AGACNP Final Exam Questions With
Correct Answers
Who should be screened for HIV? What test do you use? Do you need
| | | | | | | | | | | | | |
consent
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
| | | | |
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.
| | | | | | | | | | |
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
| | | | | | | | | | | | | | | | |
differentiation are negative for HIV 1 and HIV 2 | | | | | | | |
When would you prescribe ART therapy? How many meds? What is
| | | | | | | | | | |
most difficult besides SE of taking ART therapy
| | | | | | |
Start on all HIV positive patients regardless of CD4 count-3 drug
| | | | | | | | | | |
regimen. Adherence is the most difficult you have to be 95% adherent in
| | | | | | | | | | | |
order to prevent resistance. If you transmit HIV you also transmit the
| | | | | | | | | | | | |
resistant HIV |
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
| | | | | | | |
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
| | | | | | | |
What is the difference between primary and secondary
| | | | | | | |
immunosuppression
Primary-genetic lymphocyte deficiency | |
Secondary-from a disease process or meds | | | | |
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
Late stage (AIDS) definition
| | |
CD4 count less than 200
| | | |
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
| | | | | |
Toxoplasmosis is a protazoa parasite you should consider in | | | | | | | | |
immunocompromized patient with acute onset of fever and | | | | | | | |
lymphadenopathy, they can also present with a rash. If you have HIV | | | | | | | | | | | |
what is PPX | |
Correct Answers
Who should be screened for HIV? What test do you use? Do you need
| | | | | | | | | | | | | |
consent
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
| | | | |
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.
| | | | | | | | | | |
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
| | | | | | | | | | | | | | | | |
differentiation are negative for HIV 1 and HIV 2 | | | | | | | |
When would you prescribe ART therapy? How many meds? What is
| | | | | | | | | | |
most difficult besides SE of taking ART therapy
| | | | | | |
Start on all HIV positive patients regardless of CD4 count-3 drug
| | | | | | | | | | |
regimen. Adherence is the most difficult you have to be 95% adherent in
| | | | | | | | | | | |
order to prevent resistance. If you transmit HIV you also transmit the
| | | | | | | | | | | | |
resistant HIV |
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
| | | | | | | |
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
| | | | | | | |
What is the difference between primary and secondary
| | | | | | | |
immunosuppression
Primary-genetic lymphocyte deficiency | |
Secondary-from a disease process or meds | | | | |
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
Late stage (AIDS) definition
| | |
CD4 count less than 200
| | | |
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
| | | | | |
Toxoplasmosis is a protazoa parasite you should consider in | | | | | | | | |
immunocompromized patient with acute onset of fever and | | | | | | | |
lymphadenopathy, they can also present with a rash. If you have HIV | | | | | | | | | | | |
what is PPX | |
