APEA STD's and STI's -Questions with Correct Answers/ Verified
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Course
Apea
Institution
Apea
Fever (96%)
Pharyngitis (70%)
Nonpruritic macular skin rash (70%)
Malaise
Headache
Lymphadenopathy (74%) - HIV initial infection usual duration less than 14 days?
If high index of suspicion for HIV:
NAT* HIV-1 RNA assay (Aptima) (detects viral load and HIV)
NOTE: CDC does not recommend NAT ...
APEA STD's and STI's -Questions with Correct Answers/ Verified
Fever (96%)
Pharyngitis (70%)
Nonpruritic macular skin rash (70%)
Malaise
Headache
Lymphadenopathy (74%) - ✔✔HIV initial infection usual duration less than 14 days?
If high index of suspicion for HIV:
NAT* HIV-1 RNA assay (Aptima) (detects viral load and HIV)
NOTE: CDC does not recommend NAT for diagnosis SO if positive+, perform another HIV test
HIV 1/ 2 antigen/antibody immunoassay *NAT = HIV-1 nucleic acid test = RNA qualitative assay =
Aptima - ✔✔HIV TEST?
• 30% with a history of hepatitis C
• 8% with a history of hepatitis B
• Liver disease progresses faster and affects the choice of antiretroviral therapy
• TB: HIV is a significant risk factor for reactivation of latent TB
• History of STIs - ✔✔Primary Care of HIV-Infected Adults — History?
• Need pneumococcal, tetanus, hep A/B; flu annually
• Never administer live or attenuated vaccines!!!!!
• Consider immunization for close contacts (exceptions: oral polio, smallpox) - ✔✔Primary Care of
HIV-Infected Adults — Immunizations?
• CD4 count-baseline; repeat once and usually q 3-4 months (count determines need for prophylaxis
against opportunistic infections)
• Viral load: need baseline and q 3-4 months (if on ART, goal is undetectable viral load within 16-24
weeks of therapy)
• Screen for hepatitis: A, B, C
• Glucose and lipid panel (consequence of ART use)
, • STD assessment - ✔✔Primary Care of HIV-Infected Adults labs?
• Pneumocystis carinii (jiroveci) (CD4 <200)
• TMP-SMX first line 1 DS tab daily Prevents toxoplasmosis, Legionella, Salmonella, others MAC
(Mycobacterium avium complex) (CD4 <50)
• Azithromycin, clarithromycin once daily - ✔✔Primary Care of HIV-Infected Adults: Prophylaxis?
• Anemia, leukopenia
• Thrombocytopenia
• Involuntary weight loss
• Persistent diarrhea
• Severe chronic fatigue
• Dementia • Peripheral neuropathy
• Herpes zoster: can get Shingrix!
• Presence of opportunistic infections - ✔✔Established HIV Assessment Findings?
highly infectious!
Self-limiting viral-type syndrome occurring 2-4 weeks postinfection HIV test will be negative during
this time
usually presents with Hep B, Hep C and reactivation of TB, normally has a hx of STI's - ✔✔HIV early
detection Acute retroviral syndrome:
• Routine screening ALL ages 13-64 years — unless prevalence is <0.1% • All pregnant women (1st
trimester)
• If being treated for TB
• All seeking treatment for STIs
• Diagnosed with syphilis, gonorrhea, chlamydia
• ALL high risk for HIV
• All attending STI clinics Routinely screen at each visit Even if low risk (for HIV) by history! - ✔✔HIV:
Screening per CDC?
hispanics - ✔✔Highest risk to contract HIV?
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