Lecture 172

Question 1

Complement deficiency can increase the risk of what type of infections?

Answer 1

Neisseria infections

Question 2

Humoral immunity defects can increase the risk of what type of infections?

Answer 2

Encapsulated bacteria

Question 3

Granulocytopenia can increase the risk of what type of infections?

Answer 3

Gram-negative enterics, pseudomonas, staphylococci, Viridians streptococci fungi

Question 4

Cellular immunity defects can increase the risk of what type of infection?

Answer 4

Intracellular bacteria, viruses, fungi, and parasites

Question 5

Alpha4 integrin blockade by natalizumab increase the risk of what condition?

Answer 5

Progressive multifocal leukoencephalopathy (PML) caused by JC virus

Question 6

What infections are SOT recipients most at risk for immediately after surgery?

Answer 6

Hospital-acquired bacteria, candida, C. diff

Question 7

What combination of CMV status presents the highest risk for a SOT recipient?

Answer 7

Donor positive, recipient negative

Question 8

What CD4+ count characterizes stage 1 AIDS?

Answer 8

CD4 >500

Question 9

What CD4+ count characterizes stage 2 AIDS?

Answer 9

CD4 200-499

Question 10

What CD4+ count characterizes stage 3 AIDS?

Answer 10

CD4 <200

Question 11

What criteria other than CD4 count characterizes stage 3 AIDS?

Answer 11

Documentation of an AIDS-defining condition

Question 12

What type of organism causes PJP?

Answer 12

Fungi

Question 13

What CD4 count predisposes PJP?

Answer 13

CD4 <200

Question 14

What is the most common opportunistic infection in untreated AIDS?

Answer 14

PJP

Question 15

Subacute onset of a nonproductive cough, fever, and progressive dyspnea with lungs that are clear to auscultation suggests what AIDS OI?

Answer 15

PJP

Question 16

What radiographic findings are common in PJP?

Answer 16

CXR shows bilateral interstitial/ground-glass opacities without effusion

Question 17

What is the treatment for PJP in AIDS patients?

Answer 17

TMP/SMZ

Question 18

What is the recommended prophylaxis for PJP in AIDS?

Answer 18

TMP/SMZ

Question 19

What type of organism is CMV?

Answer 19

Beta herpesvirus

Question 20

What CD4 count predisposes to CMV?

Answer 20

CD4 <50

Question 21

Retinitis, pneumonitis, ulcerative esophagitis, colitis, and transplant rejection are clinical signs of what AIDS OI?

Answer 21

CMV

Question 22

Flame hemorrhages and cotton wool spots are diagnostic findings that suggest what AIDS OI?

Answer 22

CMV

Question 23

Tissue biopsy showing ‘Owl’s eye’ inclusion bodies suggests what AIDS OI?

Answer 23

CMV

Question 24

How is CMV treated in AIDS?

Answer 24

Ganciclovir/valganciclovir

Question 25

What is the prophylaxis of AIDS CMV?

Answer 25

Valganciclovir

Question 26

What type of organism is HSV?

Answer 26

Alpha herpesvirus

Question 27

What CD4 count predisposes to HSV?

Answer 27

CD4 <50

Question 28

Retinitis, oral ulcers, esophagitis, tracheobronchitis, pneumonitis, colitis, and encephalitis are presentations of what AIDS OI?

Answer 28

HSV

Question 29

What is the treatment for AIDS HSV?

Answer 29

Acyclovir/valacyclovir

Question 30

What is the prophylaxis for AIDS HSV?

Answer 30

Acyclovir

Question 31

What type of organism is VZV?

Answer 31

Alpha herpesvirus

Question 32

VZV retinitis in AIDS presents at what CD4 threshold?

Answer 32

CD4 <200

Question 33

VZV acute retinal necrosis presents at what CD4 threshold?

Answer 33

CD4 <50

Question 34

What is the treatment for AIDS VZV?

Answer 34

Acyclovir/valacyclovir

Question 35

What is the prophylaxis for AIDS VZV?

Answer 35

Acyclovir

Question 36

What CD4 count predisposes to MAC (mycobacterium avium complex)?

Answer 36

CD4 <50

Question 37

Fever, weight loss, night sweats, diarrhea, lymphadenopathy, hepatosplenomegaly, and anemia suggest what disseminated AIDS OI?

Answer 37

MAC

Question 38

How is AIDS MAC treated?

Answer 38

Combination therapy: clarithromycin, plus ethambutol

Question 39

What type of organism is cryptococcus neoformans?

Answer 39

Encapsulated yeast-like fungus

Question 40

Where is C. neoformans found?

Answer 40

Soil contaminated with avian droppings

Question 41

What CD4 count predisposes to C. neoformans infection?

Answer 41

CD4 <50

Question 42

What is the most common presentation of C neoformans infection in a patient with AIDS?

Answer 42

Meningitis

Question 43

What is the induction therapy for C. neoformans infection?

Answer 43

Amphotericin B and flucytosine

Question 44

What is the maintenance therapy for C. neoformans infection?

Answer 44

Oral fluconazole

Question 45

What is the prophylactic treatment for C. neoformans?

Answer 45

Fluconazole

Question 46

What CD4 count predisposes to JC reactivation and ensuing PML?

Answer 46

CD4 <50

Question 47

Subacute neurological decline affecting brain white matter and characteristic demyelinating lesions suggest what AIDS OI?

Answer 47

PML

Question 48

What type of organism is toxoplasma gondii?

Answer 48

Protozoan parasite

Question 49

What CD4 count predisposes to toxoplasma gondii infection?

Answer 49

CD4 <100

Question 50

Fever, headache, confusion, focal neurological deficits, and seizures suggest what AIDS OI?

Answer 50

Cerebral toxoplasmosis

Question 51

Brain imaging showing multiple ring-enhancing lesions, often in basal ganglia or corticomedullary junction suggest what AIDS OI?

Answer 51

Cerebral toxoplasmosis

Question 52

How is cerebral toxoplasmosis treated?

Answer 52

Pyrimethamine and sulfadiazine

Question 53

What prophylaxis is used to prevent toxoplasma gondii infection in IgG-positive patients with CD4 <100?

Answer 53

TMP/SMZ

Question 54

What is IRIS?

Answer 54

Immune reconstitution inflammatory syndrome

Question 55

What is an exaggerated inflammatory reaction to an opportunistic pathogen that occurs after initiating ART?

Answer 55

Immune reconstitution inflammatory syndrome

Question 56

What type of IRIS involves a flare-up of a previously undiagnosed/subclinical infection soon after starting ART?

Answer 56

Unmasking IRIS

Question 57

What type of IRIS involves worsening of a previously treated infection despite microbiologic control after starting ART?

Answer 57

Paradoxical IRIS

Question 58

Starting ART with a very low CD4 count and a high pathogen burden increases the risk of ____

Answer 58

IRIS