Deck 46: Human Immunodeficiency Virus Infection

Question 1

Acute HIV syndrome may be mistaken for:

A) the common cold.
B) influenza virus infection.
C) mononucleosis.
D) syphilis.
E) all of the above.

Answer 1

all of the above.

Question 2

Each year in the United States, there are approximately how many new cases of HIV?

A) 10,000
B) 20,000
C) 50,000
D) 100,000
E) 150,000

Answer 2

50,000

Question 3

Which of the following statements best summarizes the relationship between periodontal disease and HIV?

A) HIV-positive patients with low CD4+ cell counts are likely to have more advanced periodontal disease than HIV-negative patients.
B) HIV-positive patients with low CD4+ cell counts are likely to have more accelerated periodontal disease progression than HIV-negative patients.
C) The burden of conventional periodontal disease is similar in the HIV-positive and HIV-negative population.
D) Necrotizing ulcerative gingivitis is rare outside of the HIV-positive population.

Answer 3

The burden of conventional periodontal disease is similar in the HIV-positive and HIV-negative population.

Question 4

Which of the following is an example of vertical transmission of HIV?

A) A woman becoming infected after sex with her husband
B) A man becoming infected after sex with another man
C) A child becoming infected after a blood transfusion
D) A neonate becoming infected after being fed breast milk from his HIV-infected mother
E) A series of injection drug users becoming infected after sharing the same needle

Question 5

Which of the following best describes the role of CD4+ T cells in HIV?

A) CD4+ T cells have cytotoxic properties, which is important in cell-mediated immunity.
B) CD4+ T cells are one of the main cells infected by the HIV virion.
C) Depletion of CD4+ T cells via HIV infection places the patient at risk for opportunistic infections, such as tuberculosis, oropharyngeal candidiasis, and hairy leukoplakia.
D) Both a and b are correct.
E) Both b and c are correct.
F) All of the above are correct.

Question 6

Which of the following best describes the rationale for HAART?

A) Reduction in side effects
B) Reduction in selection of drug-resistant HIV strains
C) Reduction in required dose
D) Reduction in required dosing intervals
E) Reduction in prescription drug costs

Question 7

An HIV-positive man whose last CD4+ cell count was 244 is noted to have a single painless raised, cauliflower-like lesion on the lateral tongue. This lesion most likely represents:

A) cancrum oris.
B) human papillomavirus.
C) herpesvirus.
D) aphthous ulcer.
E) Kaposi's sarcoma.

Question 8

Based on the CDC's most recent HIV incidence estimates, which of the following groups has the highest risk for contracting HIV?

A) Injection drug users
B) White MSM
C) Black MSM
D) Hispanic women
E) Black women

Question 9

The risk of contracting HIV following percutaneous exposure is most approximately one in:

A) a hundred.
B) a thousand.
C) ten thousand.
D) a million.

Question 10

Reverse transcriptase is best characterized as converting:

A) RNA into DNA.
B) DNA into RNA.
C) RNA into tRNA.
D) the host cell into an HIV virion.

Question 11

In advanced HIV/AIDS, one would expect to find _____ HIV viral load and a _____ CD4+ cell count.

A) high; high
B) low; high
C) high; low
D) low; low

Question 12

Standard precautions refers to:

A) washing hands meticulously for at least 30 seconds with soap and water.
B) using gloves with every patient.
C) using only sharps with safety recapping mechanisms.
D) a prevention strategy aimed at reducing exposure, which includes hand hygiene, barrier protection, and safe disposal of sharps.
E) a strategy of identifying high-risk patients for whom additional barrier protection is likely warranted.

Question 13

A known HIV-positive patient is noted to have painless bleeding of the gingiva with minimal manipulation, as well as halitosis and gingival inflammation. Which of the following treatments will likely be helpful?

A) Twice daily 0.12% chlorhexidine gluconate rinses
B) Twice daily hydrogen peroxide rinses
C) Encouragement to brush and floss daily
D) Nystatin mouthrinse by prescription
E) No treatment is needed.

Question 14

A dental hygiene practitioner experiences a percutaneous exposure with a large-bore hollow needle while performing irrigation on a patient. Before undergoing care, the patient had stated that he had never been tested for HIV, but that he had used injection drugs in the distant past. What is the best course of action?

A) Wash the puncture site with warm water.
B) Obtain HIV tests on the patient and practitioner to determine next steps.
C) Consider starting single-agent PEP while awaiting HIV test results.
D) Consider starting double-agent PEP while awaiting HIV test results.
E) Consider starting triple-agent PEP while awaiting HIV test results.

