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Test 6: HIV-associated infections and end-of-life care

  1. What are ‘HIV-associated infections’?
    • Other retroviral infections similar to HIV
    • Bacterial, viral and fungal infections which are common in HIV-infected people
    • Infections which have similar clinical signs to HIV infection
    • Infections other than HIV which can damage the immune system
  2. Which infection is uncommon in children unless they are HIV infected?
    • Herpes stomatitis
    • Herpes zoster (shingles)
    • Chickenpox
    • Chronic otitis media
  3. Which infection is rare in children unless they are HIV infected?
    • Bacterial pneumonia
    • Pulmonary tuberculosis
    • Oesophageal candidiasis
    • Viral meningitis
  4. Which of the following is an ‘AIDS-defining infection’?
    • Pneumocystis pneumonia
    • Lymph node tuberculosis
    • Oral moniliasis
    • Severe impetigo
  5. What gastrointestinal problem is common in children with HIV infection?
    • Gastric ulcers
    • Chronic diarrhoea
    • Rectal bleeding
    • Anal fissures
  6. Severe herpes mouth ulcers can be treated with:
    • Penicillin
    • Nystatin
    • Acyclovir
    • AZT
  7. What is a common respiratory condition in children with severe HIV infection?
    • Asthma
    • Whooping cough
    • Viral croup
    • Chronic lung disease
  8. Co-trimoxazole is used to treat:
    • Herpes stomatitis
    • Cryptococcal meningitis
    • Pneumocystis pneumonia
    • Cytomegalovirus retinitis
  9. Lymphoid interstitial pneumonia (LIP) usually presents with:
    • A chronic cough and shortness of breath
    • Haemoptysis (coughing up blood)
    • Chest pain
    • High fever
  10. Lymphoid interstitial pneumonia (LIP) responds well to:
    • Antibiotics
    • Fluconazole
    • Aspirin
    • Steroids
  11. How common is tuberculosis in children with HIV infection?
    • Uncommon
    • Common in children who have not had BCG
    • Only common in stage 4
    • Common in all clinical stages
  12. What is the commonest form of tuberculosis in children with HIV infection?
    • Tuberculous meningitis
    • Pulmonary tuberculosis
    • Tuberculosis of the lymph nodes
    • Tuberculous osteitis
  13. Should tuberculosis and HIV be treated at the same time?
    • There are few serious side effects if both tuberculosis treatment and antiretroviral treatment are started at the same time.
    • Control the immune suppression with antiretroviral treatment first before starting to treat the tuberculosis.
    • Start treating the tuberculosis first and then begin antiretroviral treatment two to eight weeks later.
    • Because of drug interactions it is dangerous to treat the two conditions at the same time even if the child is seriously ill.
  14. What side effect is more common if tuberculosis and HIV treatment are given together?
    • Hepatitis
    • Anaemia
    • Respiratory failure
    • Raised intracranial pressure
  15. Which HIV-infected children should receive TB prophylaxis?
    • TB prophylaxis is not effective in children with HIV infection.
    • Children with a chronic cough and weight loss.
    • Children exposed to adults with smear-positive pulmonary tuberculosis.
    • Children who have not had BCG immunisation.
  16. What is palliative care?
    • Care given to patients with an incurable disease
    • HIV treatment which is taken at home
    • Care given to patients who are dying
    • Care given to the family after a relative has died
  17. Where should terminal care be provided?
    • In hospital
    • In a special HIV clinic
    • In a hospice
    • At home if possible
  18. What are the principles of pain management?
    • Use intramuscular analgesics as they are more effective.
    • Do not use large doses of morphine as it is addictive.
    • Give oral analgesics whenever possible to prevent pain.
    • Only give analgesics eight-hourly because they will suppress respiration if given more frequently.
  19. What analgesic should be used to control moderate pain?
    • Aspirin
    • Codeine phosphate
    • Morphine
    • Pethidine
  20. What side effect is common when morphine is used as an analgesic?
    • Constipation
    • Jaundice
    • Bleeding
    • Anaemia