Deck 66: Primary Care of Hiv-Infected Adults

Question 1

What is the preferred therapy to prevent a first episode of Pneumocystis pneumonia (PCP)?

A) Clindamycin 300 mg TID
B) atovaquone 1,500 mg daily
C) Trimethoprim-sulfamethoxazole double strength (DS) 160/800 mg daily
D) Aerosolized pentamidine 300 mg monthly
E) Azithromycin 1,200 mg weekly

Answer 1

C

Question 2

This test indicates the patient's response to antiretroviral therapy (ART) and guides the selection of an ART regimen.

A) CD4 cell count
B) HLA B-5701
C) HIV-1 RNA (viral load)
D) HIV genotype
E) HIV tropism assay

Answer 2

C

Question 3

An HIV-infected patient returns in 72 hours to have a tuberculin skin test skin (TST) read. The skin test shows 5 mm of induration. What is the recommended management for this test result?

A) Order an interferon gamma release assay (quantiferon)
B) Order a CXR
C) Repeat the TST
D) Initiate treatment for latent MTB
E) Document the TST reading as a false positive result

Answer 3

B

Question 4

Which of the following vaccines is contraindicated in HIV-infected adolescents and adults regardless of CD4 cell count?

A) Pneumococcal vaccine
B) Zostavax
C) Human papillomavirus (HPV)
D) Measles, mumps, and rubella (MMR)
E) Live attenuated influenza vaccine (LAIV)

Question 5

Which of the following statins is contraindicated in in HIV-infected patients on a protease inhibitor (PI)-based ART regimen?
Select all correct answers:

A) lovastatin
B) atorvastatin
C) pravastatin
D) rosuvastatin
E) simvastatin

Question 6

The HIV/AIDS Care Continuum or treatment cascade is a model that outlines the sequential steps or stages in HIV care. Which stage of the continuum needs the most improvement?

A) Number of patients who know their diagnosis (HIV testing)
B) Number of patients who are engaged and retained in care
C) Number of patients who are on ART
D) Number of patients who are virally suppressed
E) Number of patients who are linked to HIV medical care

Question 7

Which of the following behaviors carries the highest risk for HIV transmission?

A) Oral sex
B) Sharing sex toys
C) Anal sex
D) Biting
E) Spitting

Question 8

A 45-year-old male presents to your clinic with complaints of severe sore throat, cervical lymphadenopathy, body rash, and subjective fever for 3 days. He reports sex with men, and his last unprotected anal sex encounter was 2 weeks ago with a man of unknown HIV status. His last HIV-negative screening was 6 months ago. Which HIV laboratory diagnostics should be ordered for this patient?

A) HIV RNA viral load polymerase chain reaction (PCR) only.
B) None, the patient has an obvious upper respiratory infection.
C) HIV antibody/antigen test only.
D) HIV antigen test only.
E) HIV RNA viral load PCR and HIV antibody/antigen test.

Question 9

To support the prevention of HIV transmission, primary care providers working with patients living with HIV should:

A) Encourage all patients living with HIV to maintain sexual abstinence.
B) Discuss HIV risk behaviors at every visit.
C) Report patients with HIV who are having sex to the health department.
D) Discuss HIV risk behaviors only at the initial intake visit.
E) Discuss HIV risk behaviors only if the patient raises the subject.

Question 10

Which of the following statements about antiretroviral therapy and pregnancy is true?

A) Pregnant women with HIV should be treated with ART regardless of stage of disease or CD4 cell count.
B) Always treat pregnant women with an ART regimen containing efavirenz.
C) Despite widespread use of ART, perinatal transmission has remained high in countries where patients have access to HIV care.
D) ART in pregnancy does not need to be managed by an HIV specialist.
E) The treatment goals for pregnant women are different from the goals for other groups.

Question 11

To combat stigma in healthcare settings, providers caring for transgender patients with HIV should:

A) Use the patient's preferred gender pronoun when discussing transgender patients in case conferences.
B) Provide clinic restrooms that do not segregate men and women.
C) Provide all clinic staff with appropriate training on transgender issues.
D) Partner with community agencies that provide support services to transgender individuals.
E) All of the above.