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Test 2: Clinical and immunological diagnosis of HIV infection

  1. During the first six weeks after HIV infection:
    • The child always becomes seriously ill.
    • The CD4 count rises.
    • The amount of HIV in the blood increases.
    • The haemoglobin concentration falls.
  2. Acute seroconversion illness usually presents with:
    • A glandular fever-type illness
    • Jaundice
    • Anaemia
    • Vaginal or urethral discharge
  3. How long is the latent phase of HIV infection in children who are infected at birth?
    • 10 days
    • 6 weeks
    • About three to six months
    • Usually five to 10 years
  4. What is the value of knowing the clinical stage of HIV infection?
    • The clinical stage predicts what the prognosis will be, especially without antiretroviral treatment.
    • It helps to diagnose symptomatic HIV infection at birth.
    • Antiretroviral treatment is not useful in stage 3 and 4 HIV disease.
    • It is of very little clinical help.
  5. When is HIV infection called advanced HIV disease in children?
    • At any stage of symptomatic HIV infection.
    • If the clinical stage is 3 or 4.
    • If the CD4 percentage is below 20.
    • If the viral load is above one million copies/ml.
  6. Which clinical sign is common in stage one HIV infection?
    • Night sweats
    • Fever
    • Persistent generalised lymphadenopathy
    • Weight loss
  7. Which clinical condition is common in stage 2 HIV infection?
    • Skin rash
    • Severe diarrhoea
    • Extrapulmonary tuberculosis
    • Oral candidiasis (thrush)
  8. A common clinical condition in stage 3 HIV infection is:
    • Severe recurrent bacterial pneumonia
    • Pneumocystis pneumonia
    • Enlarged parotid glands
    • Hydrocephaly
  9. What clinical condition indicates that an HIV-positive child has stage 4 disease?
    • Oral candidiasis
    • Oesophageal candidiasis
    • Diarrhoea for less than two weeks
    • Persistent fever
  10. Unexplained severe malnutrition with wasting that does not respond to feeding indicates that the HIV infection has reached what clinical stage?
    • Stage 1
    • Stage 2
    • Stage 3
    • Stage 4
  11. What skin rash is common in children with HIV infection?
    • Acne
    • Urticaria
    • Kaposi’s sarcoma
    • Pruritic papular eruption
  12. What form of cancer is more common in children with HIV infection?
    • Cervical cancer
    • Leukaemia
    • Lymphoma
    • Neuroblastoma
  13. What test is used to screen children older than 18 months for HIV infection?
    • VDRL test
    • PCR test
    • HIV culture
    • Rapid test
  14. How long should you wait after stopping breastfeeding a nine-month-old child before doing an ultrasensitive p24 antigen test to diagnose or exclude HIV infection?
    • 72 hours
    • One week
    • Six weeks
    • 18 months
  15. Which test can confirm that a six-week-old infant has HIV infection?
    • PCR test
    • Rapid test
    • ELISA test
    • CD4 test
  16. Screening tests for HIV infection usually become positive when the person has been infected for:
    • Six days
    • Six weeks
    • Six months
    • Six years
  17. What is the normal CD4 percentage in children?
    • Below 10%
    • 10 to 25%
    • 25% or more
    • 100%
  18. During the progression of untreated HIV infection the CD4 count:
    • Rises
    • Falls
    • Stays the same
    • Is not important
  19. What is the value of knowing the CD4 percentage?
    • The lower the CD4% the greater the risk of severe illness.
    • The higher the CD4% the greater the risk of death.
    • A low CD4% indicates that the child’s immune system is improving.
    • A normal CD4% indicates that the child does not have HIV infection.
  20. In South Africa, who can give consent for a child to be tested for HIV?
    • The consent of both parents is always needed.
    • The consent of the medical superintendent is always needed.
    • A child of 12 years or older can give consent.
    • Any child attending school can give consent.