HIV

Question 1

The so-called_______ is where the plasma viral

load drops to a steady level for many years

Answer 1

‘set point’

Question 2

Patients invariably recover to enter a long period of

good health for_____ years

Answer 2

5

Question 3

_______is

the commonest presentation of AIDS

Answer 3

Pneumocystis jiroveci (ex carinii ) pneumonia (PJP)

Question 4

Approximately_______ of HIV-positive children

are infected from HIV-infected mothers

Answer 4

15–40%

Question 5

Infants born to these mothers may develop the
disease within a few months, with 30% affected by
the age of _____

Answer 5

18 months.

Question 6

The time for the onset of AIDS in HIV-affected adults
varies from 2 months to 20 years or longer; the
median time is around ____

Answer 6

10 years

Question 7

In family practice the most common presentation of
HIV-related illness is seen in the ______
for example, candidiasis and herpes

Answer 7

skin/oral mucosa,

Question 8

____is a common, serious but treatable complication

of HIV

Answer 8

TB

Question 9

HIV antibody testing is a two-stage process: the
_____ test for screening followed by
another method (e.g. Western blot) if positive

Answer 9

antigen–antibody

Question 10

The seroconversion period from acquiring HIV
infection to a positive antibody test varies between
individuals: this period is known as the_____

Answer 10

‘window

period

Question 11

The level of immune depletion is best measured
by the ________
count—the CD 4 cell count

Answer 11

CD 4 positive T-lymphocyte (helper T-cell)

Question 12

What are clinical stages of HIV

1
2
3
4
5

Answer 12

1. Seroconversion illness (self-limited 1–3 weeks)
2. Asymptomatic
3. Symptomatic—early
4. Symptomatic—late
5. Advanced

Question 13

The illness usually occurs
within 6 weeks of infection and is characterised by
fever, night sweats, malaise, severe lethargy, anorexia,
nausea, myalgia, arthralgia, headache, photophobia,
sore throat, diarrhoea, lymphadenopathy, generalised
maculoerythematous rash and thrombocytopenia

Answer 13

Acute (seroconversion) illness

Question 14

Main Sx of acute seroconversion

Answer 14

The main symptoms are headache, photophobia

and malaise/fatigue

Question 15

Close ddx of acute seroconversion

Answer 15

resembles infectious mononucleosis

Question 16

labs of acute seroconversion

Answer 16

neutropenia,
lymphopenia, thrombocytopenia, and mildly
elevated ESR and serum transaminase

Question 17

fever + severe malaise +

lymphadenopathy

Answer 17

acute HIV

Question 18

CD4 count

Seroconversion illness

Answer 18

Transient decrease, commonly
followed by a return to nearnormal
level

Question 19

CD4 count

Asymptomatic

Answer 19

Usually >500 cells/μL
Gradual decrease of
50–80 cells/μL

Question 20

CD4 count

Symptomatic—early

Answer 20

Usually 150–500 cells/μL

Question 21

CD4 count

Symptomatic—late

Answer 21

Usually <150 cells/μL

Question 22

CD4 count

Advanced

Answer 22

Usually <50 cells/μL

Question 23

What stage of HIV

Headaches
Persistent generalised lymphadenopathy

Answer 23

Asymptomatic

Question 24

What stage of HIV

Oral and vaginal candidiasis, oral hairy leukoplakia,
seborrhoeic dermatitis, psoriasis, recurrent varicella
zoster infection, cervical dysplasia, unexplained
fever, sweats, weight loss, diarrhoea, tuberculosis

Answer 24

Symptomatic—early

Question 25

What stage of HIV PJP, Kaposi sarcoma, oesophageal candidiasis, cerebral toxoplasmosis, lymphoma, HIV-1 associated dementia complex, cryptococcal meningitis

Answer 25

Symptomatic—late

Question 26

What stage of HIV ``` CMV retinitis, cerebral lymphoma, Mycobacterium avium complex (MAC) infection ```

Answer 26

Advanced

Question 27

T or F Severe PJP can have little or no chest signs, and, unless treated, patients can rapidly deteriorate and die

Answer 27

T

Question 28

Oral manifestations of patients with HIV ``` • Aphthous ulcers • Angular cheilitis • Periodontal/gingival disease • Tonsillitis • Oral candidiasis • ________ (frequently mistaken for candidiasis but affects lateral border of tongue) ```

Answer 28

Oral hairy cell leukoplakia

Question 29

Cutaneous manifestations of HIV ``` 1 2 3 4 5 6 ```

Answer 29

* Impetigo * Warts * HSV * Shingles, especially multidermatomal * Seborrhoeic dermatitis * Cutaneous mycoses

Question 30

painless red-purple lesions on any part of the body including palms, soles, oral cavity and other parts of the GIT

Answer 30

Kaposi sarcoma

Question 31

the strongest predictor | of possible clinical manifestations of HIV infection

Answer 31

CD 4 lymphocyte counts

Question 32

a measure of the serum level of RNA of the HIV virus—correlates with response to treatment and progression to AIDS and death

Answer 32

Viral load

Question 33

T or F, Monotherapy is important in HIV Tx

Answer 33

F

Question 34

In HIV Tx ______ is the limiting factor, no matter how potent an individual drug may be at reducing viral load initially.

Answer 34

Viral resistance

Question 35

The trials of combined ______ and ________demonstrated both a more sustained decrease in plasma viral load than either drug did alone, and a more delayed development of viral resistance

Answer 35

zidovudine and | lamivudine

Question 36

Most acceptable HIV Tx

Answer 36

(HAART)

Question 37

Subcutaneous injections of | ______have been shown to boost immunity

Answer 37

interleukin-2

Question 38

Current thinking favours early treatment. The | most widely used and preferred regimen consists of _________

Answer 38

2 | NTIs plus either an NNRI or a protease inhibitor

Question 39

This is a combination of three (or more) agents with | one or more penetrating the blood–brain barrier.

Answer 39

HAART (highly active antiretroviral therapy

Question 40

This is an important cause of pneumonia and not | usually seen until the CD 4 + cell count is <200/ μ L

Answer 40

Pneumocystis jiroveci 9

Question 41

Tx of Pneumocystis jiroveci

Answer 41

It is usually treated with trimethoprim + sulfamethoxazole (cotrimoxazole) oral or IV for 21 days depending on severity, which is also given orally as prophylaxis when the cell count reaches <200

Question 42

Alterantive Tx of Pneumocystis jiroveci

Answer 42

Alternative agents are IV pentamidine or oral | dapsone, clindamycin and atovaquone.

Question 43

T or F You need a Repeat HIV antibody test

Answer 43

T

Question 44

T or F You need a G6PD test for all HIV pts

Answer 44

T

Question 45

Prophylaxis—this is managed according to immune status: if CD 4 count <200 cells/ μ L use ______ to prevent opportunistic infections, particularly PJP

Answer 45

cotrimoxazole