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Question 1
Correct
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A 15-year-old girl known with HIV develops lipoatrophy over her thighs and abdomen. Which of the following medications can cause this side effect?
Your Answer: Zidovudine
Explanation:Among the options provided, zidovudine causes lipoatrophy as a side effect.Zidovudine: Although both hypertrophy and atrophy are described related to HIV medications, nucleoside reverse transcriptase inhibitor (NRTIs) such as zidovudine and stavudine are closely associated with fat loss.Other options:- Enfuvirtide is an HIV-fusion inhibitor. Lipoatrophy is not commonly associated with this drug.- Efavirenz is an NNRTI, which is not associated with lipoatrophy. Common side effects include neuropsychiatric effects, rash and nausea. – Ganciclovir is not an anti-HIV medication and is used for cytomegalovirus (CMV) infections.- Raltegravir is an integrase inhibitor and is associated with fat gain.
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This question is part of the following fields:
- HIV
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Question 2
Correct
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A 10-month-old girl is brought to the hospital by her mother. The family moved to the UK three months ago from The Congo. The baby’s mother explains that she is HIV positive and took combination antiretrovirals throughout her pregnancy. She was unable to attend follow-up for her baby as the family was displaced. The baby was breastfed until the age of six months and is thriving. A physical examination revealed no significant findings.What would be the most appropriate action concerning the baby’s HIV exposure?
Your Answer: Perform HIV PCR and commence cART and PCP prophylaxis if HIV positive
Explanation:The most appropriate action in this baby would be to perform HIV PCR and commence cART and PCP prophylaxis if HIV positive.Treatment guidelines for HIV-positive infants state that all should receive combination antiretroviral therapy (cART) and Pneumocystis jiroveci pneumonia (PJP) prophylaxis, irrespective of CD4 count or viral load.
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This question is part of the following fields:
- HIV
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Question 3
Correct
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A 16-year-old male is learning about HIV as part of sex and relationships education in school. What is the most common mode of transmission of HIV?
Your Answer: Unprotected anal or vaginal sexual intercourse with an infected individual
Explanation:Unprotected anal or vaginal sexual intercourse with an infected individual is by far the most common (95%) route by which HIV is transmitted. Other options:- Blood transfusion is an extremely rare cause of HIV transmission in the UK. – While HIV can be transmitted from mother to baby either during birth or via breastfeeding, the transmission rate is only 5 – 20%.- Sharing contaminated needles does put individuals at risk of getting HIV, although public health measures are in place to reduce this risk. – Although HIV can be transmitted via this route, it is around ten times less likely to result in transmission than unprotected anal or vaginal intercourse with an infected individual.
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This question is part of the following fields:
- HIV
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Question 4
Correct
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A 10-year-old boy presents with bilaterally enlarged parotid glands for more than 9 months. On examination, both parotid glands are firm and non-tender and are not warm to touch.What is the most probable infectious cause for chronic parotitis in the given scenario?
Your Answer: Human immunodeficiency virus (HIV)
Explanation:The most probable cause for chronic parotitis in this patient would be HIV infection.Rationale:Chronic infectious parotitis is relatively uncommon in children. While mycobacterial infection can result in chronic parotitis, HIV is a relatively more common cause. The presentation should always prompt an HIV test. Other options:- While mumps is the most common cause of acute viral parotitis, the chronic nature of the boy’s presentation rules it out. – Acute bacterial parotitis is usually unilateral and is warm and tender to touch.
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This question is part of the following fields:
- HIV
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Question 5
Incorrect
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A 12-month-old baby with HIV is scheduled for his MMR vaccine. What is the most appropriate action?
Your Answer: Proceed with standard immunization schedule
Correct Answer: Don’t give the vaccine
Explanation:Live attenuated vaccines such as the MMR, should be avoided in HIV+ patients.
