AGACNP FINAL EXAM CURRENTLY
TESTING COMPLETE 100+ ACTUAL EXAM
QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXPERT VERIFIED /ALREADY
GRADED A+
1. Who should be screened for HIV? What test do you use? Do you need
con- sent: Anyone age 15-65 at least once
High risk individuals annually (consider 3-6 months)
Always include in prenatal testing and high risk individuals in 3rd trimester
Written consent and prevention counseling is not
required This is OPT out Testing
Test using 4th generation HIV test
2. The 4th generation HIV test differs from the ELISA/Western Blot how?
What about rapid HIV test: CDC does not use rapid (Oraquick) test in algorithms
The 4th generation HIV test is an antibody and antigen test it looks for P24 antigen and HIV viral load, Qualitative
HIV RNA test. Older tests only look for antibodies which sometimes do not develop for 3 months.
3. What is considered the most specific HIV test and when do you use this?
-
NAT-Nucleic Acid Test-tests for viral particles. This is very expensive and is done after 4th gen test when first result
is positive then the HIV 1 & 2 ditterentiation are negative for HIV 1 and HIV 2
4. When would you prescribe ART therapy? How many meds? What is mos
difficult besides SE of taking ART therapy: Start on all HIV positive patients regardless
of CD4 count-3 drug regimen. Adherence is the most diflcult you have to be 95% adherent in order to
prevent resistance. If you transmit HIV you also transmit the resistant HIV
,5. Side effects of ART (Initial vs Long term): Initial: n/v/d, fatigue ha, dizzy, poor sleep
Initial symptoms worse first 2 weeks then decline over the next month.
Long term: Nephropathy, Fat redistribution, liver/kidney toxic, metabolic changes (metabolic syndrome, elevation
in triglycerides and cholesterol-high risk for heart disease and DM)
Bone-increase risk of osteoporosis and osteopenia-get
dexascan The medication is toxic to mitochondria and lactic
acidosis
6. Metabolic syndrome is a SE of ART meds what are these s/s: Insulin
resistance,
abdominal obesity, HTN, abnormal lipid panel this leads to increased risk of cardiovascular disease and DM2
7. What is the difference between primary and secondary
immunosuppression-
: Primary-genetic lymphocyte
deficiency Secondary-from a disease
process or meds
8. Who is at risk for immunocompromise: Chronic illness or critical
illness DMARDS-anti-Rheumatic meds
Chemo
High risk behaviors
Bone marrow
suppression Auto-
immune meds
Splenectomy
9. Late stage (AIDS) definition: CD4 count less than 200
10. PCP PPX is what must you test for and when do you give
this: PCP ppx in immunocompromized patients should be given if CD4 count is less than 200, you can stop
treatment when CD4 count is above 200 for 3 months. First line choice is Bactrim (TMP-SMX). You need to test
for G6PD deficiency this can cause hemolytic anemia and can be deadly if positive then use Pentamidine or
, Dapsone/Atovaquone
11. Toxoplasmosis is a protazoa parasite you should consider in
immunocom- promized patient with acute onset of fever and
lymphadenopathy, they can also present with a rash. If you have HIV what is
PPX: Bactrim for CD4 less than 100
12. Mycobacterium Avium Complex PPX: Azithromyacin 1200mg weekly if CD4 less than 50
13. Histoplasmosis is a fungi found in bird and bat poop PPX is?: Itraconazole
200 mg daily for CD4 less than 100
14. List the acute S/S of HIV infection: Fever, weight loss, malaise, sores in mouth, thrush,
myalgias, liver and spleen enlargement, N/V skin rash, lymphadenopathy
15. What is a normal CD4 count: 600-1200
16. Red flags that would make you think a patient should be
screened for HIV: ZOSTER
THRUSH
recurrent viral or bacterial infections
STD
positive TB Test
17. Symptomatic HIV s/s:
Thrush ITP
Anemia
Wt loss
Cervical Dysplasia
Neuropathy (ART cause
also) Recurrent Herpes
infections Oral hairy
leukoplakia
18. Severe ITP is a platelet count under: 20,000 with treatment required
19. A person is on a 3 drug regimen ART therapy there are many drug
interac- tions what are the top three to keep in mind: PPI/H2 blockers
TESTING COMPLETE 100+ ACTUAL EXAM
QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXPERT VERIFIED /ALREADY
GRADED A+
1. Who should be screened for HIV? What test do you use? Do you need
con- sent: Anyone age 15-65 at least once
High risk individuals annually (consider 3-6 months)
