Prevention Of Opportunistic Infections

Question 1

3 indications for PCP prophylaxis

Answer 1

1. CD4 count of

Question 2

Indication to stop PCP prophylaxis

Answer 2

CD4 count of >200/uL

Question 3

Prophylaxis for isoniazid sensitive MTB

Answer 3

Isoniazid 300mg and Pyridoxine 25mg OD x 9mos

Isoniazid 900mg twice weekly + daily Pyridoxine

Question 4

4 indications for MTB prophylaxis

Answer 4

1. Skin test >5mm
2. Positive IFN release assay
3. Prior positive test without treatment
4. Close contact with case of active TB

Question 5

Prophylaxis for M. Avium complex

Answer 5

Azithromycin 1200mg weekly

Azithromycin 600mg twice weekly

Clarithromycin 500mg BID

Question 6

Prophylaxis for MAC with prior documented disease

Answer 6

Clarithromycin 500mg BID + Ethambutol 15mg/kg/day

Question 7

Indication for MAC prophylaxis

Answer 7

CD4 count of

Question 8

Indication to stop MAC prophylaxis

Answer 8

CD4 count of >100/uL x >/=6months

Question 9

Prophylaxis for Toxoplasma gondii

(Toxo IgG positive and CD4 count

Answer 9

TMP-SMX 1DS tab OD

Question 10

Prophylaxis for Toxoplasma gondii

(Prior toxoplasmic encephalitis and CD4 count

Answer 10

Sulfadiazine 2000-4000mg in 2-4 divided doses per day
Pyrimethamine 25-50mg per day
Leucovorin 10-25mg per day

Question 11

Indication to stop Toxoplasma prophylaxis

Answer 11

CD4 count >200/uL x >/=3 months

Question 12

VZV prophylaxis

Answer 12

Varicella Zoster immune globulin IM within 10days of exposure

Question 13

Indication for VZV prophylaxis

Answer 13

Significant exposure to chickenpox or shingles in a patient with no prior immunization

Prior exposure to either

Question 14

Prophylaxis for cryptococcus neoformans

Answer 14

Fluconazole 200mg per day

Question 15

Indication for crytococcus neoformans prophylaxis

Answer 15

Prior documented disease

Question 16

3 indications to stop cryptococcus neoformans prophylaxis

Answer 16

1. CD4 count >100/uL
2. No evidence of active disease
3. HIV RNA levels 3 months

Question 17

Alternative prophylaxis for crytococcus neoformans

Answer 17

Itraconazole 200mg per day

Question 18

Prophylaxis for Histoplasma capsulatum

Answer 18

Itraconazole 200mg BID

Question 19

2 indications for Histoplasma prophylaxis

Answer 19

1. Prior documented disease

2. CD4 count

Question 20

Prophylaxis for Salmonella infection

Answer 20

Ciprofloxacin 500mg BID x 6 months

Question 21

Indication for Salmonella prophylaxis

Answer 21

Prior recurrent bacteremia

Question 22

Prophylaxis for Coccidiodes immitis

Answer 22

Fluconazole 400mg per day

Question 23

2 indications for Coccidiodes prophylaxis

Answer 23

1. Prior documented disease or positive serology

2. CD4 count

Question 24

Indication to stop Coccidiodes prophylaxis

Answer 24

CD4 count >250/uL x 6 months

Question 25

CMV prophylaxis

Answer 25

Valganciclovir 900mg BID PO

Question 26

3 Indications to start CMV prophylaxis

Answer 26

1. Prior end-organ disease 2. Prior retinitis 3. CD4 count

Question 27

Indication to stop CMV prophylaxis

Answer 27

CD4 count >100/uL x 6 months And No active CMV disease

Question 28

Prevention of severe or frequent recurrence of HSV

Answer 28

Valacyclovir 500mg BID Acyclovir 400mg BID Famciclovir 500mg BID

Question 29

Prevention of severe or frequent recurrence of Cadida

Answer 29

Fluconazole 100-200mg per day

Question 30

Preventive drug of choice for P. Jiroveci

Answer 30

TMP-SMX 1DS tab OD