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This question is part of the following fields:
- HIV
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Question 6
Correct
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An 18-year-old male presents to his family physician after a sexual encounter with his new girlfriend during which they had sexual intercourse around ten days ago. The girlfriend's HIV status is unknown, and the patient is concerned that he might have acquired HIV. He has a blood test for a 4th generation assay, testing for HIV antibody and a p24 antigen. The results come out negative, however, HIV infection cannot be ruled out as he may be presenting in the window period. Which of the following most likely explains the pathology of the window period?
Your Answer: Antibodies to HIV undetectable
Explanation:Any blood test used to detect HIV infection must have a high degree of sensitivity (the probability that the test will be positive if the patient is infected) and specificity (the probability that the test will be negative if the patient is uninfected). Unfortunately, no antibody test is ever 100 % sensitive and specific. Therefore, if available, all positive test results should be confirmed by retesting, preferably by a different test method. HIV antibody tests usually become positive within 3 months of the individual being infected with the virus (the window period). In some individuals, the test may not be positive until 6 months or longer (considered unusual). In some countries, home testing kits are available. These tests are not very reliable, and support such as pre and post test counselling is not available.
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This question is part of the following fields:
- HIV
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Question 7
Correct
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An 18-year-old homosexual male presents 36 hours after having unprotected sex with his partner whose HIV status is not known. He is concerned about his risk of acquiring HIV. He is feeling well and shows no symptoms. The physician offers him a post exposure prophylaxis, which consists of 3 different antiviral drugs. Two of these drugs act by which of the following mechanisms?
Your Answer: Inhibition of viral reverse transcriptase
Explanation:Recommended regimens3 NRTI (e.g., zidovudine, lamivudine, abacavir) OR2 NRTI (e.g., lamivudine + abacavir) AND1 NNRTI (e.g., efavirenz) OR1 PI (e.g., lopinavir) OR1 INI (e.g., raltegravir)
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This question is part of the following fields:
- HIV
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Question 8
Correct
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The mother of 6 months old girl tests positive for HIV. Doctors test her daughter as well and the results turn out to be positive for HIV, both by polymerase chain reaction (PCR) and serology. The girl is clinically healthy and seems to attain normal developmental milestones. Which of the following is the most appropriate next step?
Your Answer: Start co-trimoxazole prophylaxis immediately and plan to start antiretrovirals once further work-up is complete
Explanation:Infants exposed to maternal HIV and with positive results require immediate management with co-trimoxazole prophylaxis, regardless of their CD4 levels. Antiretroviral treatment is necessary as well but it could wait until further work-up is complete.
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This question is part of the following fields:
- HIV
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Question 9
Correct
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A new-born delivered at term with a birth weight of 2.5kgs was admitted to the NICU with suspected congenital TB. Her mother is HIV positive and is on HAART, recently diagnosed with tuberculosis 1 week ago. All of the following are features of congenital tuberculosis EXCEPT?
Your Answer: Diarrhoea
Explanation:Congenital TB symptoms typically develop during the second or third week of life and include poor feeding, poor weight gain, cough, lethargy, and irritability. Other symptoms include fever, ear discharge, and skin lesions.Signs of congenital TB include failure to thrive, icterus, hepatosplenomegaly, tachypnoea, and lymphadenopathy.
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This question is part of the following fields:
- HIV
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Question 10
Incorrect
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Which of the following is true of mother to child transmission in the case of a mother with HIV infection?
Your Answer: HIV positive mothers established on combination ART should be encouraged to breastfeed
Correct Answer: The risk of HIV vertical transmission is increased by concurrent maternal Hepatitis C infection
Explanation:To prevent mother to child transmission in the case of an HIV infected mother, guidelines have been put in place in the that guide practices. During pregnancy the risk of intrauterine transmission is quite low, as is the risk of transmission during vaginal delivery. As a result the number of women that choose to have caesarean sections have fallen, with vaginal births increasing by 40%. One factor that can however increase the risk of mother to child HIV transmission is concurrent Hepatitis C infection which double the risk of vertical transmission.
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This question is part of the following fields:
- HIV
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SESSION STATS - PERFORMANCE PER SPECIALTY
