AG-ACNP - Renal, GU, STD- Questions &
Answers
Initial symptoms after exposure: Correct Ans-Flu likes syndrome weeks after infection
- Suggests high viral replication
** Take PPX if exposed b/c can eradicate virus before period of replication
HIV Diagnosis: Correct Ans-Screening: ELISA 99.99% sensitivity
Confirmation: Western blot 99.9% specificity
HIV testing schedule for those who have exposed Correct Ans-1) Always immediately to
prove no prior exposure
2) 6 weeks
3) 3 months - unlikely to seroconvert at this point if negative
4) 6 months
Labs for HIV Correct Ans-CD4+ count: indicates level of functional immunity
- Normal: 800-1100
- 500-800: still immunocompetent
- < 500: insufficient - < 350: immunocompromised
,Viral load: measures viral replication, how well controlled HIV is on medication
When do you begin antiretroviral therapy for persons infected with HIV? Correct Ans-CDC:
offer treatment to anyone at time of diagnosis
Recommend CD4 < 350 absolutely go on meds
When do you give PPX for PCP in HIV person? Correct Ans-CD4 <350 give Bactrim PPX
Herpes Correct Ans-- Can be spread through saliva and body fluids
- After exposure, primary outbreak within 6 weeks
- Latent, remission, outbreaks
- Typically have prodrome before outbreak
- Start antivirals at this time to control outbreak
- Contagious all the time
Condoms do not protect against herpes
Herpes symptoms: Correct Ans-Grouped vesicles with serous drainage on mucous
membranes with subsequent crusting
Herpes diagnosis Correct Ans-Viral culture of a lesion
Serology for antibodies
,Treatment for herpes Correct Ans-- Antivirals
- Continuous, episodic, or none
- Barrier protection with sex
What is the most common type of urinary incontinence in elderly? Correct Ans-Urge
incontinence
- Leakage of urine with strong and sudden sensations in the bladder
Neurologic disorders may result in which type of incontinence? Correct Ans-Urge: decrease
sensory in bladder, therefore have strong, sudden sensations of bladder urgency and leak urine.
What medications are most commonly associated with urinary incontinence in elderly?
Correct Ans-Diuretics
Other medications:
- Sedatives
- Muscle relaxants
- Ethanol
- Hypnotics
What are some contributing factors to urinary incontinence in the older adult? Correct Ans--
Loss of kidney's ability to concentrate urine
, - Decreased bladder capacity
- Decreased activity
Estrogen replacement therapy in the postmenopausal period is associated with an increase in
what? Correct Ans-Incidence in endometrial cancer
**It IS NOT risk factor for breast cancer
What is an absolute contraindication to estrogen replacement therapy? Correct Ans-Breast
cancer
Differential diagnosis for dysfunctional uterine bleeding in women over 40: Correct Ans-1)
Anovulation (failure to release egg every month)
2) Uterine fibroids
3) Endometrial cancer
4) Uterine polyps
Pelvic inflammatory disease Correct Ans-Infection of upper part of female reproductive
system
- Often gonorrhea or chlamydia
- Can cause infertility, ecopic pregnancy, chronic pelvic pain, cancer, scarring
- Clinical diagnosis
Answers
Initial symptoms after exposure: Correct Ans-Flu likes syndrome weeks after infection
- Suggests high viral replication
** Take PPX if exposed b/c can eradicate virus before period of replication
HIV Diagnosis: Correct Ans-Screening: ELISA 99.99% sensitivity
Confirmation: Western blot 99.9% specificity
HIV testing schedule for those who have exposed Correct Ans-1) Always immediately to
prove no prior exposure
2) 6 weeks
3) 3 months - unlikely to seroconvert at this point if negative
4) 6 months
Labs for HIV Correct Ans-CD4+ count: indicates level of functional immunity
- Normal: 800-1100
- 500-800: still immunocompetent
- < 500: insufficient - < 350: immunocompromised
,Viral load: measures viral replication, how well controlled HIV is on medication
When do you begin antiretroviral therapy for persons infected with HIV? Correct Ans-CDC:
offer treatment to anyone at time of diagnosis
Recommend CD4 < 350 absolutely go on meds
When do you give PPX for PCP in HIV person? Correct Ans-CD4 <350 give Bactrim PPX
Herpes Correct Ans-- Can be spread through saliva and body fluids
- After exposure, primary outbreak within 6 weeks
- Latent, remission, outbreaks
- Typically have prodrome before outbreak
- Start antivirals at this time to control outbreak
- Contagious all the time
Condoms do not protect against herpes
Herpes symptoms: Correct Ans-Grouped vesicles with serous drainage on mucous
membranes with subsequent crusting
Herpes diagnosis Correct Ans-Viral culture of a lesion
Serology for antibodies
,Treatment for herpes Correct Ans-- Antivirals
- Continuous, episodic, or none
- Barrier protection with sex
What is the most common type of urinary incontinence in elderly? Correct Ans-Urge
incontinence
- Leakage of urine with strong and sudden sensations in the bladder
Neurologic disorders may result in which type of incontinence? Correct Ans-Urge: decrease
sensory in bladder, therefore have strong, sudden sensations of bladder urgency and leak urine.
What medications are most commonly associated with urinary incontinence in elderly?
Correct Ans-Diuretics
Other medications:
- Sedatives
- Muscle relaxants
- Ethanol
- Hypnotics
What are some contributing factors to urinary incontinence in the older adult? Correct Ans--
Loss of kidney's ability to concentrate urine
, - Decreased bladder capacity
- Decreased activity
Estrogen replacement therapy in the postmenopausal period is associated with an increase in
what? Correct Ans-Incidence in endometrial cancer
**It IS NOT risk factor for breast cancer
What is an absolute contraindication to estrogen replacement therapy? Correct Ans-Breast
cancer
Differential diagnosis for dysfunctional uterine bleeding in women over 40: Correct Ans-1)
Anovulation (failure to release egg every month)
2) Uterine fibroids
3) Endometrial cancer
4) Uterine polyps
Pelvic inflammatory disease Correct Ans-Infection of upper part of female reproductive
system
- Often gonorrhea or chlamydia
- Can cause infertility, ecopic pregnancy, chronic pelvic pain, cancer, scarring
- Clinical diagnosis
