bones and kidneys

A

descovy

(prodrug, spends more time in cells less in plasma)

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4
Q

descovy can be used with a CrCl of […]

truvada requires a CrCl of […]

A

descovy: 30 (prodrug, less toxic)

truvada: 60

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5
Q

[truvada/descovy] is associated with weight gain

A

descovy

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6
Q

[truvada/descovy] approved for all patients 13+

A

turvada

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7
Q

[truvada/descovy] only approved for males as assigned at birth

A

descovy

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8
Q

[truvada/descovy/apretude]
less expensive, more likely to be approved by insurace

A

truvada

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9
Q

[truvada/descovy/apretude]
smaller pill

A

descovy

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10
Q

[truvada/descovy/apretude]
better kidney/bone health over long term use

A

descovy

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11
Q

[truvada/descovy/apretude]
lower risk of weight gain

A

truvada

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12
Q

[truvada/descovy/apretude]
decreases pill burden

A

apretude (IM)

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13
Q

[truvada/descovy/apretude]
higher efficacy

A

apretude

(trial over truvada was stopped early due to effectiveness, but hard to get insurance to approve)

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14
Q

[truvada/descovy/apretude]
least impact of bone/renal disease

A

apretude

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15
Q

only medication option for ciswomen/transmen if apretude is not approved

A

truvada

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16
Q

appropriate for younger, healthy individuals at low risk of renal/bone disease

A

truvada

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17
Q

[truvada/descovy]

best for individuals at risk or have underlying renal/bone disease

A

descovy

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18
Q

best choice for individuals with significant renal impairment or osteoporosis

A

apretude

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19
Q

contraindications for prescribing PrEP [3]

A

HIV +
HIV exposure <72 hours (PEP instead)
renal disease

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20
Q

cautions for prescribing PrEP [5]

A

recent viral syndrome (test for HIV)
Hep B infection
kidney disease
osteoporosis
pregnancy/breastfeeding (can have PrEP if risk of HIV is high)

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21
Q

5 Ps of taking a sexual history

A

Partners
Practices
Past History of STIs
Protection of STIs
Pregnancy intention

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22
Q

PrEP requires […] days to be effective for anal sex and […] days to be effective for vaginal sex

A

PrEP requires [7] days to be effective for anal sex and [20] days to be effective for vaginal sex

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23
Q

HBsAg –
HBsAb –
HBcAb –

A

not immune, not protected

(need vaccine)

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24
Q

HBsAg –
HBsAb +
HBcAb +

A

previous infection
protected, no vaccine needed

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25
Q

HBsAg –
HBsAb +
HBcAb –

A

previously vaccinated

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26
Q

HBsAg +
HBsAb –
HBcAb +

A

infected

27
Q

HBsAg –
HBsAb –
HBcAb +

A

past exposure, not immune

more testing is needed

28
Q

patients receiving PrEP should follow up every […] months

A

3

(to ensure HIV - status continues)

29
Q

approximately when after exposure would you expect a patient to have a positive HIV result?

(assume 4th gen test, he said that’s what KU uses)

A

15-20 days

30
Q

best PrEP for individuals having less frequent sex and those who can anticipate having sex

only indicated for patients engaging in anal sex

A

on demand PrEP (2-1-1)

(two pills 24 hrs prior, 1 pill every 24 hrs after)

31
Q

an HIV+ individual with undetectable viral load [can/cannot] transmit the virus to others

A

cannot

U=U

32
Q

in order to qualify for U=U, viral load must remain undetectable for […] months and continue to be sustained by daily medication

A

6

(important to ensure partner is undetectable and correctly taking medications)

33
Q

PrEP is […]% effective for sexual contact and […]% effective for injection drug use

A

PrEP is [99]% effective for sexual contact and [74]% effective for injection drug use

34
Q

[…] is rarely a barrier to PrEP

A

cost

35
Q

descovy is currently only approved for what gender?

A

cismen
transwomen

(people assigned male sex at birth; limited due to current study data)

36
Q

approved for all individuals over 13 [2]

A

truvada
apretude

37
Q

can be used at any creatinine clearance

A

apretude

38
Q

can only be used if CrCl is over 60

A

truvada

39
Q

approved if CrCl is over 30

A

descovy

40
Q

initial labs to get before starting PrEP [7]

A

HIV
Hep B
Hep C
CMP
Syphilis
GC/CT
pregnancy test

41
Q

HBsAg positive signals

A

infection

42
Q

HBsAb positive signals

A

immunity (previous infection or vaccination)

43
Q

HBcAb positive signals

A

previous exposure

(could be vaccinate or infection)

44
Q

patients should be seen for follow up […] after starting PrEP

A

3 months

45
Q

follow up labs after initiating PrEP

A

HIV
GC/CT, syphilis if new risk
BMP (can space to 6 months after initial 3 month is normal)

46
Q

PEP must be started within […] of exposure

A

72 hrs

47
Q

IV drug use [is/is not] an indication for PrEP

A

is

48
Q

if the Hep B results come back positive, can the patient still start PrEP?

A

yes

truvada and descovy actually treat Hep B

49
Q

options for PrEP for a cisfemale with low CrCl

A

apretude

can consider off label use of descovy if insurance does not approve

50
Q

indications for PEP [2]

A

known HIV exposure
unknown exposure with high risk factors

51
Q

truvada + dolutegravir for 4 weeks is

A

PEP

(can transition to PrEP after)

52
Q

should PrEP be delayed if the STI results come back positive?

A

no

53
Q

does PrEP interact with any form of birth control?

A

no

54
Q

is PrEP safe in pregnant/breastfeeding mothers?

A

yes

55
Q

does PrEP protect against HPV?

A

no

best protection from HPV is vaccination and condom use

56
Q

trudava can be used with a CrCl greater than

A

60

57
Q

descovy can be used with a CrCl greater than

A

30

58
Q

what is the window period for a 4th gen IgM and IgG Ab and p24Ag test?

A

15-20 days

59
Q

what is the window period for an HIV viral load?

A

10-15 days

60
Q

a positive Hep B core Ab indicates

A

previous exposure

61
Q

a positive Hep B surface Ag indicates

A

infection is present

62
Q

components of “Ending the HIV Epidemic: A Plan for America”?

A

Diagnose as early as possible
Treat rapidly
Prevent new transmissions
Respond quickly to outbreaks

63
Q

people in mutually monogamous relationships with an HIV negative partner [are/are not] good candidates for PrEP

A

are not

(unless they ask to be treated)

RDS Test 2 (21 decks)

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