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APEA STD's and STI's -Questions with Correct Answers/ Verified
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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 ...

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  • August 21, 2024
  • 9
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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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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