ACRN Opportunistic Infections Management 2

Question 1

What is the first-line induction treatment for cryptococcal meningitis in HIV patients?

Accepted Answer

Amphotericin B plus flucytosine

Answer

Fluconazole alone

Answer

Itraconazole plus voriconazole

Answer

Voriconazole plus caspofungin

Question 2

A patient on TMP-SMX for PCP prophylaxis develops a severe sulfonamide allergy. What is the most appropriate alternative?

Accepted Answer

Dapsone or atovaquone

Answer

Fluconazole

Answer

Azithromycin

Answer

Ganciclovir

Question 3

Which medication regimen is recommended for MAC prophylaxis in HIV patients with CD4 < 50 cells/mm³?

Accepted Answer

Weekly azithromycin or daily clarithromycin

Answer

Daily TMP-SMX double-strength

Answer

Daily isoniazid

Answer

Daily fluconazole

Question 4

What is the treatment of choice for CMV retinitis in HIV-positive patients?

Accepted Answer

Ganciclovir IV or oral valganciclovir

Answer

Acyclovir IV

Answer

Foscarnet only

Answer

TMP-SMX

Question 5

Which diagnostic test is considered the gold standard for confirming active pulmonary tuberculosis in an HIV-positive patient?

Accepted Answer

Sputum acid-fast bacilli (AFB) culture

Answer

Tuberculin skin test (TST)

Answer

QuantiFERON-TB Gold assay

Answer

Chest X-ray with cavitation

Question 6

A nurse caring for an HIV patient who starts ART notices the patient develops worsening lymphadenopathy and fever. The patient was recently diagnosed with MAC. What is the most likely explanation?

Accepted Answer

Immune Reconstitution Inflammatory Syndrome (IRIS)

Answer

ART drug toxicity reaction

Answer

New opportunistic infection

Answer

MAC treatment failure

Question 7

When can PCP prophylaxis be safely discontinued in an HIV patient on ART?

Accepted Answer

When CD4 count rises above 200 cells/mm³ and remains there for at least 3 months

Answer

When viral load becomes undetectable

Answer

When the patient has been on ART for 6 months

Answer

When the patient has no OI symptoms for 1 year