MN 576 UPDATED EVALUATION TEST QUESTIONS AND
SOLUTIONS GUARANTEE A+
✔✔What are the 4 stages of HIV infection - ✔✔1.Acute infection
2.Clinical latency
3.Disease progression
4.AIDs defining disease
✔✔How is HIV transmitted? - ✔✔•Vaginal sex - Open cuts and sores increase the risk.
In resource poor settings heterosexual sex is the major mode of transmission.
•Anal sex - Higher risk than vaginal sex because the lining of the anus is more likely to
tear, creating an entry point for HIV.
•Oral sex - Small risk.
•Injecting drugs - Shared unsterilized equipment. Needles used for tattooing and body
piercing can also carry a small risk.
•Blood transfusions/transplants - All donated blood is tested for HIV;
•Mother-to-child transmission - Pregnancy, labor, delivery or breastfeeding 20-45%
•Needle stick injuries 0.3% with no PEP
✔✔Where can the virus be found? - ✔✔•Bodily fluids
semen or pre-seminal fluid
•vaginal fluid
•breast milk
•blood (including menstrual blood)
•rectal secretions/mucosa.
✔✔What immunoglobulin can cross the placental barrier? - ✔✔IgG
✔✔For mother to child transmission, what age is a positive antibody test diagnostic? -
✔✔18 months. As with adults 2 tests should be performed using 2 separate blood
samples before confirmation of diagnosis.
✔✔What are the aims of management of HIV? - ✔✔•Diagnose.
•Early diagnosis fewer complications.
•Suppress HIV RNA
•Restore and improve immunological function
•Prevent opportunistic infections
•Prevent transmission
•Reduce Viral load
✔✔What was the life expectancy of HIV/AIDS prior to the use of ARV? - ✔✔1-3 years
Aids defining disease 1 year
✔✔What can improve survival of HIV+ people? - ✔✔early Tx/early diagnosis/good
adherence to Tx
,undetectable viral load after 12 months
With good Tx HIV is a chronic rather than fatal disease
Life expectancy with good Tx 83 years. comparable to average population.
✔✔Do physiological changes of pregnancy have adverse effects on asymptomatic HIV+
women? - ✔✔No. No major adverse effects.
✔✔Women with advanced HIV disease are at high risk of? - ✔✔short term deterioration
✔✔Normal pregnancy has what effect on cell mediated immunity? - ✔✔Depression of
cell mediated immunity and fall in CD4 count
✔✔Does pregnancy increase risk of AIDS progression? - ✔✔No.
✔✔Association between HIV and Pregnancy. Especially advanced HIV. -
✔✔Miscarriage
preterm delivery
fetal growth restriction
low birth rate
✔✔MTCT stands for - ✔✔mother to child transmission
✔✔What is the MTCT of untreated HIV mothers? What about treated mothers? - ✔✔15-
45%
Less than 5%
✔✔What percentage of new HIV infections in children are from MTCT - ✔✔90%
✔✔What can be used to predict MTCT - ✔✔Maternal HIV RNA viral load
✔✔Where does the risk for MTCT occur? - ✔✔•In utero - transplacental
•At delivery - exposure to blood and fluids - 2/3 occur at delivery
•Postpartum - breast feeding can double transmission
Other risk factors inlcude
•Preterm labor especially < 35/40
•Smoking
•Infection - chorioamnionitis
•Vitamin A deficiency
•Illegal drug use - especially cocaine
•Hep C co infection
•Invasive procedures at delivery, episiotomy, instrumental delivery, fetal scalp
electrodes
, ✔✔What are the aims of management of HIV+ pregnant women. - ✔✔•Identify all
women who are HIV positive
•Including those who seroconvert during pregnancy and breastfeeding.
•Provide ART, as soon as HIV positive status is known
•ART improves maternal health outcomes
• And reduces mother to child transmission of HIV.
✔✔What is the risk of MTCT of HIV during breastfeeding in untreated women? - ✔✔15-
45%
✔✔How can you manage MTCT of HIV in breast feeding? - ✔✔•In countries with SAFE
alternatives to breastfeeding women are advised not to breastfeed.
•Infant prophylaxis based on maternal HIV RNA
•Start within 72 hours of birth
•South Africa
•All women on HAART
•Infant prophylaxis Nevirapine for 6 weeks
✔✔Go over the risks V benefits of breastfeeding V formula in resource poor settings. -
✔✔•Infant formula is expensive
•It requires clean water and sterilization equipment
•It is easy to make mistakes mixing the formula
•Carries a risk of diarrhea and malnutrition
•If mother is compliant with ARV the risk of transmission of HIV is low
•The risk of formula feeding are higher than risk of HIV
✔✔TB characteristics - ✔✔•Mycobacterium tuberculosis
•Obligate
•Non-spore producing
•Aerobic
•Non-motile
•Slow dividing
•Ziehl- Nielsen stain
•Humans are only reservoir
✔✔What percentage of TB infections result in active disease? - ✔✔10%
✔✔Symptoms of TB - ✔✔•Chronic cough
•Blood stained sputum
•Fever
•Night sweats
•Weight loss
✔✔What drug management for TB - ✔✔RIPE
rifampin
SOLUTIONS GUARANTEE A+
✔✔What are the 4 stages of HIV infection - ✔✔1.Acute infection
2.Clinical latency
3.Disease progression
4.AIDs defining disease
✔✔How is HIV transmitted? - ✔✔•Vaginal sex - Open cuts and sores increase the risk.
