hematologic infections

Question 1

What are additional complications (besides fever, myalgias, abd pain, vomiting/diarrhea) of P. falciparum infection?

Answer 1

decr. consciousness, pulm edema, renal insufficiency

Question 2

What prophylactic medications should be given to travelers to sub-saharan africa, tropical South america, and southwest Asia to prevent malaria?

Answer 2

chloroquine, mefloquine

Question 3

What meds can be used for chloroquine resistant P. falciparum?

Answer 3

atovaquone-proguanil or mefloquine

Question 4

When after infection do symptoms of mononucleosis appear?

Answer 4

2-5 wks

Question 5

How long should a pt with mono avoid contact sports?

Answer 5

1 month

Question 6

What are the key differences btw HIV-1 and HIV-2?

Answer 6

-HIV-2 progresses more slowly, is less infectious early in the disease, is more infectious in late disease, and is less common in the US

Question 7

When after exposure do pts develop signs of acute HIV infection? How long does it last?

Answer 7

• two to four weeks after infection

- lasts ~2 wks

Question 8

What is the next step for a health care worker exposed to HIV via needle stick?

Answer 8

prophylactic zidovudine and lamivudine for 4 wks; follow-up HIV tests for up to 6 months after exposure

Question 9

How is HIV detected?

Answer 9

ELISA detects HIV antibodies. After 2 positive ELISA tests, which are 99% sensitive, confirm with western blot testing

Question 10

What are common HAART regimens?

Answer 10

1. two nucleoside reverse transcriptase inhibitors and either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor
2. low dose ritonavir can be added to increase protease inhibitor activity

Question 11

What is the goal viral load for HAART?

Answer 11

load

Question 12

What is the treatment for an infant born to an HIV positive mother?

Answer 12

zidovudine for 6 wks after birth. test infants for presence of virus in the first 6 months of life (anti-HIV antibodies will always be present in these kids)

Question 13

What parasitic diarrheas are seen in HIV+ people and at what CD4 cell count?

Answer 13

isospora, strongyloides, cryptosporidium

seen at CD4 count

Question 14

What are the pulmonary infections of HIV+ people and how can you tell them apart?

Answer 14

1. coccidiomycosis (CD4

Question 15

What are key neurologic consequences of HIV?

Answer 15

1. AIDS dementia: CD4

Question 16

At what CD4 count does wasting syndrome appear in HIV?

Answer 16

CD410% baseline weight

Question 17

What is bacilliary angiomatosis?

Answer 17

seen in HIV d/t bartonella henselae or bartonella quintana. fever, weight loss, malaise, abd pain, purple skin masses (large pedunculated granulomas/cherry angiomas) and visceral nodular contrast enhancing lesions that bleed easily.

Question 18

What are the nucleoside reverse transcriptase inhibitors and what are their adverse effects?

Answer 18

abacavir, didanosine, lamivudine, zidovudine. some are associated with bone marrow toxicity, neruopathy, pancreatitis

Question 19

What are the non-nucleoside reverse transcriptase inhibitors and what are their adverse effects?

Answer 19

delavirdine, efavirenz, nevirapine. possible neuro/hepatic effects

Question 20

What are the protease inhibitors and what are their adverse effects?

Answer 20

idinavir, nelfinavir, ritonavir. hyperglycemia, hypertriglyceridemia, drug interactions, lipodystrophy

Question 21

What is an integrase inhibitor and wat is its negative effect?

Answer 21

raltegravir inhibits the final step of integration of viral DNA into host DNA. can cause neutropenia, pancreatitis, hepatotoxicity, hyperglycemia

Question 22

What are the fusion inhibitors and what are their side effects?

Answer 22

enfurvutide- prevents viral fusion with CD4 membrane. can cause hypersensitivity at injection site, bacterian PNA

Question 23

What are the CCR5 antagonists and how to they work?

Answer 23

maraviroc- inhibits CCR5 coreceptor to block viral entry to host cell. may cause fever, cough, URI, neuropathy, dizziness