2: STIs 2

Question 1

If symptomatic, when do Hep B symptoms begin?

Answer 1

An average of 90 days after HBV exposure and usually last for several weeks.

Question 2

How many Hep B patients become chronically infected and how many of those then die from liver cancer or cirrhosis?

Answer 2

Approximately 5% of adults with HBV infection become chronically infected, and 15% to 25% of individuals with chronic HBV infection will die prematurely from liver cancer or cirrhosis.

Question 3

What is used to mark the progression of Hep B disease?

Answer 3

Serologic markers

Question 4

T/F There is a Hep B vaccine that also protects against Hep A.

Answer 4

True

Question 5

Where is the Hep B vaccine injected?

Answer 5

Deltoid muscle

Question 6

How do you treat someone exposed to Hep B?

Answer 6

Give them hep B immunoglobulin IM in a single dose as soon as possible, preferably within 24 hours of exposure.

Question 7

What are treatments for acute and chronic Hep B?

Answer 7

No specific treatment for acute. Recovery is usually spontaneous. Chronic can be treated with several antiviral drugs.

Question 8

Women with Hep B should also receive what vaccination?

Answer 8

Hep A

Question 9

Can the Hep B vaccine be administered with other vaccines?

Answer 9

Yes

Question 10

Can pregnant women be vaccinated for Hep B during pregnancy?

Answer 10

Yes

Question 11

What is treatment protocol for a newborn whose mother has Hep B?

Answer 11

They need to receive immunoprophylaxis after birth.

Question 12

If symptomatic, average time from exposure to symptoms is 4-12 weeks, but can take as long as 24 weeks.

Answer 12

Hep C

Question 13

T/F In heterosexual, monogamous partners without HIV infection, sexual transmission of Hep C to a discordant partner is rare.

Answer 13

True

Question 14

What is the goal of treatment for Hep C?

Answer 14

The goal of treatment is to reduce all-cause mortality and prevent or halt liver injury.

Question 15

This is defined as the absence of HCV RNA 12 weeks after completion of treatment.

Answer 15

Virologic Cure

Question 16

T/F Success rate for Hep C treatment is most effective when begun within 6 months of exposure.

Answer 16

False. Treatment is most effective when begun in the ACUTE phase of the infection.

Question 17

Who is not recommended to receive Hep C treatment?

Answer 17

Those with a short life expectancy.

Question 18

Can women with Hep C breastfeed?

Answer 18

Most of the time. HCV is not transmitted through breastmilk, but women with cracked and bleeding nipples should avoid this method of feeding until complete healing has taken place.

Question 19

Women with Hep C should also receive what vaccination?

Answer 19

Hep A and B.

Question 20

In what poor country were many HIV cases initially diagnosed?

Answer 20

Haiti

Question 21

_____ women are disproportionately affected by HIV.

Answer 21

BLACK women are disproportionately affected by HIV.

Question 22

How are most new HIV infections acquired in women?

Answer 22

Heterosexual contact.

Question 23

How does HIV target the immune system?

Answer 23

• HIV specifically targets CD4 cells, binding to the cell surface protein known as the CD4 receptor.
• The virus affects the cells in two ways:
  
  • The absolute numbers of these cells are depleted.
  • Function of the remaining cells is impaired, resulting in a gradual loss of immune function.
• Progressive depletion of CD4 cells in peripheral blood occurs with advancing HIV infection, such that CD4 cell counts are used to estimate the cumulative immunologic damage caused by HIV.
• If its course is unimpeded, HIV can destroy as many as one billion CD4 cells per day.
• In addition to its aggressive destruction of the immune system, HIV is genetically highly variable, mutating with apparent ease.

Question 24

What are the components of the immune system?

Answer 24

1. Humoral immunity: Involved with antibody production.
2. Cellular immunity: Effected largely through T-helper lymphocytes (CD4 cells). Central components are macrophages and CD4 cells.

Question 25

CDC recommends HIV screening be a routine part of care for patients aged _____ in all healthcare settings.

Answer 25

CDC recommends HIV screening be a routine part of care for patients aged 13-64 years in all healthcare settings.

Question 26

T/F HIV testing is anonymous and confidential.

Answer 26

False. All states offer confidential testing. Only some states offer anonymous testing.

Question 27

Pre-exposure prophylaxis for HIV is recommended in which populations?

Answer 27

1. Injection drug users.
2. Women with HIV+ sexual partners.
3. Commercial sex workers.
4. Inconsistent or absent condom use.
5. High number of partners.

Question 28

What meds/doses are used for pre-exposure prophylaxis to HIV?

Answer 28

PrEP, which is taken every day, is composed of an oral fixed-dose combination of tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg.

Question 29

What are the 6 classes of antiretroviral therapy (ART)?

Answer 29

1. Nucleoside reverse transcriptase inhibitors (NRTIs)
2. Nonnucleoside reverse transcriptase inhibitors (NNRTIs)
3. Protease inhibitors (PIs)
4. Fusion inhibitors (FIs)
5. CCR5 antagonists
6. Integrase strand transfer inhibitors (INSTIs)

Question 30

What supplements interfere with HIV treatments meds?

Answer 30

1. St. John’s Wort
2. Garlic

Question 31

When do you test pregnant women for HIV?

Answer 31

Initial visit and again at 36 weeks if they are high risk.

Question 32

Should pregnant women with HIV receive treatment?

Answer 32

Yes, as this reduces fetal transmission rates from 30% to as low as 2%.

Question 33

With which STIs should you wait until 7 days after beginning treatment before resuming sex?

Answer 33

1. Chlamydia
2. Gonorrhea
3. Trichomoniasis
4. Molluscum
5. Syphilis