FREE PHARMACOLOGY AND STUDY GAMES ABOUT BCPS

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FREE PHARMACOLOGY AND STUDY GAMES ABOUT BCPS

STUDY GUIDE EXAM QUESTIONS

Qs and Ans Expert- Explanation

This Exam contains:

-Guarantee passing score -37 Questions and Answers -format set of multiple-choice -Expert- Explanation

Question 1: treatment of fever/chills with amphotericin B and MOA

Answer:

amp B induces PGE synthesis. hydrocortisone or ibuprofen may help. ASA/APAP/benadryl have not been shown to help but were also not specifically studied

Question 2: in a low risk HIV positive pt, when should ART be initiated

Answer:

when CD4 counts drop below 350 FOR SURE. 350-500 and over 500 can consider. if pt likely to transmit HIV to sexual partners start as well. if pt preggers or AIDs defining condition or Hep B coinfection as well.

Question 3: PrEP therapy

Answer:

Truvada (emtricitabine/tenofovir) 300mg/200mg QD Question 4: percent change in CD4 counts to be expected in pts getting potent ART therapy

Answer:

increase 50-100/mm^3 annually

Question 5: how long and with what should the baby be treated with post natally if mom has HIV

Answer:

• weeks with zidovudine 4 mg/kg/dose Q12H. if mom didn't take ART during preggers add nevirapine at

birth and repeat at 48 hours then 96 hours after the second dose, repeat.

Question 6: standard therapy for toxoplasmosis

Answer:

pyrimethamine and sulfasalazine and leucovorin to prevent bone marrow effects of pyrimethamine. if sulfa allergy can use clindamycin.

Question 7: treatment for CMV infections

Answer:

same for all. valgancyclovir or gancyclovir [both interact with zidovudine, gancyclovir can do lower doses but not recommended]; foscarnet - no notable DDIs and has anti-HIV activity and decreased mortality,; cidofovir - can cause renal impairment.

Question 8: diagnostic tests for cryptococcus meningitis

Answer:

positive CSF cultures, CSF india ink, CSF cryptococcal antigen titer, elevated opening pressure >20,

serum cryptococcal antigen more than 1:8

Question 9: CD4 count diagnostic of AIDS (stage 3 HIV)

Answer:

<200/uL or <14%

Question 10: preferred post exposure prophylaxis

Answer:

raltegravir PLUS Truvada (emtricitabine/tenofovir) [occupational]. no preference for ART if non-occupational other than that it be potent combination ART.Question 11: what drug should be included in perinatal therapy for HIV prevention

Answer:

zidovudine

Question 12: why is there no renal adjustment dose for voriconazole?

Answer:

crcl <50 should not get vori due to vehicle sulfobutyl ether-B-cyclodextrin

Question 13: when are live vaccines contraindicated in pts with HIV

Answer:

if CD4 count <200

Question 14: preferred treatment for cryptococcus meningitis

Answer:

amphotericin B and flucytosine for at least 2 weeks followed by fluconazole for at least 8 weeks. can also do amp B monotherapy or just fluconazole and flucytosine or amp B and fluconazole but this is the preferred treatment

Question 15: dose adjustments for voriconazole with tacrolimus and cyclosporine

Answer:

tac decrease dose by 2/3. cyclosporine decrease dose by 1/2

Question 16: treatment for latent TB in pts NOT coinfected with HIV

Answer:

isoniazid 300 mg daily or 900 mg twice weekly for 6-9 months. may also use rifampin 600 mg daily for 4 months. other options require DOT or are not CDC recommended regimens

Question 17: treatment for latent TB in pts coinfected with HIV

Answer:

isoniazid 300 mg daily for 9 months. may also do 900 mg twice weekly for 9 months but requires DOT

Question 18: what are the principles of HIV opportunistic infections

Answer:

severe and typically not curable, suppressive therapy is used; not contagious to others typically as usually reactivation of previous exposure; depends on local bugs; more B cell associated infections such as pneumococcal becoming more common

Question 19: treatment for active TB in pt coinfected with HIV

Answer:

isoniazid, rifampin, pyrazinamide and ethambutol for 2 months followed by isoniazidand rifampin for 4 months (same as for non-HIV) may need to change to rifabutin due to DDI with PI and NNRTIs.decrease rifabutin dose with PIs. need HIV RNA conc. checked Question 20: what HIV drug should be avoided in women of childbearing age to avoid first trimester exposure

Answer:

efavirenz

Question 21: prevention of renal toxicity with amphotericin B

Answer:

• L NS for 24 hrs or 500 ml before and after dose. avoid diuretics and liberalize salt intake

Question 22: symptoms of acute/primary HIV infection

Answer:

lethargy, sweats, arthralgias, myalgias,fevers, headache, photophobia, sore throat, lymphadenopathy, diarrhea Question 23: how long should post exposure prophylaxis continue and how soon after exposure should it start

Answer:

continue therapy for 4 weeks. if non-occupational exposure start within 72 hours. if occupational try to start within hours and start treatment while status is evaluated

Question 24: calculate Aa gradient

Answer:

150-PCO2-PO2

Question 25: other than CD4 count, what defines AIDS

Answer:

documentation of an AIDS defining condition along with laboratory confirmation of HIV