Lewis ch 14: infection and human
immunodeficiency virus infection
QUESTIONS
1. Emerging and reemerging infections affect health care by (select all that apply)
a. reevaluating vaccine practices.
b. revealing antimicrobial resistance.
c. limiting antibiotics to those with life-threatening infection.
d. challenging researchers to discover new antimicrobial therapies. - ANS 1. Correct answers:
a, b, d
An emerging infection is an infectious disease whose incidence has increased in the past 20
years or threatens to increase in the immediate future. Reemerging infections are those
infections that were previously controlled but have resurfaced. The most common reason for
reemerging infectious diseases is low vaccination rates. Ways in which emerging and
reemerging infectious have affected the health care system include revising vaccine
recommendations for previously controlled infections (e.g., pertussis and measles); discovery of
antimicrobial-resistant organisms; and creation of new antiinfective agents to combat new
organisms or antimicrobial-resistant infections.
2. Which types(s) of isolation precautions is (are) appropriate for a patient with tuberculosis
(select all that apply)?
a. contact precautions
b. droplet precautions
c. airborne precautions
d. standard precautions
e. neutropenic precautions - ANS 2. Correct answers: c, d
Standard precautions should be used for all patients. In addition to standard precautions,
patients with TB should be placed on airborne precautions to minimize risk of transmission and
infection of HCPs and visitors.
3. Transmission of HIV from an infected individual to another most commonly occurs as a result
of
a. unprotected anal or vaginal sexual intercourse.
b. low levels of virus in the blood and high levels of CD4+ T cells.
c. transmission from mother to infant during labor and delivery and breastfeeding.
, d. sharing of drug-using equipment, including needles, syringes, pipes, and straws. - ANS 3.
Correct answer: a
Unprotected sexual contact (semen, vaginal secretions, or blood) with a partner infected with
human immunodeficiency virus (HIV) is the most common mode of HIV transmission.
4. During HIV infection
a. reverse transcriptase helps HIV fuse with the CD4+ T cell.
b. HIV RNA uses the CD4+ T cell's mitochondria to replicate.
c. the immune system is impaired predominantly by the eventual widespread destruction of
CD4+ T cells.
d. a long period of dormancy develops during which HIV cannot be found in the blood and there
is little viral replication. - ANS 4. Correct answer: c
Immune dysfunction in HIV disease is caused predominantly by damage to and destruction of
CD4+ T cells (i.e., T helper cells or CD4+ T lymphocytes).
5. Which statements accurately describe HIV infection (select all that apply)?
a. Untreated HIV infection has a predictable pattern of progression.
b. Late chronic HIV infection is called acquired immunodeficiency syndrome (AIDS).
c. Untreated HIV infection can remain in the early chronic stage for a decade or more.
d. Untreated HIV infection usually remains in the early chronic stage for 1 year or less.
e. Opportunistic diseases occur more often when the CD4+ T cell count is high and the viral
load is low. - ANS 5. Correct answers: a, b, c
The typical course of untreated HIV infection follows a predictable pattern. However, treatment
can significantly alter this pattern, and disease progression is highly individualized. Late chronic
infection is another term for acquired immunodeficiency syndrome (AIDS). The median interval
between untreated HIV infection and a diagnosis of AIDS is about 11 years.
6. A diagnosis of AIDS is made when an HIV-infected patient has
a. a CD4+ T cell count below 200/µL.
b. a high level of HIV in the blood and saliva.
c. lipodystrophy with metabolic abnormalities.
d. oral hairy leukoplakia, an infection caused by Epstein-Barr virus. - ANS 6. Correct answer: a
AIDS is diagnosed when an individual with HIV infection meets one of several criteria; one
criterion is a CD4+ T cell count below 200 cells/L. Other criteria are listed in Table 14-10.
