Question 1

What is the most common oral manifestation of HIV infection worldwide?&#10;A) hairy leukoplakia&#10;B) Kaposi sarcoma&#10;C) necrotizing stomatitis&#10;D) candidiasis

Accepted Answer

Worldwide,candidiasis is the most common oral manifestation of HIV infection.Oral candidiasis diagnosed in HIV-infected patients with persistent generalized lymphadenopathy may be of predictive value for the subsequent development of AIDS.The erythematous form of candidiasis also indicates progression toward AIDS.

Question 2

Which of the following is the most common method of sexual transmission of HIV in the United States?&#10;A) transmission from injection drug use&#10;B) anal intercourse in men who have sex with men (MSM)&#10;C) male-to-female heterosexual transmission&#10;D) female-to-male heterosexual transmission

Accepted Answer

The most common method of sexual trAnswermission in the United States is anal intercourse in MSM,in whom the risk of HIV infection is 40 times higher than in other men and in women.Heterosexual trAnswermission (male to female,or female to male)is the second most common form of trAnswermission in the United States,but it accounts for 80% of the world's HIV infections.Injection drug use is the third most common mode of trAnswermission in the United States.

Question 3

A person is defined as having AIDS when the CD4+ count is less than ____ cells/&#181;L.&#10;A) 400&#10;B) 200&#10;C) 100&#10;D) 0

Accepted Answer

In untreated persons and in persons in whom therapy is ineffective,the CD4+ count continues to decline while HIV proliferates.As the CD4+ count drops and approaches 200 cells/µL,persons can exhibit weight loss,diarrhea,and night sweats.When the CD4+ count drops below 200 cells/µL,the person has AIDS and is susceptible to opportunistic infections.

Question 4

The median time from primary infection to the development of AIDS in untreated patients is about ________ following HIV exposure.&#10;A) 2 to 6 weeks&#10;B) 6 months&#10;C) 2 to 3 years&#10;D) 10 years

Accepted Answer

It is about 10 years.About 30% of patients with AIDS can be expected to live approximately 2 to 3 years,with most others living 10 years or longer.Long-term survival with HIV infection (beyond 15 years)occurs and is associated with less virulent HIV strains,lower-level viremia,HAART,and robust immune responses.

Question 5

Which of the following is a legitimate reason for a general dentist to make a referral of an asymptomatic HIV-positive patient to an endodontist for endodontic treatment of a molar tooth?&#10;A) The general dentist simply does not want to treat a person who is HIV positive.&#10;B) The general dentist feels that the patient is immunocompromised, but the patient refuses to undergo testing for HIV.&#10;C) The general dentist does not perform endodontic treatment for molar teeth.&#10;D) a and b&#10;E) b and c

Accepted Answer

No medical or scientific reason exists to justify why patients with AIDS who seek routine dental care may be declined treatment by the dentist,regardless of the practitioner's personal reason.Dental treatment may not be withheld if the patient refuses to undergo testing for HIV exposure.The dentist may refer a patient to another provider who is better suited to provide treatment.

Question 6

The current definition of AIDS is the laboratory-confirmed evidence of HIV infection in a person who has stage 3 HIV infection,meaning that the CD4+ lymphocyte count is less than _______ cells/&#956;L.&#10;A) 400&#10;B) 200&#10;C) 100&#10;D) 50

Accepted Answer

Stage 3 HIV infection meAnswer that the CD4+ lymphocyte count is less than 200 cells/μL.The current definition of AIDS also includes HIV-infected persons whose CD4+ count may be above 200 but who have an AIDS-defining condition.

Question 7

Which of the following should be a major consideration when planning dental treatment for the patient with HIV infection/AIDS?&#10;A) current CD4+ lymphocyte count&#10;B) immunosuppression level&#10;C) level of viral load&#10;D) all of the above

Accepted Answer

A major consideration in dental treatment of the patient with HIV infection/AIDS involves determining the current CD4+ lymphocyte count and level of immunosuppression of the patient.Another point of emphasis in dental treatment planning is the level of viral load,which may be related to susceptibility to opportunistic infections and rate of progression of AIDS.

Question 8

The risk of HIV transmission from infected patients to health care workers is about ___% in cases in which a needlestick or other sharp instrument transmitted blood from patient to health care worker.&#10;A) 0.03&#10;B) 0.3&#10;C) 3.0&#10;D) 30.0

Accepted Answer

The risk of HIV trAnswermission from infected patients to health care workers is very low,reportedly about 3 of every 1,000 cases (0.3%)in which a needlestick or other sharp instrument trAnswermitted blood from patient to health care worker.In comparison,the risk of infection from a needlestick is 3% for hepatitis C and 30% for hepatitis B.

Question 9

Which of the following represents an acceptable expanded postexposure prophylaxis regimen (PEP)after exposure to HIV-infected blood?
1.tenofovir plus emtricitabine
2.zidovudine plus lamivudine
3.ritonavir-boosted (/r)lopinavir

A) 1, 2, 3
B) 1, 2
C) 1, 3
D) 3

Accepted Answer

The recommended basic regimen for HIV PEP is tenofovir plus emtricitabine or zidovudine plus lamivudine.The expanded regimen includes a standard two-drug regimen plus a protease inhibitor such as ritonavir-boosted (/r)lopinavir,darunavir/r,atazanavir/r,or raltegravir.PEP should be continued for 4 weeks,during which time the exposed clinician should be provided expert consultation,and follow-up monitoring for compliance,adverse events,and possible seroconversion.Tests for seroconversion should be performed at 3,6,and 12 months.

Question 10

Which of the following types of gingival erythema is associated with the HIV positive patient?&#10;A) papillary gingivitis&#10;B) diffuse gingivitis&#10;C) linear gingival erythema&#10;D) desquamative gingivitis

Accepted Answer

Candidiasis,hairy leukoplakia,specific forms of periodontal disease (i.e.,linear gingival erythema and necrotizing ulcerative periodontitis),Kaposi sarcoma,and non-Hodgkin lymphoma are believed to be strongly associated with HIV infection.

Deck 18: Aids, HIV Infection, and Related Conditions