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Heme Onc 7 HIV

HIV

QuestionAnswer
What is the classic (but rare) EKG finding in PE? S wave in lead 1, Q wave in lead 3, and inverted T wave in lead 3. S1Q3T3
A post-op pt with significant pain presents with hyponatremia and normal volume status. Dx? SIADH 2/2 stress of post-op pain
What is the tx for mild unconjugated hyperbilirubinemia? Severe unconjugated hyperbilirubinemia? Mild: phototherapy. Severe: exchange transfusion
HIV + pt is seen in ER w/dyspnea. Over past few weeks, he reports incr difficulty breathing on exertion. He has a cough, fever, and you notice white plaques on the tongue and pharynx. He also admits to odynophagia. What would you expect his CD4 ct to be? <200 (thrush and esophagitis)
A 39yo male HIV pt receives a head CT for HA and new-onset confusion and slurring of words. The imaging reveals a ring-enhancing lesion. What is the suspected dx? How could that dx be confirmed? Toxoplasmosis. Toxo IgG Ab confirms dx
What is the rate of transmission of HIV thru a needle stick incident? What drugs should be given in case there is appreciable risk of transmission of HIV in this setting? 0.3%. Give zidovudine and lamivudine
A 25yo man is dx with HIV and must begin a HAART regimen. What classes of drugs should his regimen include initially? 2 Nucleoside Reverse Transcriptase Inhibitors (NRTI) + 1 protease inhibitor or NNRTI
Which antiretroviral (class) matches the following statements?: SE lactic acidosis NRTIs
Which antiretroviral (class) matches the following statements?: SE GI intolerance Protease inhib
Which antiretroviral (class) matches the following statements?: SE pancreatitis Zalcitabine, stavudine, didanosine, *ritonavir*
Which antiretroviral (class) matches the following statements?: SE peripheral neuropathy Zalcitabine, stavudine, didanosine
Which antiretroviral (class) matches the following statements?: SE megaloblastic anemia Zidovudine
Which antiretroviral (class) matches the following statements?: SE rash NNRTI
Which antiretroviral (class) matches the following statements?: SE hyperglycemia, DM, and lipid abnormalities Idinavir, saquinavir, amprenavir
Which antiretroviral (class) matches the following statements?: SE bone marrow suppression Zidovudine
Which antiretroviral (class) matches the following statements?: given to pregnant women with HIV HAART, zidovudine during labor
Which antiretroviral (class) matches the following statements?: regimen for occupational HIV exposures Zidovudine + lamivudine
Regarding abx prophylaxis in HIV pts, when with what, and for what organisms? <200: bactrim or dapsone for PCP pneumonia <50: azithro or clarithromycin for MAC
What is AIDS defined as? CD4 <200 or presence of an AIDS defining illness
What labs should be done to determine if a pt has HIV? ELISA (2 if the first 1 is +) and Western blot.
When should HIV tx be started? CD4 ct <350 or symptomatic development of opportunistic dz
Indicator of HIV disease progression? Viral load
What should be given to HIV/AIDS pts with close contact with TB-infected persons? Isoniazid
How should newborns of HIV-infected mothers be treated? Give zidovudine for 6wk after birth. Test for presence of virus in initial 6mos of life. Note that anti-HIV Ab will always be present. Early on, viral load is prob a better measurement of dz.
Should HIV-infected moms breastfeed? No
Which HIV drug class?: inhibit production of viral genome, prevent incorporation of viral DNA into host genome thru reverse transcriptase inhibition NRTI
Which HIV drug class?: inhibit reverse transcriptase activity to prevent viral replication NNRTI
Which HIV drug class?: interfere with viral replication to cause production of non-functional viruses Protease inhibitors
Which HIV drug class?: combine multiple meds into same pill. Ideal to reduce confusion of dosing schedules or to increase compliance Combination agents
Which HIV drug class?: binds to glycoprotein 41 to prevent fusion of HIV to CD4 cells Fusion inhibitor
Which HIV drug (class)?: SE incr rate of bacterial pneumonia Enfuvirtide (fusion inhibitor)
Created by: sarah3148