HIV

Question 1

A condition seen in some cases during HAART when the immune system recovers, then responds to a previously acquired opportunistic
infection with an inflammatory response that paradoxically makes
symptoms of the infection worse is known as what?

Answer 1

Immune reconstitution inflammatory syndrome (IRIS)

Question 2

30 year old female presents to the ED with 3 week history of progressive shortness of breath and non-productive cough
ROS: fever, weight loss, diarrhea (for several months)
Physical exam: General: thin, chronically ill-appearing. Vital signs: RR 32 (tachypneic), O2 sat = 96% @ rest desats to 88%
Lungs: diminished breath sounds
Chest X ray: diffuse bilateral infiltrates
Labs: LDH elevated
What is the most likely diagnosis?

Answer 2

pneumocystis pneumonia

Question 3

45 y/o M presents to clinic for routine HIV care. He was diagnosed with HIV in 1992 and has never been on antiretroviral therapy. In general he feels fine.
CD4 cell count of 675 cells/ml (unchanged since 1998)
Viral load non detectable (less than 20 now, use to be less than 400 before)
Most likely diagnosis?

Answer 3

He is an elite controller

Question 4

A 34 y/o M with h/o AIDS presents with c/o chronic facial lesions. On your exam you note the following wart-like pearly lesions with central umbilication. Most likely diagnosis?

Answer 4

Molluscum contagiosum

Question 5

A 41 y/o CM with a CD4 count of 56 presents with onset of headache, fevers, photophobia, no nuchal rigidity and the following cutaneous lesions.
Lumbar puncture reveals a high opening pressure and the following is seen on india ink staining:

Answer 5

cryptococcal meningitis

Question 6

cat feces, raw or uncooled meat. pt presents with HA, seizure and fever. what is the treatment?

Answer 6

sulfadiazine +pymethamine + folinic acid for toxoplasmosis

Question 7

What is the primary prophylaxis for PCP, toxoplasmosis, and diarrhea?

Answer 7

bactrim

Question 8

What is the primary prophylaxis for MAC?

Answer 8

zithromax

Question 9

What is the typical CD4 count and what are the typical symptoms for MAC?

Answer 9

CD4 less than 50 and symptoms are typically drenching night sweats, fever, chills, weight loss and diarrhea

Question 10

how do you treat oral oral candida?

Answer 10

mycelex or nystatin

Question 11

how do you treat esophageal candida?

Answer 11

fluconazole

Question 12

How do you treat cryptococcal disease?

Answer 12

amphotericin B, fluconazole. CD4 less than 50. india ink stain

Question 13

NRTIs work where?

Answer 13

reverse transcriptase

Question 14

NNRTIs work where?

Answer 14

reverse transcriptase

Question 15

What is the preferred combination of therapy?

Answer 15

NNRTI, PI or II + 2 NRTIs

Question 16

What is the preferred regimen (actual drugs, not classes)?

Answer 16

Raltegravir combined with tenofovir disoproxil fumarate (DF)/emtricitabine