Infectious Disease

Question 1

retrovirus that targets and destroys CD4 + T cells

Answer 1

HIV

Question 2

this predicts rate of dz progression in HIV and gauges response to anti retroviral therapy

Answer 2

viral load

Question 3

Sx of HIV

Answer 3

1. Acute: asymptomatic, mono and flu like sxs such as fever, lymphadenopathy, wt loss, headache
2. AIDS CD4 count < 200: AIDS defining illness: recurrent infections/malignancies, HIV wasting syndrome (chronic diarrhea + wt loss)

Question 4

Dx for HIV

Answer 4

1. Elisa test: detects anti-HIV antibodies in the blood (can take 6 mos for antibodies to appear)
2. Western Blot: confirms dx

Question 5

What should a baseline evaluation for a patient w/suspected HIV include?

Answer 5

HIV RNA PCR (viral load)

CD4+ cell count

CXR

PPD skin test

CMV serologies (other viral and bacterial serologies)

Question 6

sx when CD4 T cell count is 500-700

Answer 6

lymphadenopathy

Question 7

sx when CD4 T cell count is 200-500

Answer 7

TB

Kaposi Sarcoma

Question 8

Tx for TB + CD4+ T cell count 200-500

Answer 8

latent: IINH

2nd line: Rifampin

Question 9

sx when CD4+ count is < or equal to 200

Answer 9

Pneumocystis (PCP)

Question 10

tx for pneumocystis pneumonia

Answer 10

Bactrim

Question 11

sx when CD4+ T cell count < or equal to 100

Answer 11

toxoplasmosis

cryptococcus

Question 12

toxoplasmosis tx

Answer 12

bactrim

Question 13

cryptococcus tx

Answer 13

fluconazole

Question 14

sx for CD4+ T cell count < or equal to 50

Answer 14

MAC

CMV Retinitis

Question 15

Tx for MAC

Answer 15

macrolides

Question 16

Tx for CMV Retinitis

Answer 16

Valganciclovir

Question 17

What are the 3 tx options for HIV?

Answer 17

1. NNRTI + 2NRTIS
2. PI + 2NRTI
3. INSTI + 2NRTIS

Question 18

Truvada (Emtiricitabine/Tenofovir)

Answer 18

NRTI

Question 19

Side Effects of Truvada (Emtiricitabine/Tenofovir)

Answer 19

peripheral neuropathy, pancreatitis

Question 20

Zidovudine

Answer 20

NRTI

Question 21

SES of Zidovudine (NRTI)

Answer 21

bone marrow suppression

Question 22

Efavirenz

Answer 22

NNRTI

Question 23

SES of Efavirenz (NNRTI)

Answer 23

vivid dreams, depression, neuro disturbances

Question 24

SES of protease inhibitors

Answer 24

GI, lipodystrophy, hyperlipidemia

Question 25

Indinavir SES

Answer 25

Renal stones

Question 26

Fusion inhibitors SES

Answer 26

hyperlipidemia

Question 27

Tx for gonococcal ophthalmia neonatorum

Answer 27

Topical Erythromycin

Question 28

Neisseria Gonorrhea Conjunctivitis

Answer 28

Newborns < 5 days old, sexually active adults

Hyperpurulent discharge

Corneal ulceration/perforation

Admission

Topical Erythromycin + IV antibiotics