ART Provider Treatment Planning & Patient Care 3

Question 1

A patient on efavirenz-based ART reports vivid nightmares and difficulty concentrating three weeks after initiation. What is the most appropriate response?

Accepted Answer

Counsel that these CNS side effects are common with efavirenz and usually resolve within 2–4 weeks

Answer

CNS side effects including vivid dreams, dizziness, and difficulty concentrating are common with efavirenz and typically resolve within the first 2–4 weeks of therapy.

Question 2

Which monitoring parameter is most critical within the first 2 weeks of ART initiation in a patient with CD4 < 50 cells/µL?

Accepted Answer

Signs and symptoms of immune reconstitution inflammatory syndrome (IRIS)

Answer

Patients with very low CD4 counts are at high risk for IRIS when ART is initiated, which can unmask or worsen underlying opportunistic infections.

Question 3

A patient's genotype resistance test reveals a K65R mutation. Which nucleoside reverse transcriptase inhibitor should be avoided?

Accepted Answer

Tenofovir disoproxil fumarate (TDF)

Answer

The K65R mutation confers reduced susceptibility to tenofovir (TDF and TAF), making it an inappropriate choice when this mutation is present.

Question 4

A 55-year-old male patient on ART develops a buffalo hump and central fat accumulation. These findings are most consistent with which condition?

Accepted Answer

Lipodystrophy associated with antiretroviral therapy

Answer

Lipodystrophy, characterized by central fat accumulation and peripheral fat loss, is a recognized metabolic complication of long-term ART, particularly with older agents.

Question 5

Before prescribing abacavir (ABC), the most essential pre-treatment screening test is:

Accepted Answer

HLA-B*5701 genotyping

Answer

HLA-B*5701 screening must be performed before abacavir initiation because carriers are at high risk for a severe, potentially fatal hypersensitivity reaction.

(ART) Certified Art Provider Practice Test

(ART) Certified Art Provider Practice Test

ART Provider Treatment Planning & Patient Care 3