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Test 3: Preparation for antiretroviral treatment

  1. When should antiretroviral treatment start?
    • When HIV infection is first diagnosed
    • When either the clinical signs or CD4 count suggest that the immune function is failing
    • When the patient becomes seriously ill with tuberculosis
    • When the patient is terminally ill
  2. At what stage of the HIV infection is antiretroviral treatment indicated?
    • Stage 2, 3 and 4
    • Stage 1 only
    • Stage 2 only
    • Stage 3 or 4 only
  3. Antiretroviral treatment is indicated when the CD4 count falls below:
    • 350 cells/µl
    • 500 cells/µl
    • 100 cells/µl
    • 50 cells/µl
  4. Should psychosocial factors be considered when deciding whether to start antiretroviral treatment?
    • Yes, because they determine whether treatment is likely to be successful or not.
    • Yes, because poor people cannot be relied upon to take regular treatment.
    • No, because it is the democratic right of all HIV positive people to have antiretroviral treatment.
    • No, because assessing psychosocial factors is unreliable and too difficult.
  5. What may happen if antiretroviral treatment is started too early?
    • Male patients may become sexually impotent.
    • Poor adherence and drug resistance are more likely to become a problem.
    • The patient has an increased risk of developing tuberculosis.
    • The HIV infection may progress rapidly.
  6. How long does it take to prepare a patient for antiretroviral treatment?
    • Two to four days
    • One week
    • Two to four weeks
    • Three months
  7. Which group of patients with HIV infection should be fast tracked onto antiretroviral treatment?
    • There is no need to fast track any patient.
    • All women should be given treatment without delay.
    • Patients over the age of 45 years should be started on antiretroviral treatment urgently.
    • Pregnant women should be fast tracked.
  8. Which of the following factors must be considered before starting antiretroviral treatment in the state health service?
    • The patient should be able to afford the cost of treatment.
    • The patient should not have untreated depression.
    • The patient should be older than 21 years.
    • The patient must disclose their HIV status to their community.
  9. What is one of the aims of preparing a patient for antiretroviral treatment?
    • They should agree to stop smoking.
    • They should agree to stop having sexual relations unless married.
    • The importance of excellent adherence must be understood and accepted.
    • The patient must be employed.
  10. What should be done at the screening visit?
    • The HIV screening test should be repeated.
    • Make sure that tuberculosis has been excluded.
    • Prophylactic treatment with INH should be started.
    • Blood should be taken for a viral load.
  11. What physical examination is needed when a patient is assessed for antiretroviral treatment?
    • A full general examination
    • A limited examination only looking for signs of HIV infection
    • An examination specifically looking for signs of tuberculosis
    • A physical examination is not needed if the patient is well
  12. Who should prepare a patient for antiretroviral treatment?
    • A doctor
    • A specially trained nurse
    • A lay (non-professional) counsellor
    • A multidisciplinary team
  13. What education is needed for treatment preparation?
    • Patients must learn to read.
    • Patients must know the side effects of commonly used drugs.
    • Patients must weigh themselves at home every week.
    • Patients must come to the clinic every day for their drugs.
  14. How is education best provided for treatment readiness?
    • In individual and group sessions
    • By TV and radio
    • Patients should be given books to read
    • They should speak to other patients at the clinic.
  15. Taking co-trimoxazole prophylaxis while preparing for the start of antiretroviral treatment:
    • Prevents tuberculosis
    • Is useful in assessing whether the person can take medication regularly
    • Improves the CD4 count
    • Prevents later side effects to nevirapine
  16. Is a home visit needed?
    • No, as the patient will be followed at the clinic.
    • No, as the home address of most patients is not known.
    • Yes, as this helps to assess treatment readiness.
    • Yes, at it helps to confirm that the patient is still alive.
  17. What are the benefits of lay counsellors?
    • They help maintain close contact between the clinic and patients.
    • They do not have to be trained.
    • They do not have to be paid.
    • They are HIV negative.
  18. What should be done at the second clinic visit?
    • The HIV screening test should be repeated.
    • Patients should have a CD4 count done.
    • All patients should have a chest X-ray.
    • Blood results should be checked and tests repeated if necessary.
  19. What is a common cause for postponing the start of antiretroviral treatment?
    • The patient is unreliable and does not attend clinic regularly.
    • The patient is too old.
    • The patient is too sick.
    • The patient will not disclose her HIV status to her employer.
  20. What baseline safety blood tests are needed?
    • ALT (alanine amino transferase) if AZT is used
    • ALT (alanine amino transferase) if nevirapine is used
    • Full blood count if 3TC is used
    • Full blood count if lopinavir/ritonavir is used