In resource poor settings heterosexual sex is the major mode of transmission.
•Anal sex - Higher risk than vaginal sex because the lining of the anus is more likely to
tear, creating an entry point for HIV.
•Oral sex - Small risk.
•Injecting drugs - Shared unsterilized equipment. Needles used for tattooing and body
piercing can also carry a small risk.
•Blood transfusions/transplants - All donated blood is tested for HIV;
•Mother-to-child transmission - Pregnancy, labor, delivery or breastfeeding 20-45%
•Needle stick injuries 0.3% with no PEP
✔✔Where can the virus be found? - ✔✔•Bodily fluids
semen or pre-seminal fluid
•vaginal fluid
•breast milk
•blood (including menstrual blood)
•rectal secretions/mucosa.
✔✔What immunoglobulin can cross the placental barrier? - ✔✔IgG
✔✔For mother to child transmission, what age is a positive antibody test diagnostic? -
✔✔18 months. As with adults 2 tests should be performed using 2 separate blood
samples before confirmation of diagnosis.
✔✔What are the aims of management of HIV? - ✔✔•Diagnose.
•Early diagnosis fewer complications.
•Suppress HIV RNA
•Restore and improve immunological function
•Prevent opportunistic infections
•Prevent transmission
•Reduce Viral load
✔✔What was the life expectancy of HIV/AIDS prior to the use of ARV? - ✔✔1-3 years
Aids defining disease 1 year
✔✔What can improve survival of HIV+ people? - ✔✔early Tx/early diagnosis/good
adherence to Tx
,undetectable viral load after 12 months
With good Tx HIV is a chronic rather than fatal disease
Life expectancy with good Tx 83 years. comparable to average population.
✔✔Do physiological changes of pregnancy have adverse effects on asymptomatic HIV+
women? - ✔✔No. No major adverse effects.
✔✔Women with advanced HIV disease are at high risk of? - ✔✔short term deterioration
✔✔Normal pregnancy has what effect on cell mediated immunity? - ✔✔Depression of
cell mediated immunity and fall in CD4 count
✔✔Does pregnancy increase risk of AIDS progression? - ✔✔No.
✔✔Association between HIV and Pregnancy. Especially advanced HIV. -
✔✔Miscarriage
preterm delivery
fetal growth restriction
low birth rate
✔✔MTCT stands for - ✔✔mother to child transmission
✔✔What is the MTCT of untreated HIV mothers? What about treated mothers? - ✔✔15-
45%
Less than 5%
✔✔What percentage of new HIV infections in children are from MTCT - ✔✔90%
✔✔What can be used to predict MTCT - ✔✔Maternal HIV RNA viral load
✔✔Where does the risk for MTCT occur? - ✔✔•In utero - transplacental
•At delivery - exposure to blood and fluids - 2/3 occur at delivery
•Postpartum - breast feeding can double transmission
Other risk factors inlcude
•Preterm labor especially < 35/40
•Smoking
•Infection - chorioamnionitis
•Vitamin A deficiency
•Illegal drug use - especially cocaine
•Hep C co infection
•Invasive procedures at delivery, episiotomy, instrumental delivery, fetal scalp
electrodes
, ✔✔What are the aims of management of HIV+ pregnant women. - ✔✔•Identify all
women who are HIV positive
•Including those who seroconvert during pregnancy and breastfeeding.
•Provide ART, as soon as HIV positive status is known
•ART improves maternal health outcomes
• And reduces mother to child transmission of HIV.
✔✔What is the risk of MTCT of HIV during breastfeeding in untreated women? - ✔✔15-
45%
✔✔How can you manage MTCT of HIV in breast feeding? - ✔✔•In countries with SAFE
alternatives to breastfeeding women are advised not to breastfeed.
•Infant prophylaxis based on maternal HIV RNA
•Start within 72 hours of birth
•South Africa
•All women on HAART
•Infant prophylaxis Nevirapine for 6 weeks
✔✔Go over the risks V benefits of breastfeeding V formula in resource poor settings. -
✔✔•Infant formula is expensive
•It requires clean water and sterilization equipment
•It is easy to make mistakes mixing the formula
•Carries a risk of diarrhea and malnutrition
•If mother is compliant with ARV the risk of transmission of HIV is low
•The risk of formula feeding are higher than risk of HIV
✔✔TB characteristics - ✔✔•Mycobacterium tuberculosis
•Obligate
•Non-spore producing
•Aerobic
•Non-motile
•Slow dividing
•Ziehl- Nielsen stain
•Humans are only reservoir
✔✔What percentage of TB infections result in active disease? - ✔✔10%
✔✔Symptoms of TB - ✔✔•Chronic cough
•Blood stained sputum
•Fever
•Night sweats
•Weight loss
✔✔What drug management for TB - ✔✔RIPE
rifampin