Always include in prenatal testing and high risk individuals in 3rd trimester
Written consent and prevention counseling is not
required This is OPT out Testing
Test using 4th generation HIV test
2. The 4th generation HIV test differs from the ELISA/Western Blot how?
What about rapid HIV test: CDC does not use rapid (Oraquick) test in algorithms
The 4th generation HIV test is an antibody and antigen test it looks for P24 antigen and HIV viral load, Qualitative
HIV RNA test. Older tests only look for antibodies which sometimes do not develop for 3 months.
3. What is considered the most specific HIV test and when do you use this?
-
NAT-Nucleic Acid Test-tests for viral particles. This is very expensive and is done after 4th gen test when first result
is positive then the HIV 1 & 2 ditterentiation are negative for HIV 1 and HIV 2
4. When would you prescribe ART therapy? How many meds? What is mos
difficult besides SE of taking ART therapy: Start on all HIV positive patients regardless
of CD4 count-3 drug regimen. Adherence is the most diflcult you have to be 95% adherent in order to
prevent resistance. If you transmit HIV you also transmit the resistant HIV
,5. Side effects of ART (Initial vs Long term): Initial: n/v/d, fatigue ha, dizzy, poor sleep
Initial symptoms worse first 2 weeks then decline over the next month.
Long term: Nephropathy, Fat redistribution, liver/kidney toxic, metabolic changes (metabolic syndrome, elevation
in triglycerides and cholesterol-high risk for heart disease and DM)
Bone-increase risk of osteoporosis and osteopenia-get
dexascan The medication is toxic to mitochondria and lactic
acidosis
6. Metabolic syndrome is a SE of ART meds what are these s/s: Insulin
resistance,
abdominal obesity, HTN, abnormal lipid panel this leads to increased risk of cardiovascular disease and DM2
7. What is the difference between primary and secondary
immunosuppression-
: Primary-genetic lymphocyte
deficiency Secondary-from a disease
process or meds
8. Who is at risk for immunocompromise: Chronic illness or critical
illness DMARDS-anti-Rheumatic meds
Chemo
High risk behaviors
Bone marrow
suppression Auto-
immune meds
Splenectomy
9. Late stage (AIDS) definition: CD4 count less than 200
10. PCP PPX is what must you test for and when do you give
this: PCP ppx in immunocompromized patients should be given if CD4 count is less than 200, you can stop
treatment when CD4 count is above 200 for 3 months. First line choice is Bactrim (TMP-SMX). You need to test
for G6PD deficiency this can cause hemolytic anemia and can be deadly if positive then use Pentamidine or
, Dapsone/Atovaquone
11. Toxoplasmosis is a protazoa parasite you should consider in
immunocom- promized patient with acute onset of fever and
lymphadenopathy, they can also present with a rash. If you have HIV what is
PPX: Bactrim for CD4 less than 100
12. Mycobacterium Avium Complex PPX: Azithromyacin 1200mg weekly if CD4 less than 50
13. Histoplasmosis is a fungi found in bird and bat poop PPX is?: Itraconazole
200 mg daily for CD4 less than 100
14. List the acute S/S of HIV infection: Fever, weight loss, malaise, sores in mouth, thrush,
myalgias, liver and spleen enlargement, N/V skin rash, lymphadenopathy
15. What is a normal CD4 count: 600-1200
16. Red flags that would make you think a patient should be
screened for HIV: ZOSTER
THRUSH
recurrent viral or bacterial infections
STD
positive TB Test
17. Symptomatic HIV s/s:
Thrush ITP
Anemia
Wt loss
Cervical Dysplasia
Neuropathy (ART cause
also) Recurrent Herpes
infections Oral hairy
leukoplakia
18. Severe ITP is a platelet count under: 20,000 with treatment required
19. A person is on a 3 drug regimen ART therapy there are many drug
interac- tions what are the top three to keep in mind: PPI/H2 blockers
