VPI Clinical and Pharmacy Practice

Question 1

Advice to give patients for preventing bites

Answer 1

Stay somewhere airconditions
Use Preventer nets on doors and beds
Try not to be outside from dusk to dawn
Loose-fitted trousers and long sleeve shirts
Use Insect repellent on skin and sleeping environments (DEET - Diethyltoluamide)

Question 2

Malaria chemoprophylaxis: Casual and suppresive

Answer 2

Casual ( Targets liver stage 7 days to develope)

Suppressive prophulaxis: erythrocytic stage (4 weeks after continue)

Question 3

Malaria chemophrophylaxis: Specific medicine + Side effects

Answer 3

Malarone (atovaquone + proguanil)

Works or eryhrocytic and prevents development of liver schizonts

SE: Headache, GI upset

Question 4

Mefloquine (Lariam) : Side effects

Answer 4

Side effects: dizziness, insomnia, anxiety, depression

Question 5

Doxycycline : MOA + Side effects

Answer 5

Prevents development of erythrocytic stages

SE:
Sunburn (light sensitive)
GI upset
TAKEN with food

Question 6

Treating Malaria : Clinical presentation

Answer 6

Pro-dromal S: headache, muscular paionts

History of travel to an enemic area, Chills and fever cycle

Question 7

Malaria febrile paroxysms three stages

Answer 7

1) Cold stage (last 1 hr)
2) Hot stage (last 6 hours)
3) Sweating stage

Question 8

Treating Malaria : complications

Answer 8

If >2% RBCs infected -> Cerebral malria & black water fever

Question 9

Cerebral malaria & black water fever S&S

Answer 9

Cerebral malaria: Coma and death body temp up

Black water fever: Dark urine, (only P.falc)

Question 10

What is the burden of malaria?

Answer 10

1) Anaemia and low birth weight
2) lifelong effects childhood anaemia
3) persistant language deficits

Question 11

What is a DALY

Answer 11

Disabililty-adjusted life years

Question 12

What is YLL

Answer 12

Years of life lost due to premature mortalilty

Question 13

What is YLD

Answer 13

Years lost due to disability (people living with health conditon & its consequences)

Question 14

Malaria elimination stratergy (3)

Answer 14

1) aggresive control in malrai endemic areas
2) Progresive elimination from endemic margins
3) Research bring new tech

Question 15

If p is < 0.0005

Answer 15

Signficant

Question 16

FIxed cost

Answer 16

Running the intervetion

Question 17

Variable cost

Answer 17

Resources used treating patients : drugs

Question 18

Current Recommendations for HAART options in HIV + when to start threapy?

Answer 18

2 NRTIs (e.g Abacavir + Iamivudine Third drug)

Start therapy Early (simplicity of current regimens + mortalilty at higher CD4)

Question 19

Benefits of HAART

Answer 19

Prevention mother -> Child
Secondary prevention HIV Transmission
Increase or maintain CD4 nubmbers
Delays progresion to AIDS

Question 20

Limitations of HAART

Answer 20

non-adherence may cause resistance

Question 21

The role of indicator diseases + indicator disease e.g.

Answer 21

Indicator diseases are diseases that aren’t usually transmitted unless the patient is immunocomprimised

e.g. Any STI, Aspergiolloisis, Pneumonia, pyrexia

Question 22

HAART Side effects (short and long term)

Answer 22

Short term: N & V & D + headache

Long term: Dyslipidaemia, peripheral neuropath, diabetes, Bone mineral density

Question 23

When to change therapy & 2nd line therapies?

Answer 23

Side effects
Pregnacy
Drug interations

Question 24

Factors affecting medicines adherence?

Answer 24

Failure to acknowledge need and benefit of treatment
Stigmatism (fear HIV status)
Intolerance to Side effects
Complex regimes

Question 25

How to imrpove adherence;

Answer 25

Simpified drug regimens

Question 26

Management of HIV-related illnesses

Answer 26

E.g Tuberculosis

Question 27

Role of Post-exposure prophylaxis

Answer 27

Prophylaxis for transmission of HIV Remove virus before systemic dissemination (Zidovudine)

Question 28

Managment of TB in HIV

Answer 28

Treat TB immediately (rifampicin)

Question 29

Management of HIV in pregnancy

Answer 29

cART regimen + start second trimester Reduce mothers viral load Careful management of deilvery + avoid breastfeeding

Question 30

Current recommendations for OTC management of Varicella Zoster?

Answer 30

Chickepox Rash that turns (Fluid filled blisters) Treat with antiviral

Question 31

Current recommendations for OTC management of herpes simplex (shingels)

Answer 31

Infection of a nerve and area of skin around it (caused bt dormant VZV from chicken pox) Treatment: Antivrials + analgesia + keep clean

Question 32

Current recommendations for OTC management of HPV

Answer 32

HSV-1 Cold sores Tingling -> fluid filled sores ``` Antiviral cream (Zovirax) Cream applied as soon as tingling ```

Question 33

Current recommendations for OTC management of Viral UTIs

Answer 33

Common cold No cure: Symptomatic treatments: Ibuprofen, fluids

Question 34

Measles Epidemiology , Presentation + Diagnosis

Answer 34

Epidemiology: Transmission via respiratory Presentation : Rash 3 days + fever 1 day Diagnosis : lab confirmation

Question 35

Mumps Epi, Presentation

Answer 35

Asymptomatic or non-specific, distoriton of mouth and neck

Question 36

Rubella Epi, presentation, Diagnosi,

Answer 36

Epi : Togavirus Presentation: fever, malaise, rash on face and neck Diagnosis: Rubella-specific IgM in saliva

Question 37

Management of i) Measels ii) Mumps iii) Rubella

Answer 37

i) symptomatic relief ii) symptomatic relief iii) Antipyretics (not near pregnant women)

Question 38

CRS (congenital rubella syndrom)

Answer 38

Causes Miscarriage, Cataracs Deafness Cardiac abnormalities