Ms. Hunt is a 48-year-old Caucasian female with HIV who presents today for her routine primary care follow-up. Dr. Smith tells you that Ms. Hunt has had HIV for a long time, although she has been well. Her last CD4 count was 24 cells/μL. Based on Ms. Hunt's CD4 count, does she meet the criteria for AIDS (acquired immunodeficiency syndrome)?
YESAIDS CD4 count = below 200
Which of the following are AIDS-defining illnesses? Select all that apply.A. Cervical dysplasiaB. Kaposi sarcomaC. LeukemiaD. Oral candidiasisE. Pneumocystis jiroveci pneumoniaF. Pulmonary tuberculosisG. Recurrent pneumonia
Kaposi sarcoma, Pneumocystis jiroveci pneumonia (PJP), Pulmonary tuberculosis, and recurrent pneumonia are AIDS-defining illnessesWhile invasive cervical cancer is AIDS-defining, cervical dysplasia or carcinoma in situ are not considered AIDS-defining illnesses because these latter cervical lesions are common, frequently do not progress to invasive disease, and can be difficult to diagnose.While Burkitt's and primary CNS lymphomas are AIDS-defining, leukemia is not.Esophageal candidiasis, not oral candidiasis, is AIDS-defining.
What is viral load in terms of HIV?
(plasma HIV RNA) represents the number of viral copies detected in the blood
What is the most reliable marker for the current risk of opportunistic complications of HIV and AIDS
CD4+ cells (subset of T cells)
Which of the following immunizations are recommended for HIV-infected adults with CD4+ cell counts under 200 cells/μL? Select all that apply.A. Covid vaccineB. Hepatitis A vaccineC. Hepatitis B vaccineD. Influenza vaccine (inactivated)E. Pneumococcal vaccineF. Varicella vaccine
A. Covid vaccineB. Hepatitis A vaccineC. Hepatitis B vaccineD. Influenza vaccine (inactivated)E. Pneumococcal vaccineFor those that have CD4+ cell counts under 200 cells/μL, live attenuated vaccines, such as varicella, are contraindicated.
WHAT IS HIV?a) A RETROVIRUSb) A BACTERIAc) A VIRUSd) A MUTATED CEL
RETROVIRUS
2. WHAT DOES HIV DO?a) INFECTS HUMAN CELLS DISPLAYING CD4(HELPER-INDUCER T-LYMPHOCYTES, ANDA FEW MORE)b) INTEGRATES ITSELF INTO THE HOST CHROMOSOMEc) DIRECTS THE CELL TO MAKE MOREd) ALL OF THE ABOVE
all of the above
N A HEALTHY PERSON THE NUMBER OF CD4 CELLS IS:a) 100 - 300b) 300 - 700c) 700 - 1500
700 - 1500
Discordant couples
One partner has HIV, one does not
WHO HAS/HAVE AIDS? select all that apply A) CD4 COUNT 500B) CD4 COUNT 195C) CD4 COUNT 600 AND OID) CD4 13%
B) CD4 COUNT 195C) CD4 COUNT 600 AND OID) CD4 13%
IN GENERAL HOW DO YOU DECIDE THE HIV ARV REGIMEN?a) 2 MEDICATIONS: A INSTI AND A NNRTIb) 3 MEDICATIONS OR 2 MEDICATIONS: 2 NRTIS ADDED TO ABASE OF EITHER AN NNRTI OR A PI OR AN INSTI OR INSTI PLUS NRTIc) 3 MEDICATIONS: 1 NRTI, 1 NNRTI, AND 1 CCR5ANTAGONISTSd) 2 MEDICATIONS: 1 PI, 1 NNRTIe) 1 MEDICATION: 1 NRT
3 MEDICATIONS OR 2 MEDICATIONS: 2 NRTIS ADDED TO A BASE OF EITHER AN NNRTI OR A PI OR AN INSTI OR INSTI PLUS NRTI
PT WHO WAS TAKING CARE OF NEIGHBOR'S CAT NOW C/O SEVERE HEADACHE. HEAD CT SHOWS MULTIPLE RINGED-ENHANCED LESIONS. WHAT ORGANISM DO YOU SUSPECT?a) HISTOPLASMA CAPSULATUMb) CRYPTOCOCCUS NEOFORMANSc) TOXOPLASMA GONDIId) CYTOMEGALOVIRUS (CMV)e) HERPES SIMPLEX VIRUS
TOXOPLASMA GONDII
WHICH OF THE FOLLOWING PHYSICAL EXAM FINDINGS IS MOST SPECIFIC FOR HIV INFECTION?a) BASILAR RALES ON LUNG AUSCULTATIONb) ORAL HAIRY LEUKOPLAKIA ON TONGUEc) VITILIGOd) ALOPECIA AREATA
ORAL HAIRY LEUKOPLAKIA ON TONGUE
POST EXPOSURE PROPHYLAXIS (PEP)GUIDELINES?a) START ARV ASAP W/IN 1 WEEK AND TREAT FOR 28 DAYSb) START ARV W/IN 24 HOURS AND TREAT FOR14 DAYSc) START W/IN 72 HOURS AND TREAT FOR 28 DAYSd) START W/IN 72 HOURS AND TREAT FOR 2 MONTHSe) NONE OF THE ABOVE
START W/IN 72 HOURS AND TREAT FOR 28 DAYS
This branch of the immune system involves non-specific, rapid response to invaders through mechanism such as phagocytosis and cytokines
Innate Immune System
This type of hypersensitivity reaction involves T-cells and cytokines and is further characterized as contact, tuberculin, or granulomatous hypersensitivity.
Type IV Cell-mediated/Delayed Hypersensitivity
This immunoglobulin class binds mast cells or basophils and triggers the release of histamine.
IgE
This immunodeficiency involves multiple gene mutations resulting in non-functional B-cells and T-cells
Severe Combined Immunodeficiency Syndrome (SCID)
Deficiency of this inhibitor causes the autosomal dominant disorder hereditary angioedema
C1 inhibitor
DURING SCRATCH TESTING THIS AGENT IS USED AS THE POSITIVE CONTROL.
HISTAMINE
THIS SYNDROME IS THE REASON A PATIENT WITH A CONTACT ALLERGY TO LATEX MANY NOT BE ABLETO CONSUME AVOCADOS OR BANANAS
oral allergy syndrome
CLASSES OF MEDICATIONS THAT MUST BE DISCONTINUED PRIOR TO ALLERGY SKIN TESTING
ANTIHISTAMINES & TRICYCLIC ANTIDEPRESSANTS
DEBRIS FROM DEAD BODIES OF THIS DETRITIVORE IS A COMMON ANTIGEN IMPLICATED IN ALLERGIES AND ASTHMA, ESPECIALLY IN URBAN AREAS
cockroaches