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Stack #207880

HIV Opportunistic Infections

QuestionAnswer
Immune Reconstitution Inflammatory Syndrome (IRIS) 1)Result of? 1)Rapid immunologic response to ART (CD4 inc >100cells/mm3 from baseline)
Immune Reconstitution Inflammatory Syndrome (IRIS) 2) Time to? 2)Occurs 4-8wks post ART
Immune Reconstitution Inflammatory Syndrome (IRIS) 3)Sx? 3)Fever worsening OI sx
Immune Reconstitution Inflammatory Syndrome (IRIS) 4)Occurs w/? 4)most common in Mycobacterium (TB,MAC)
Immune Reconstitution Inflammatory Syndrome (IRIS) 5) Tx 5) give corticosteroids or NSAIDS
PCP is caused by what type of org ? that org is normally found where? org with Protozoal fungal properties that is part of normal lung flora
PCP S/SX slow onset, fever, fatigue, dyspnea, tachypnea, nonproductive cough, CP that worsens over days.
PCP most commonly presents as Pneumonia
PCP DX CXR, Arterial Blood Gas, Sputum Culture, Bronchial alveolar lavage
PCP-- 1st Line Tx Bactrim 15-20mg/kg/day IV in 3-4 divided doses x 21 days OR 2 DS tabs TID x 21 days
Bactrim AE Hypersensitivity (sulfa Allergy), Crystalization (take w/ water), NVD, pt w/ G6PD deficiency can't take it
Bactrim Monitoring K+, SCr (inc), CBC (BMS), LFT (transient inc)
Alt 1st line PCP tx Atovoquone (ND, rash, HA, LFT), Dapsone (not in G6PD deficiency), Clindamycin (cause C. dificille)
Adjuvant Steroids for PCP-- Who do you give it to? When do you start it? -pt w/ severe PCP and PaO2<70mmHg -must be started within 72hrs of tx
Adjuvant Steroid for PCP-- Regimen Days1-5 --> 40 mg Prednisone bid Days6-10--> 40mg prednisone daily Days 11-21 --> 20mg prednisone daily
Primary Prophylaxis PCP-- Who gets it? CD4<200___Bactrim DS or SS 1 tab po daily___or Bactrim TIW___or Atovaquone (tastes bad)
Primary Prophylaxis PCP-- When do you DC? Pt on HAART with CD4>200 for >= 3 months
Secondary Prophylaxis of PCP restart when CD4 drops <200 or if PCP occurs >200___same regimen as Primary and DC
Created by: stormesk
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