ADVANCES IN THE DIAGNOSIS AND MANAGEMENT OF HIV/AIDS

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1. The majority of US women contract HIV through:
a. heterosexual contact
b. injecting drug users
c. women having sex with women
d. recipients of contaminated blood products
e. tatooing
2. The risk of infection after a needle stick from an HIV-infected source is:
a. 0.36%
b. 3.6%
c. 36%
d. cannot be estimated
e. highly variable
3. ZDV-containing regimens should be given for an HIV-infected pregnant women:
a. for the entire course of the pregnancy
b. beginning at the time of labor, when the intravenous form of zidovudine is given at 1 mg/kg until delivery
c. if a viral load is detectable
d. beginning at 14 to 34 weeks of gestation and continuing throughout pregnancy until delivery
e. but not for the newborn because of concerns for hepatotoxicity
4. An HIV Western blot test:
a. is an antigen test
b. is reactive if at least two of three antigen bands are present
c. is considered negative if less than two antigen bands are present
d. does not have to be performed if the ELISA is reactive on repeat testing
e. that is read as indeterminate remains so indefinitely
5. Posttest counseling:
a. is not necessary if the result is a negative one
b. involving a positive result should not be given by telephone or on a Friday
c. should only be provided by a certified counselor
d. is not needed if the client has been tested and counseled in the past
e. involves the counselor notifying all probably exposures, with or without the client's consent
6. Initial staging of a newly diagnosed HIV-infected person
a. includes CD4 cell count, chest x-ray, complete blood count, and beta2-microglobulin level
b. includes CD4 cell count, HIV-1 RNA viral load, purified protein derivative status, and repeat HIV antibody if result is not documented
c. should not be commenced until a patient's insurance status is established
d. includes CD4 cell count, HIV-1 RNA viral load, and empiric initiation of antiretroviral therapy until results of bloodwork are available
e. should not be done unless the patient is willing to start antiretroviral therapy if indicated
7. Initiation of antiretroviral therapy:
a. should be postponed until the patient has a CD4 cell count less than 200 or is symptomatic to avoid early exposure and potential resistance to the medications
b. should start with one drug such as zidovudine and sequentially add two more drugs to aid in compliance and tolerability
c. ideally includes two protease inhibitors and a nucleoside RTI
d. should never include a nonnucleoside RTI initially
e. requires a readiness on the patient's part to commit to the regimen prescribed.
8. Viral load monitoring:
a. should be done at baseline and at 4, 8-12 and 16-24 weeks after starting therapy
b. precludes the need to follow CD4 counts once a baseline is obtained
c. is only done at the start of therapy
d. is not affected by vaccinations or viral illnesses
e. can be accomplished readily in most office laboratory settings
9. Prophylaxis against Pneumocystis jiroveci pneumonia:
a. is never indicated in patients with a CD4 cell count greater than 200
b. is 60% effective when using trimethoprim-sulfamethoxazole
c. includes dapsone and atovaquone as alternatives to trimethoprim-sulfamethoxazole
d. is not provided when CD4 cell counts drop below 50 cells/mm3
e. can be complicated by rash from trimethoprim-sulfamethoxazole in <20% of patients
10. Prophylaxis against Mycobacterium avium complex:
a. includes rifabutin as a first-line agent
b. involves using at least two drugs in order to reduce resistance
c. includes either clarithromycin or azithromycin as the preferred agent
d. provides virtually complete protection against development of related bacteremia
e. is initiated when the CD4 cell count drops below 200 cells/mm3
 

Before you submit your test for grading, please complete the following form.

Program Evaluation

Upon completion of this presentation, I am able to:

identify at-risk populations for HIV infection and counsel patients on avoiding high-risk behavior and exposures to HIV.

Yes No NA

determine when HIV testing is appropriate and how to adequately explain the implications of a positive test result.

Yes No NA

understand the types of HIV diagnostic tests available and be familiar with the advantages and limitations of each test.

Yes No NA

discuss the importance of antiretroviral therapeutic intervention for HIV-positive pregnant women and how that treatment is administered.

Yes No NA

appreciate the issues of confidentiality, notification of exposed persons, and reporting.

Yes No NA

know how to perform initial staging of an HIV-positive person, including immune status, underlying illnesses, and potentially complicating factors such as social issues and financial circumstances.

Yes No NA

determine the follow-up necessary to maintain the health status of an HIV-infected person, including blood test monitoring, social issues, vaccinations, and physical examinations.

Yes No NA

understand the importance of appropriate antiretroviral therapy to prevent resistance and keep viral load as close to undetectable levels as possible.

Yes No NA

recognize the advent of a failing drug regimen and be able to initiate appropriate adjustments in therapy.

Yes No NA

know when and how to provide prophylaxis against opportunistic infections, including Pneumocystis jiroveci pneumonia and Mycobacterium avium complex.

Yes No NA


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