ACRN Opportunistic Infections Management 1

Question 1

At what CD4 count threshold is prophylaxis for Pneumocystis jirovecii pneumonia (PCP) recommended?

Accepted Answer

Less than 200 cells/mm³

Answer

PCP prophylaxis is initiated when the CD4 count falls below 200 cells/mm³, the threshold at which cellular immunity is severely compromised.

Question 2

A patient with HIV presents with fever, dry cough, and hypoxia. Chest X-ray shows bilateral interstitial infiltrates and the CD4 count is 150 cells/mm³. Which opportunistic infection is most likely?

Accepted Answer

Pneumocystis jirovecii pneumonia (PCP)

Answer

PCP classically presents with bilateral interstitial infiltrates, dry cough, and progressive hypoxia in patients with CD4 < 200 cells/mm³.

Question 3

Mycobacterium avium complex (MAC) most commonly occurs when the CD4 count drops below:

Accepted Answer

50 cells/mm³

Answer

MAC disseminated disease typically develops when the CD4 count falls below 50 cells/mm³, making it one of the latest-stage opportunistic infections.

Question 4

A patient with HIV and CD4 of 45 cells/mm³ presents with headache, stiff neck, and altered mental status. CSF India ink preparation reveals encapsulated yeast. What is the diagnosis?

Accepted Answer

Cryptococcal meningitis

Answer

India ink staining identifying encapsulated yeast in CSF is a classic diagnostic finding for Cryptococcal meningitis caused by Cryptococcus neoformans.

Question 5

Toxoplasma gondii encephalitis typically occurs in HIV patients when the CD4 count falls below:

Accepted Answer

100 cells/mm³

Answer

Toxoplasma encephalitis generally develops when the CD4 count drops below 100 cells/mm³, placing it at a CD4 threshold between PCP and MAC.

ACRN - AIDS Certified Registered Nurse Practice Test

ACRN - AIDS Certified Registered Nurse Practice Test

ACRN Opportunistic Infections Management 1