HIV

Question 1

definition of late diagnosis of HIV

Answer 1

CD4 count < 350 cells/mm2 within 3 months of diagnosis

Question 2

late diagnosis of HIV is associated with (3)

Answer 2

• increased risk of opportunistic infections
• increased morbidity + mortality
• impaired response to HAART

Question 3

prevalence of HIV in an area which recommends by NICE to offer HIV testing to

Answer 3

HIV > 2 per 1000 population

Question 4

in high prevalence areas where should HIV testing be offered

Answer 4

• all new GP practices
• all patients attended GP for another reason
• all acute presentations to hospital

Question 5

what is a HIV indicator disease

Answer 5

conditions where GIV infection is part of the differentials

Question 6

HIV consent requires…

Answer 6

• to be informed + verbal

- should be documented in patients notes

Question 7

who should be tested if individual found to be positive

Answer 7

• all known sexual contacts with the individual including current and previous partners
• children

Question 8

what is PCP?

Answer 8

Pneumocystic jiroveci (yeast like fungal pathogen)

can cause pulmonary infection in immunocompromised individuals

Question 9

PCP occurs in those with CD4 counts of..

Answer 9

< 200 cells/mm3

Question 10

PCP diagnosed by?

Answer 10

broncho-alveolar lavage

Question 11

PCP treatment

Answer 11

high dose IV co-trimoxazole

steroids

Question 12

how to reduce risk of HIV pos patients from PCP

Answer 12

PCP prophylaxis

Question 13

1st + 2nd line PCP prophylaxis

Answer 13

1st = low dose co-trimoxazole

2nd = dapsone

Question 14

when can PCP prophylaxis be stopped

Answer 14

CD4 count > 200 for > 3 months

Question 15

what testing does a baby need if born to a mother HIV positive

Answer 15

testing at:

• 6 weeks
• 12 weeks
• 18 months

Question 16

HAART stands for

Answer 16

highly active anti retroviral therapy

Question 17

what is undetectable viral load defined as

Answer 17

HIV viral load < 20 copies/ml

Question 18

common HIV trx side effects

Answer 18

• diarrhoea
• nausea + vomiting
• headache
• tiredness
• rash

Question 19

what does U = U in publicity mean?

Answer 19

once on trx with undetectable viral load; patients are unable to transmit the virus

undetectable = untransmittable

Question 20

how do medical practitioners notify a notifiable disease

Answer 20

notify proper officer at local council or local health protection team (HPT)

Question 21

risk factors for travel abroad

Answer 21

• exposure to sick patients
• exposure to animals
• contaminated food
• sexual contacts

Question 22

different types of travel to ask about… to indicate the level of expsure to different risks

Answer 22

• working in healthcare facility
• visiting friends and family
• organised package holiday

Question 23

5 viral haemorrhagic fevers

Answer 23

1) lassa fever
2) crimean-congo
3) marburg
4) ebola
5) dengue

Question 24

transmission of VHF

Answer 24

• bodily fluids

- contact/bites from certain animals

Question 25

presenting features of VHF

Answer 25

- fever - headache - muscle aches - exhaustion

Question 26

features of severe disease from VHF

Answer 26

- pulmonary oedema - shock - coma - bleeding (e.g. gums + intestines)