Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
14 HIV infection and AIDS MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 10 practice questions
- Mucocutaneous disease
- Immunology
- Vaccination and pregnancy
- Retinopathy and oesophageal disease
- Respiratory disease
- Fever and weight loss
- Prevention
- Neurological disease
1. A patient with HIV has dyspnoea for 6 weeks with dry cough, interstitial infiltrates and hypoxia; another with CD4 below 200 has cough, effusion, hilar adenopathy and negative smears. Which statements are correct?
- APneumocystis pneumonia is diagnosed on BAL or induced sputum and treated with co-trimoxazole plus glucocorticoids, and advanced-HIV TB is atypical with more than half smear-negative
- BPneumocystis needs steroids alone, and TB has apical cavitation
- CPneumocystis is treated with fluconazole, and TB is always smear positive
- DPneumocystis is diagnosed on spontaneous sputum, and TB is typical with cavities
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A. Pneumocystis pneumonia is diagnosed on BAL or induced sputum and treated with co-trimoxazole plus glucocorticoids, and advanced-HIV TB is atypical with more than half smear-negative Spontaneously produced sputum has low yield for PCP; in advanced HIV TB progresses rapidly with fewer cavities, more effusions and lymphadenopathy.
2. A physician explains why ART cannot cure HIV and why CD4 cells fall. Which statements are correct?
- AART is poorly absorbed, and CD4 loss is autoimmune B-cell attack
- BThe virus mutates too slowly, and CD4 loss is from antibiotics
- CLatent cells are dead, and CD4 loss is from direct lysis
- DLatent long-lived CD4 cells hold proviral DNA and are unaffected by drugs acting on replicating virus, and CD4 destruction is mainly immune-mediated
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D. Latent long-lived CD4 cells hold proviral DNA and are unaffected by drugs acting on replicating virus, and CD4 destruction is mainly immune-mediated Current ART cannot eradicate infection because of persisting proviral DNA in latent cells; CD4 cells are destroyed primarily by the host immune response with CD8 lymphocytosis.
3. A patient on co-trimoxazole prophylaxis achieves CD4 250 on ART, and a health worker has a needlestick 96 hours ago. Which statements are correct?
- AProphylaxis continues lifelong everywhere, and PEP works at any time
- BProphylaxis can stop above 200 in high-income settings but continues in low-income countries, and PEP is not started after 72 hours
- CProphylaxis is doubled, and PEP is given with steroids
- DProphylaxis stops at 100, and PEP starts at 7 days
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B. Prophylaxis can stop above 200 in high-income settings but continues in low-income countries, and PEP is not started after 72 hours Co-trimoxazole prophylaxis stops when CD4 exceeds 200 on ART except in low-income countries; PEP is ineffective if given more than 72 hours after exposure.
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