HIV, TB, and Traveler’s Diarrhea

Question 1

Screening test for asymptomatic HIV adult patients:

Answer 1

• ELISA, if positive – Western blot for confirmation

Question 2

Window for seroconversion for HIV:

Answer 2

• 3-4 weeks false negative window

Question 3

Symptomatic HIV test:

Answer 3

• Viral load/IgM

Question 4

Infant HIV screening

Answer 4

HIV DNA PCR test

Question 5

HIV med tx:

Ritonavir drug interaction

Answer 5

• Drug interaction to corticosteroids – risk of adrenal suppression (Cushing’s)
• Effects atorvastatin/simvastatin (fat-soluble) – increase statin concentration

Question 6

Screening TB:

Answer 6

• HIV, healthcare workers
• Vaccinated = no skin test but can do quant gold and CXR
• HIV TB induration is different (at least 5mm)
• No HIV TB induration >15mm

Question 7

Traveler’s Diarrhea:

Answer 7

• Classic: Passage of three or more unformed stools in a 24-hour period plus at least one of these other symptoms: nausea, vomiting, abdominal pain or cramps, fever, blood in stools
• Moderate: Passage of one or two unformed stools in 24 hours plus at least one of the above symptoms or more than two unformed stools in 24 hours without other symptoms
• Mild: Passage of one or two unformed stools in 24 hours without other symptoms

Question 8

Patient with diarrhea + belching and upper intestinal problems

Answer 8

• Giardia

Question 9

Patient with watery diarrhea:

Answer 9

• Cholera, cryptosporidiosis, Cyclospora

Question 10

Patient with intermittent diarrhea + bloating

Answer 10

• Microsporidiosis

Question 11

Traveler’s diarrhea in Southeast Asia:

Answer 11

• Campylobacter

- Tx: azithromycin

Question 12

Highest predictor of mortality in elderly

Answer 12

• Malnutrition – can’t heal from wounds/infections