Deck 37: Medical Nutrition Therapy for Hiv and Aids

Question 1

Opportunistic infections seen in patients with AIDS may increase the presence of malnutrition because of

A) further compromise of the immune system.
B) a reduction in available iron for the WBCs.
C) a reduction in RBCs, causing inadequate oxygenation of the tissues.
D) a decreased oncotic pressure in the intravascular space.

Answer 1

A
Explanation: Immune changes seen in AIDS are comparable to those that occur in protein-energy malnutrition. Opportunistic infections can develop in both. These infections impair food intake or interfere with nutrient absorption and metabolism, resulting in further compromise of the immune system. Unless adequate nutrition can be provided to support immune function, a cycle of malnutrition and impaired immunity continues until the patient dies. As opportunistic infections stimulate the proliferation of immune cells and proteins, nutrient resources are redirected toward trying to maintain immune function.

Question 2

It is important to talk with patients about body shape and fat redistribution to combat what aspect of HIV disease?

A) Food-medication interaction
B) Opportunistic infections
C) Peripheral neuropathy
D) HIV-associated lipodystrophy syndrome (HALS)

Answer 2

D
Explanation: Patients with HIV are aware of changes in their body shape and are instrumental in identifying these changes. Health care professionals should remember to ask patients about body shape changes every 3 to 6 months. Changes in body shape and fat redistribution can be monitored by anthropometric measurements. Unintentional weight changes should be monitored closely because they can indicate progression of HIV disease. There is no consensus on the clinical definition of HALS, and the manifestations vary greatly from patient to patient.

Question 3

Which herbal supplement is contraindicated when used with antiretroviral medication such as indinavir?

A) Echinacea
B) Cat's claw
C) Milk thistle
D) St. John's wort

Answer 3

D
Explanation: St. John's wort induces the cytochrome P450 pathway and causes a decrease in indinavir by promoting its metabolism. This results in resistance to the drug and therapy failure. Other AIDS medications, such as protease inhibitors and nonnucleoside reverse transcriptase inhibitors, may be similarly affected. Milk thistle can reduce the activity of the CYP3A4 enzyme, which could lessen metabolism of coadministered medications and increase potential toxicity. Echinacea and cat's claw are two other herbal supplements frequently used by people with HIV infection.

Question 4

What is the most valuable indicator of nutritional status in HIV-infected children?

A) Energy levels
B) Viral load
C) CD4 levels
D) Growth

Question 5

Low levels of literacy, vision loss, cognitive impairment, homelessness, stigma, and active substance abuse can have significant effects on what aspect of HIV disease?

A) Coinfection
B) Drug resistance
C) Increased nutrition needs
D) Increased transmission rates

Question 6

What should a pregnant woman who is HIV positive be advised in regard to feeding her baby?

A) Breastfeed her baby.
B) Do not breastfeed her baby.
C) Breastfeed her baby only if she is asymptomatic.
D) Breastfeed her baby only if her disease is in its early stage.

Question 7

What period of disease progression does acute HIV infection make up?

A) The period from transmission to up to 10 years after infection
B) The period from transmission of HIV to the production of detectable antibodies
C) The period between normal and less than 500 CD4+ cells/mm³
D) The period when CD4 decrease falls to even lower levels and the infection becomes symptomatic and progresses to AIDS

Question 8

Protein intake for individuals with HIV is recommended to be

A) decreased.
B) maintained to current dietary reference intake (DRI) for healthy individuals.
C) increased to double the DRI for energy needs.
D) adjusted according to CD4+ levels.

Question 9

What condition can be a result of malabsorption, altered metabolism, gut infection, and altered gut barrier function?

A) Oversupplementation
B) Opportunistic infections
C) Micronutrient deficiencies
D) Low protein intake

Question 10

Individuals are more susceptible to developing signs and symptoms of HIV infection when the CD4+ cell count falls below

A) 200 cells/mm³.
B) 500 cells/mm³.
C) 1000 cells/mm³.
D) CD4+ cell concentrations do not relate to signs and symptoms of HIV.

Question 11

For HIV-infected individuals with high triglyceride levels, what kind of supplementation might be helpful?

A) Vitamin A
B) Fish oil
C) Magnesium
D) Garlic

Question 12

What opportunistic infection manifests as purple nodules or lesions on the skin and mucous membranes?

A) Candidiasis
B) Herpes zoster
C) Kaposi sarcoma
D) Pneumococcal sinusitis

Question 13

Which area of the world has the highest prevalence of HIV infection?

A) North America
B) Latin America
C) South and Southeast Asia
D) Sub-Saharan Africa

Question 14

Retrovir and AZT are what type of antiretroviral medications?

A) Fusion inhibitors
B) Protease inhibitors
C) Nonnucleoside analog reverse transcriptase inhibitors
D) Nucleoside analog reverse transcriptase inhibitors

Question 15

What is the primary adverse effect of some kinds of complementary and alternative medicine (CAM)?

A) Drug interactions
B) Increase in side effects and disease progression
C) Decreased adherence
D) Micronutrient malabsorption

Question 16

Hepatitis C virus coinfection with HIV is highly correlated with

A) men who have sex with men.
B) injection drug use.
C) poverty.
D) low literacy rates.

Question 17

Hepatoxicity in association with treatment with nucleoside and nucleotide reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors is associated with what opportunistic infection?

A) Mycobacterium avium
B) Cryptosporidiosis
C) Hepatitis C virus
D) Dysesthesia

Question 18

The most widely studied combination regimen for treatment naïve patients includes

A) two NRTIs plus either one NNRTI or a PI.
B) an INSTI with two NRTIs.
C) a PI and a fusion inhibitor.
D) two NNRTIs with a NRTI and PI (with or without ritonavir boosting).

Question 19

Which cells become infected by the human immunodeficiency virus that causes AIDS?

A) All lymphocytes
B) All immature lymphocytes
C) CD4+ or mature T-helper lymphocytes
D) T8 lymphocytes

Question 20

Obesity in people with HIV should be treated with

A) altered antiviral medications.
B) decreased protein intake.
C) supplementation and complementary medicine.
D) physical activity, aerobic exercise, and regular medical nutrition therapy.