7. Screening for HIV infection generally involves
a. detecting CD8+ cytotoxic T cells in saliva.
b. laboratory analysis of saliva to detect CD4+ T cells.
c. analysis of lymph tissues for the presence of HIV RNA.
d. laboratory analysis of blood to detect HIV antigen or antibody. - ANS 7. Correct answer: d
immunodeficiency virus infection
QUESTIONS
1. Emerging and reemerging infections affect health care by (select all that apply)
a. reevaluating vaccine practices.
b. revealing antimicrobial resistance.
c. limiting antibiotics to those with life-threatening infection.
d. challenging researchers to discover new antimicrobial therapies. - ANS 1. Correct answers:
a, b, d
An emerging infection is an infectious disease whose incidence has increased in the past 20
years or threatens to increase in the immediate future. Reemerging infections are those
infections that were previously controlled but have resurfaced. The most common reason for
reemerging infectious diseases is low vaccination rates. Ways in which emerging and
reemerging infectious have affected the health care system include revising vaccine
recommendations for previously controlled infections (e.g., pertussis and measles); discovery of
antimicrobial-resistant organisms; and creation of new antiinfective agents to combat new
organisms or antimicrobial-resistant infections.
2. Which types(s) of isolation precautions is (are) appropriate for a patient with tuberculosis
(select all that apply)?
a. contact precautions
b. droplet precautions
c. airborne precautions
d. standard precautions
e. neutropenic precautions - ANS 2. Correct answers: c, d
Standard precautions should be used for all patients. In addition to standard precautions,
patients with TB should be placed on airborne precautions to minimize risk of transmission and
infection of HCPs and visitors.
3. Transmission of HIV from an infected individual to another most commonly occurs as a result
of
a. unprotected anal or vaginal sexual intercourse.
b. low levels of virus in the blood and high levels of CD4+ T cells.
c. transmission from mother to infant during labor and delivery and breastfeeding.
, d. sharing of drug-using equipment, including needles, syringes, pipes, and straws. - ANS 3.
Correct answer: a
Unprotected sexual contact (semen, vaginal secretions, or blood) with a partner infected with
human immunodeficiency virus (HIV) is the most common mode of HIV transmission.
4. During HIV infection
a. reverse transcriptase helps HIV fuse with the CD4+ T cell.
b. HIV RNA uses the CD4+ T cell's mitochondria to replicate.
c. the immune system is impaired predominantly by the eventual widespread destruction of
CD4+ T cells.
d. a long period of dormancy develops during which HIV cannot be found in the blood and there
is little viral replication. - ANS 4. Correct answer: c
Immune dysfunction in HIV disease is caused predominantly by damage to and destruction of
CD4+ T cells (i.e., T helper cells or CD4+ T lymphocytes).
5. Which statements accurately describe HIV infection (select all that apply)?
a. Untreated HIV infection has a predictable pattern of progression.
b. Late chronic HIV infection is called acquired immunodeficiency syndrome (AIDS).
c. Untreated HIV infection can remain in the early chronic stage for a decade or more.
d. Untreated HIV infection usually remains in the early chronic stage for 1 year or less.
e. Opportunistic diseases occur more often when the CD4+ T cell count is high and the viral
load is low. - ANS 5. Correct answers: a, b, c
The typical course of untreated HIV infection follows a predictable pattern. However, treatment
can significantly alter this pattern, and disease progression is highly individualized. Late chronic
infection is another term for acquired immunodeficiency syndrome (AIDS). The median interval
between untreated HIV infection and a diagnosis of AIDS is about 11 years.
6. A diagnosis of AIDS is made when an HIV-infected patient has
a. a CD4+ T cell count below 200/µL.
b. a high level of HIV in the blood and saliva.
c. lipodystrophy with metabolic abnormalities.
d. oral hairy leukoplakia, an infection caused by Epstein-Barr virus. - ANS 6. Correct answer: a
AIDS is diagnosed when an individual with HIV infection meets one of several criteria; one
criterion is a CD4+ T cell count below 200 cells/L. Other criteria are listed in Table 14-10.
7. Screening for HIV infection generally involves
a. detecting CD8+ cytotoxic T cells in saliva.
b. laboratory analysis of saliva to detect CD4+ T cells.
c. analysis of lymph tissues for the presence of HIV RNA.
d. laboratory analysis of blood to detect HIV antigen or antibody. - ANS 7. Correct answer: d
