MTB 4

Question 1

HIV PPX < 200 Pts w rash w TMP SMZ

Answer 1

Dapsone

Atorvaquone

Question 2

HIV PPX < 200 Pts w rash w TMP SMZ and G6PD

Answer 2

Pentamidine - Aerolized

Atovaquone

Question 3

Pt on TB TX and develops optic neuritis - next best step

Answer 3

STop Ethambutol

Question 4

TB drugs CI in Pregnancy

Answer 4

Pyrazinamide

Streptomycin

Question 5

What bug with fisherman?

Answer 5

Vibrio vulnificans

Question 6

Presentation of C.Dif

Answer 6

Profuse
Watery
Diarrhea

Question 7

TX for C.Dif

Answer 7

1. Metronidazole
2. Recurs - Metronidazole 10 d
3. PO Vanco Taper down hi to low dose
4. Fidoxmycin
5. Fecal transplant

Question 8

DX test for Giardia and Cryptosporidia

Answer 8

Stool for ova and parasites
ELISA - Giardia
Modified AFB stain - Cryptosporidia

Question 9

Most important contributory factor to perinephric abscess

Answer 9

Stones

Question 10

Best initial test for HIV

Answer 10

ELISA

Question 11

Confirmatory test for HIV

Answer 11

Western Blot

Question 12

HIV test for infants

Answer 12

PCR

Viral culture

Question 13

How long are maternal HIV abs present in infants

Answer 13

Up to 6 months

Question 14

When is viral load testing used in HIV

Answer 14

Viral load = PCR RNA

1. Response to therapy
2. Detect TX failure
3. DX for HIV in babies

Question 15

HIV pts w CD4 < 100 + living in endemic areas of Histoplasmosis

Answer 15

PPX Itraconazole

Question 16

First manifestation of failing TX

Answer 16

Rising PCR-RNA load

Question 17

When do we start TX for HIV

Answer 17

CD4 < 500 in asymptomatic pt 
OR
Very high Viral load (> 55,000-100,000)
OR 
Opportunistic infxn occurs

Question 18

What is TX for HIV

Answer 18

3 Drugs from at least 2 classes

Emtricitabine, Tenofovir, Efavirenz = Atripla

Question 19

Combos of HAART

Answer 19

2 NRTIs + 1 NNRTI or 1 PI
2 Nucleosides + 1 PI
2 Nucleosides + Efavirenz

Question 20

HIV drug CI in Pregnancy

Answer 20

Efavirenz = NNRTI

Question 21

When do we do postexposure PPX for needle stick injury and HIV

Answer 21

Serious exposure to blood containing body fluids

Question 22

What is PEP for needle stick

Answer 22

3 drug combo for 4 weeks

AZT, lamivudine, nelfinavir

Question 23

How does acute HIV Infxn present

Answer 23

Fever, sore throat, cervical LA, oral ulcers, diffuse maculopapular rash

Question 24

AE of zidovudine

Answer 24

Anemia
Leukopenia
GI

Question 25

AE of Didanosine and Stavudine

Answer 25

Pancreatitis | Peripheral Neuropathy

Question 26

AE of Abacavir

Answer 26

HSN - usually first 6 wks | Steven Johnson rxn

Question 27

AE of PIs

Answer 27

Hyperlipidemia | Hyperglycemia

Question 28

AE of Indinavir

Answer 28

Nephrolithiasis

Question 29

AE of Tenofovir

Answer 29

Renal Insufficiency

Question 30

How is HSN to Abacavir predicted

Answer 30

HLA B5701

Question 31

AE of Zalcitabine

Answer 31

Pancreatitis Peripheral Neuropathy Lactic Acidosis

Question 32

Drugs that Cause Pancreatitis

Answer 32

``` Pentamidine Didanosine Stavudine Zalcitabine Azathiorpine Sulfas - thiazides, TMP-SMX ```

Question 33

How to ID NNRTI

Answer 33

"vir" in middle

Question 34

Pregnant HIV woman on HAART - management

Answer 34

Continue regimen | Switch Efavirenz to PI

Question 35

Pregnant HIV pt with CD4 > 350 and not on HAART - management

Answer 35

TX with combo HAART

Question 36

Pregnant HIV pt with high CD4 and low viral load - management

Answer 36

HAART in 2nd and 3rd trimester to prevent perinatal trasmission Stop after delivery if not needed for pt

Question 37

TX for babies born to HIV + mothers

Answer 37

Zidovudine during delivery for 6 wks after

Question 38

C section in HIV + pts

Answer 38

If CD4 < 350 | Viral load is high > 1,000