HIV QUIZ high score center .dr wala awad

Question 1 of 10

1

K.E. is a 29-year-old asymptomatic patient who is human immunodefiiency virus (HIV) positive. She
recently found out she is pregnant and is estimatedto be early in her fist trimester. Her most recent
CD4 count was 170/mm3, and her viral load was 100,000 copies/mL by reverse transcriptase–polymerase chain reaction. Which is the best therapy forK.E. to prevent HIV transmission to her child?

Select one of the following:

A. No drug therapy is needed—the risks to the fetus outweigh any benefis.
B. Administer zidovudine 300 mg twice daily orally throughout the pregnancy, followed byzidovudine during labor and consequently to the baby for 6 weeks.
C. No drug therapy is required now, but administer a single dose of nevirapine at the onset of labor.
D. Administer a potent combination antiretroviral therapy (ART) regimen that includes zidovudine throughout the pregnancy.

Explanation

Question 2 of 10

1

R.E. is a 33-year-old man who has been HIV positive since 2005. Recently, his CD4 counts started to
decrease signifiantly, and his viral load started to increase. He is initiated on tenofovir, emtricitabine,and atazanavir/ritonavir. Which is the best counseling for R.E.?

Select one of the following:

A. Watch for jaundice because atazanavir can cause hyperbilirubinemia.
B. If you think you are having a drug-related adverse effect, cut the dose of all of your drugs
in half.
C. Talk to your pharmacist about drug interactions because both atazanavir and tenofovir
inhibit cytochrome P450 (CYP) 3A4.
D. Tenofovir and emtricitabine cause additive peripheral neuropathy, so let your pharmacist know if you experience tingling in your extremities.

Explanation

Question 3 of 10

1

3. One year later, R.E. is concerned that his antiretroviral therapy (ART) is not working and asks whether he should make some changes. Which statement best represents what to tell him?

Select one of the following:

A. His therapy should be changed only if he is deteriorating clinically (e.g., having more opportunistic infections).
B. His therapy should be changed if his viral load is detectable after initial suppression to undetectable concentrations.
C. If he is concerned about his regimen not being effective, then atazanavir/ritonavir should be changed to fosamprenavir/ritonavir.
D. Resistance usually occurs with emtricitabine,so this should be changed to lamivudine.

Explanation

Question 4 of 10

1

.P.P., a 43-year-old man who is HIV positive, presents to the clinic with a headache that has gradually worsened during the past 2 weeks. He does not feel very sick and has not experienced any focal seizures. His most recent CD4 count was His laboratory profie is performed with the follow ing results: Gram stain = negative; white blood cell count = 2 cells/mm3; protein = 35 mg/dL; glucose = 75 mg/dL (peripheral = 110 mg/dL); India ink =positive; and cryptococcal antigen = 1:1024. Which is the best therapy for P.P.?

Select one of the following:

A. Fluconazole 200 mg/day orally.
B. Amphotericin B deoxycholate 0.3 mg/kg/dayalone
C. Amphotericin B deoxycholate 0.3 mg/kg/day plus flcytosine 37.5 mg/kg every 6 hours.
D. Amphotericin B deoxycholate 0.7 mg/kg/day plus flcytosine 25 mg/kg every 6 hours for 2
weeks, followed by flconazole 400 mg/day.

Explanation

Question 5 of 10

1

.A 57-year-old man presents with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) with a CD4 count of 75 cells/microliter at diagnosis and a viral load of 89,000 copies/mL. He has no other significant medical history and has an allergy to sulfa medications with hive reaction. Pertinent laboratory values are as follows:
Glucose-6-phosphate dehydrogenase positive Which medication would be best to initiate in the patient for prophylaxis
against Pneumocystis jirovecii?

Select one of the following:

A Sulfamethoxazole/trimethoprim 800/160-mg tablet 1 tablet by mouth once
daily
B Pentamidine 300 mg inhalation once monthly
C Dapsone 100 mg by mouth once daily
D Atovaquone 1500 mg by mouth once daily

Explanation

Question 6 of 10

1

. J.C., a 36-year-old woman positive for HIV, has severe anemia. She has been tested for iron defiiency and has been taken off zidovudine and trimethoprim/sulfamethoxazole. She has also started to lose weight and to have severe diarrhea. A blood culture is positive for MAC. Which treatment is best for J.C.?

