Tuesday, August 13, 2013

HIV Virus


  1. Q: An HIV-postitive, 37-year-old man presents to his physician because of worsening odynophagia and oral thrush. His CD4+ cell count is 250/mm³. He is prescribed a course of fluconazole and begun on highly active antiretroviral therapy. Over the next 3 months he experiences intermittent nausea and diarrhea, and notices a redistribution of fat on his body. Which agents is most likely causing this patient's symptoms?

    A: Protease inhibitors

  2. Q: A 37-year-old man presents to the emergency department (ED) with difficulty breathing. He notes that he has been feeling worse over the past few days, but he woke up this morning gasping for breath. He also complains of a productive cough, which he suspects is preventing him from breathing better. On physical examination, bilateral rales and rhonchi are heard upon auscultation of the lungs. X-ray of the chest is ordered, and shows diffuse interstitial infiltrates. Sputum samples confirm a diagnosis of Pneumocystis jiroveci pneumonia. Additionally, HIV tests come back positive. He is placed on several antiretroviral medications to manage his condition. Several weeks later, he returns to his physician for a routine complete blood cell count, which is normal except for a platelet count of 80,000/mm³. His physician suspects that this laboratory finding is caused by one of his HIV medications, which acts by blocking protease in progeny virions. What medication could have caused his thrombocytopenia?

    A: Indinavir

  3. Q: With the advent of antiretroviral therapy, the morbidity and mortality of HIV-positive individuals have been improved tremendously. Which group of these antiretroviral drugs produce peripheral neuropathy?

    A: Reverse transcriptase inhibitors