WASTEWATER TREATMENT OPERATOR
EXAMINATION TEST BANK EXPERT
REVIEWED QUESTIONS ANSWERS
◉ Advanced HIV infection: definition, symptoms, prognosis. Answer:
CD4 below 50
Wasting, fevers, fatigue
Poor
◉ HIV serologic testing. Answer: - ELISA: test for antibodies,
requires seroconversion (neg to pos) which happens 3wks to 6mo
after infection
- Rapid test: fast but not as sensitive as ELISA
- Confirmatory HIV test: Western blot test (HIV antibody test), used
after pos with ELISA
◉ HIV prevention. Answer: - Condoms
- Male circumcision
- Pre-exposure prophylaxis (PrEP), for MSM sexually active men,
adult iv drug users, women with HIV pos partner who try to
conceive. Give Tenofir with Emtricitabine
,- Post exopsure prophylaxis (PEP), 28 day course of 3 drugs,
emtricitabine, tenofovir, raltegravir
◉ LABS for HIV + people. Answer: CD4 count (viral load)
HIV RNA level
WBC (neutropenia, lymphopenia)
CBC (anemia)
LFT's ( ^liver enzymes)/ Hep A, B, C screening
TB test
Resistance testing for RX\Syphilis testing
Pap smear
xr chest
◉ Initiation of Antiretroviral therapy (ART). Answer: - Start for all
asymptomatic HIV infected patients to reduce viral load and risk of
disease progression. Also for HIV+ peope to for prevention of
transmission.
- Start for every symptomatic patient regardless of CD4count or viral
load
- Pt's should understand regimen, risks, benefits and importance of
adherence before commencing,
- Should be managed by HIV/ AIDS specialist
,◉ Antiretroviral therapy (ART). Answer: - Combination therapy, 3 or
more from different drug classes
- Follow up with HIV viral load determination at 4 - 6 wks after
initiation and then every 3 - 6 mo.
- Adherence is vital
- always assess drug- drug interactions/ medication reconciliation
- May make changes when CD4 exceeds evidence level
- check GFR/ creat/ BUN monthly for elderly on Tenofovir
- If deteriorating on ART (decline in CD4) then perform drug
resistance testing and revision of ART
◉ Prophylaxis against opportunistic infections - HIV. Answer: - TB:
Isoniazid with Pyridoxine
- Pneumocystis jiroveci (sudden rapid decline CD4): Trimethoprim-
sulfamethoxazole neb. Stop if CD4 above 300
- Toxoplasmosis: when CD4 less than 100. Trimethoprim-
sulfamethoxazole plus pyrimethamine. Dc if CD4 above 200.
- Mycobacterium avium. Cd4 below 50. Zithromax or clarithromycin
◉ Recommended vaccines for HIV. Answer: - Hep B, if Hep B antigen
neg
- Inactivated flu vaccine (assess viral load and do not give live
vaccine)
- Hep A, liver disease risk, iv drug use, MSM
, - Pneumococcal vaccine
- Tdap (instead of Td)
- Varcella Zoster for elderly
◉ Test for HIV with following infections. Answer: - candidiasis of
esophagus/ trachea/ bronchi/ lungs
- extrapulm cryptococcus
- invasive cervical ca
- cryptosporidiosis with diarrhea
- CMV
- Herpes simplex lasting longer than 1mo
- Lymphoma brain, in younger than 60
- Kaposi sarcoma, younger than 60
- Mycobacterium TB
- Pneumocystis jiroveci pneumonia
- CD4 less than 200
◉ Giant cell arteritis, definition and etiology. Answer: Inflammation
of the medium and large arteries, often temporal artery or aorta,
represents polymyalgia rheumatica
- adults older than 50
EXAMINATION TEST BANK EXPERT
REVIEWED QUESTIONS ANSWERS
◉ Advanced HIV infection: definition, symptoms, prognosis. Answer:
CD4 below 50
Wasting, fevers, fatigue
Poor
◉ HIV serologic testing. Answer: - ELISA: test for antibodies,
requires seroconversion (neg to pos) which happens 3wks to 6mo
after infection
- Rapid test: fast but not as sensitive as ELISA
- Confirmatory HIV test: Western blot test (HIV antibody test), used
after pos with ELISA
◉ HIV prevention. Answer: - Condoms
- Male circumcision
- Pre-exposure prophylaxis (PrEP), for MSM sexually active men,
adult iv drug users, women with HIV pos partner who try to
conceive. Give Tenofir with Emtricitabine
,- Post exopsure prophylaxis (PEP), 28 day course of 3 drugs,
emtricitabine, tenofovir, raltegravir
◉ LABS for HIV + people. Answer: CD4 count (viral load)
HIV RNA level
WBC (neutropenia, lymphopenia)
CBC (anemia)
LFT's ( ^liver enzymes)/ Hep A, B, C screening
TB test
Resistance testing for RX\Syphilis testing
Pap smear
xr chest
◉ Initiation of Antiretroviral therapy (ART). Answer: - Start for all
asymptomatic HIV infected patients to reduce viral load and risk of
disease progression. Also for HIV+ peope to for prevention of
transmission.
- Start for every symptomatic patient regardless of CD4count or viral
load
- Pt's should understand regimen, risks, benefits and importance of
adherence before commencing,
- Should be managed by HIV/ AIDS specialist
,◉ Antiretroviral therapy (ART). Answer: - Combination therapy, 3 or
more from different drug classes
- Follow up with HIV viral load determination at 4 - 6 wks after
initiation and then every 3 - 6 mo.
- Adherence is vital
- always assess drug- drug interactions/ medication reconciliation
- May make changes when CD4 exceeds evidence level
- check GFR/ creat/ BUN monthly for elderly on Tenofovir
- If deteriorating on ART (decline in CD4) then perform drug
resistance testing and revision of ART
◉ Prophylaxis against opportunistic infections - HIV. Answer: - TB:
Isoniazid with Pyridoxine
- Pneumocystis jiroveci (sudden rapid decline CD4): Trimethoprim-
sulfamethoxazole neb. Stop if CD4 above 300
- Toxoplasmosis: when CD4 less than 100. Trimethoprim-
sulfamethoxazole plus pyrimethamine. Dc if CD4 above 200.
- Mycobacterium avium. Cd4 below 50. Zithromax or clarithromycin
◉ Recommended vaccines for HIV. Answer: - Hep B, if Hep B antigen
neg
- Inactivated flu vaccine (assess viral load and do not give live
vaccine)
- Hep A, liver disease risk, iv drug use, MSM
, - Pneumococcal vaccine
- Tdap (instead of Td)
- Varcella Zoster for elderly
◉ Test for HIV with following infections. Answer: - candidiasis of
esophagus/ trachea/ bronchi/ lungs
- extrapulm cryptococcus
- invasive cervical ca
- cryptosporidiosis with diarrhea
- CMV
- Herpes simplex lasting longer than 1mo
- Lymphoma brain, in younger than 60
- Kaposi sarcoma, younger than 60
- Mycobacterium TB
- Pneumocystis jiroveci pneumonia
- CD4 less than 200
◉ Giant cell arteritis, definition and etiology. Answer: Inflammation
of the medium and large arteries, often temporal artery or aorta,
represents polymyalgia rheumatica
- adults older than 50