Select one of the following:

A. Clarithromycin plus ethambutol for 2 weeks, followed by maintenance with clarithromycin alone.
B. Azithromycin plus ethambutol for at least 12 months.
C. Clarithromycin plus isoniazid for 2 weeks, followed by maintenance with clarithromycin alone.
D. Ethambutol plus rifabutin indefiitely

Explanation

Question 7 of 10

1

. C.C. is a 30-year-old health care worker who is stuck by a needle that was being used to perform a venipuncture in a known HIV-seropositive patient. Which is the most important determinant with
respect to the effiacy of postexposure prophylaxis (PEP)?

Select one of the following:

A. The time elapsed since the stick occurred.
B. The sex of the source patient.
C. The nonprescription drug history of the source patient.
D. The source patient’s CD4+ cell count.

Explanation

Question 8 of 10

1

. L.L. is a 42-year-old woman who underwent an allogeneic stem cell transplant for acute leukemia. Her
initial posttransplant course was uncomplicated;however, 1 month after engraftment (7 weeks posttransplant), the patient developed a fever and rash.A skin biopsy revealed graft-vs.-host disease, forwhich the patient’s tacrolimus dose was increased.L.L. also received high-dose steroids, which caused her fever to resolve and rash to improve. She was maintained on prednisone 30 mg orally once daily.One month later, L.L. presents to the hematology clinic with a worsening dry cough, shortness of breath, fever, and one episode of hemoptysis. Chest CT reveals a left-sided cavitary lesion. The hematologist would like to initiate antiAspergillus
therapy.
Which agent would be best to recommend?

Select one of the following:

A. Itraconazole.
B. Voriconazole.
C. Liposomal amphotericin B.
D. Caspofungin.

Explanation

Question 9 of 10

1

The viral load relates to

Select one of the following:

A. the activity of the virus and efficacy of antiretroviral therapy.
B. the status of the immune system.
C. when the patient was infected.
D. how much a patient is at risk for acquiring an opportunistic infection.

Explanation

Question 10 of 10

1

L. L. comes to the clinic with a chief complaint of burning and tingling in his feet that started about 1 month ago. His current medications include nelfinavir, stavudine, lamivudine, sertraline, and gemfibrozil. Which medication might be causing this problem?

Select one of the following:

A. Nelfinavir
B. Stavudine
C. Lamivudine
D. Sertraline

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american board exam

HIV QUIZ high score center .dr wala awad

Question 1 of 10

Select one of the following:

Explanation

Question 2 of 10

R.E. is a 33-year-old man who has been HIV positive since 2005. Recently, his CD4 counts started to decrease signifiantly, and his viral load started to increase. He is initiated on tenofovir, emtricitabine,and atazanavir/ritonavir. Which is the best counseling for R.E.?

Select one of the following:

Explanation

Question 3 of 10

3. One year later, R.E. is concerned that his antiretroviral therapy (ART) is not working and asks whether he should make some changes. Which statement best represents what to tell him?

Select one of the following:

Explanation

Question 4 of 10

Select one of the following:

Explanation

Question 5 of 10

Select one of the following:

Explanation

Question 6 of 10

Select one of the following:

Explanation

Question 7 of 10

. C.C. is a 30-year-old health care worker who is stuck by a needle that was being used to perform a venipuncture in a known HIV-seropositive patient. Which is the most important determinant with respect to the effiacy of postexposure prophylaxis (PEP)?

Select one of the following:

Explanation

Question 8 of 10

Select one of the following:

Explanation

Question 9 of 10

The viral load relates to

Select one of the following:

Explanation

Question 10 of 10

L. L. comes to the clinic with a chief complaint of burning and tingling in his feet that started about 1 month ago. His current medications include nelfinavir, stavudine, lamivudine, sertraline, and gemfibrozil. Which medication might be causing this problem?

Select one of the following:

Explanation

R.E. is a 33-year-old man who has been HIV positive since 2005. Recently, his CD4 counts started to
decrease signifiantly, and his viral load started to increase. He is initiated on tenofovir, emtricitabine,and atazanavir/ritonavir. Which is the best counseling for R.E.?

. C.C. is a 30-year-old health care worker who is stuck by a needle that was being used to perform a venipuncture in a known HIV-seropositive patient. Which is the most important determinant with
respect to the effiacy of postexposure prophylaxis (PEP)?