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

The induction phase for cryptococcal meningitis requires amphotericin B deoxycholate (or liposomal) plus flucytosine for at least 2 weeks, followed by fluconazole consolidation.

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

Dapsone and atovaquone are both acceptable alternatives for PCP prophylaxis in patients who cannot tolerate TMP-SMX due to sulfa allergy.

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

Weekly azithromycin (1200 mg) or daily clarithromycin (500 mg BID) are the preferred macrolide-based regimens for MAC prophylaxis at CD4 < 50 cells/mm³.

Question 4

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

Accepted Answer

Ganciclovir IV or oral valganciclovir

Answer

Ganciclovir (IV) or its oral prodrug valganciclovir is the standard of care for induction and maintenance treatment of CMV retinitis.

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

Sputum AFB culture remains the gold standard for TB diagnosis because TST and IGRA may be falsely negative in severely immunocompromised HIV patients.

ACRN - AIDS Certified Registered Nurse Practice Test

ACRN - AIDS Certified Registered Nurse Practice Test

ACRN Opportunistic Infections Management 2