Question 15

An HIV-positive woman presents for oral care. She has white patches on her lingual surfaces, which do not easily scrape off. This is most likely to represent:

A) poor oral hygiene.
B) esophageal candidiasis.
C) oropharyngeal candidiasis.
D) herpes simplex.
E) hairy leukoplakia.

Question 16

Since 1992, the number of documented cases of HIV following occupational exposure in the dental or dental hygiene care setting is:

A) 0.
B) 1.
C) 2.
D) 3.
E) 4.

Question 17

Which best describes the most recent trends in the incidence and prevalence rates of HIV infections globally?

A) Incidence is increasing; prevalence is increasing.
B) Incidence is decreasing; prevalence is decreasing.
C) Incidence is increasing; prevalence is decreasing.
D) Incidence is decreasing; prevalence is increasing.
E) Incidence and prevalence have been relatively unchanged in recent years.

Question 18

Which of the following exposure scenarios is least likely to transmit HIV?

A) Unprotected sexual intercourse with HIV-positive partner
B) Needlestick with contaminated sharp
C) Blood transfusion
D) Bite on the hand from an HIV-positive patient
E) Consumption of breast milk from an HIV-positive woman

Question 19

Highly active antiretroviral therapy (HAART) refers to:

A) using three or more antiviral drugs to prevent HIV viral replication and improve disease prognosis.
B) using a single "highly active" agent against HIV.
C) ensuring that the agent is "active" against a particular strain of HIV.
D) prescribing a cocktail of various medications against HIV that have not yet expired and are therefore active.

Question 20

A middle-aged man of Mediterranean ancestry presenting for professional oral care is noted to have purple, papular lesions on the hard palate. He states that he has not noticed the lesions before, and that he has not received routine medical care for over a decade. What is the next most appropriate step in oral care management?

A) Double-glove and wear a mask during the examination, as he has human immunodeficiency virus (HIV).
B) Stop the examination and refer emergently for medical care.
C) Continue with examination, but be sure to refer for medical care and likely tissue biopsy for definitive diagnosis.
D) Note the lesion, but continue with examination as normal.

Question 21

What is the best treatment for the patient described in question 20?

A) No therapy is needed
B) Mechanical removal
C) Antifungal mouthrinse
D) Systemic antifungals
E) Acyclovir

Question 22

Most patients with HIV are unmotivated to preserve their oral health.

Question 23

An HIV-positive woman presents for oral care. She has a line of red, inflamed gingiva, which is very painful when manipulated. This is most likely to represent:

A) cancrum oris.
B) necrotizing ulcerative gingivitis.
C) necrotizing ulcerative periodontitis.
D) linear gingival erythema.
E) herpesvirus.
F) aphthous ulcer.
G) Kaposi's sarcoma.

Question 24

Why should immunocompromised patients avoid hydrogen peroxide rinses?

A) It causes accelerated tissue breakdown.
B) It is associated with oral candidiasis.
C) It is associated with oral herpes.
D) It is associated with worsening necrotizing periodontal disease.
E) It is associated with halitosis.

Question 25

A woman with unknown HIV status is found to have a white film on her tongue, which when scraped away, reveals smooth, red patches on the tongue and buccal mucos a. She asks what she should do to treat this white film. The best response is:

A) antiretroviral drugs.
B) hydrogen peroxide mouthrinse.
C) nystatin swish and swallow.
D) mechanical scraping.
E) nothing is likely to help.

Question 26

A patient complains of painful ulcerations around one side of his mouth. You suspect oral herpesvirus infection. Which of the following is the best advice for this patient?

A) "You are contagious for 10 to 14 days, so be sure not to allow others to kiss you or drink after you."
B) "Be sure to wash your hands frequently and avoid touching your eyes."
C) "You are unlikely to experience this infection again in the future."
D) "The only way to cure this infection is to take chronic antiviral medications."

Question 27

Kaposi's sarcoma lesions frequently regress after initiation of an effective HAART regimen.

Question 28

It is recommended that HIV-positive patients with periodontal disease receive dental hygiene care on which interval?

A) Monthly
B) Every 2 to 3 months
C) Every 3 to 6 months
D) Yearly

Question 29

Power scaling devices generate an aerosol, which has been implicated in HIV transmission.

Question 30

Which of the following is not an expected side effect of chlorhexidine mouthrinse?

A) Staining of oral surfaces
B) Increased accumulation of calculus (plaque)
C) Altered taste sensation
D) Stomach upset
E) Proliferation of oral yeast