RxPrep: 2026 edition > HIV > Flashcards

HIV Flashcards

(97 cards)

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1
Q

What kind of virus is HIV?

A

RNA retrovirus

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2
Q

What kind of T-cell s does HIV use to replicate?

A

CD-4

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3
Q

When the CD4 count falls below this number the immune system can’t defend itself against opportunistic infections?

A

200

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4
Q

CDC recommends routine screening for HIV how often?

A

Once

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5
Q

When is annual HIV testing recommended?

A

history of sexually transmitted infections
hepatitis
tuberculosis
high risk activities: multiple partners or sharing injection equipment

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6
Q

Acute HIV infection presents with what kind of symptoms?

A

Flu-like

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7
Q

When is AIDs diagnosed?

A

when the CD4 count is <200
OR
opportunistic infections
Kaposi’s Sarcoma
HIV wasting sydrome

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8
Q

What are treatments for HIV wasting syndrome?

A

Dronabinol
Megestrol

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9
Q

How long does it take for HIV antibodies to be detected?

A

4-12 weeks after infection

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10
Q

What does OraQuick detect?

A

presence of HIV antibodies

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11
Q

How many lines indicated a negative result for OraQuick?

A

1

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12
Q

Testing with Oraquick sooner than how many months may lead to a false negative?

A

3

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13
Q

What are the 8 stages of HIV replication?

A
  1. Binding and attachment
  2. Fusion
  3. Reverse Transcription
  4. Nuclear Import
  5. Integration
  6. Transcription and Translation
  7. Assembly
  8. Budding and Maturation
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14
Q

What is the most important indicator of ART response?

A

HIV viral load

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15
Q

While monitoring an individual with HIV, what should they be screened for?

A

hep B and C
sexually transmitted infections
pregnancy
HLA-B*5701 allele
tropism assay

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16
Q

What are the options for initial ART regimens in treatment naive adults that prefer one pill once daily

A

Biktarvy
Dovato

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17
Q

What are the options for initial ART regimens in treatment naive adults that prefer two pills once daily

A

Tivicay + Truvada
Tivicay + Descovy

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18
Q

How should most HIV medications be dispensed?

A

in the original container

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19
Q

Most preferred regimens contain how many NRTIs and how many INSTI?

A

2 NRTIs
1 INSTI

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20
Q

When should Dovato not be used?

A

when HIV RNA >500,000
hep B coinfection
HIV resistance

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21
Q

Biktarvy, Dovato, Truvada, and Descovy cannot be used when CrCl is <?

A

30

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22
Q

Should a mother with HIV breast feed?

A

no

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23
Q

What can be administered during delivery to prevent perinatal HIV transmission?

A

IV zidovudine

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24
Q

What is immune reconstitution inflammatory syndrome?

A

worsening of a known underlying condition or after ART is started

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25
How do nucleoside reverse transcriptase inhibitors work?
inhibit reverse transcriptase enzyme
26
Which NRTI does not need to be adjusted for renal impairment?
abacavir
27
Tenofovir, abacavir, and lamuvidine can be taken how often?
once daily
28
What are the warnings for NNRTIs?
lactic acidosis and hepatomegaly with steatosis
29
What are the common side effects of NNRTIs?
Nausea and diarrhea
30
Severe acute HBV exacerbation can occur if which 3 meds are discontinued?
emtricitabine lamivudine tenofovir
31
Will lamivudine doses for HBV treat HIV?
no
32
Which allele should be screened for before starting abacavir?
HLA-B*5701
33
Which medication may have a side effect of hyperpigmentation of the palms of the hands or soles of the feet?
Emtricitabine
34
What are some side effects of tenofovir?
renal impairment decreased bone mineral density
35
When switching from TDF to TAF what should be monitored?
lipids
36
Which medication has warnings for neutropenia, anemia, and macrocytosis?
Zidovudine
37
How do integrase strand transfer inhibitors work?
block the integrase enzyme, preventing HIV DNA from inserting into the host cell
38
Which integrase strand transfer inhibitor is taken twice daily?
Isentress
39
At which CrCl can Stribild not be started?
<70
40
At which CrCl should Stribild be discontinued?
<50
41
At which CrCl should Biktarvy and Genvoya not be started?
<30
42
What is cabotegravir ER IM injection indicated for?
pre-exposure prophylaxis
43
What are the side effects of all INSTIs?
Weight gain insomnia depression and suicidal ideation
44
Bictegravir and dolutegravir with increase SCr, but do what to GFR?
nothing
45
Raltegravir and Dolutegravir with increase CPK which may lead to?
myopathy and rhabdomyolysis
46
Raltegravir and Dolutegravir carry the risk of what type of reaction?
Hypersensitivity
47
What is the warning for dolutegravir?
hepatotoxicity
48
What is the warning for Cabotegravir?
injection site reactions
49
INSTIs should be taken how many hours before and after polyvalent cations?
2 hours before 6 hours after
50
How do non-nucleoside reverse transcriptase inhibitors work?
inhibit the reverse transcriptase enzyme
51
Should rilpivirine be taken with a meal?
yes
52
Should efavirenz be taken with food?
no
53
All NNRTIs have a safety risk of?
hepatotoxicity and rash
54
What are the safety issues with efavirenz?
Psychiatric symptoms CNS effects that resolve in 2-4 weeks Increased total cholesterol and triglycerides
55
All NNRTIs are major substrates of which enzyme?
CYP3A4
56
Rilpivirine and doravirine should not be used with strong CYP3A4 inducers or inhibitors?
Inducers
57
What are the safety features with rilpivirine?
Depression increased SCr with no effect on GFR dont use if viral load >100,000 or CD4<200
58
Can rilpivirine be used with PPIs?
no
59
H2RA should be separated by how much before and after rilpivirine?
12 hours before 4 hours after
60
Antacids should be separated by how much before and after rilpivirine?
2 hours before 4 hours after
61
How do protease inhibitors work?
inhibit the protease enzyme which ultimately inhibits budding and maturation
62
All protease inhibitors are recommended to be taken with a ?
booster such as ritonavir or cobicistat
63
Atazanavir needs what kind of gut for absorption?
acidic
64
All protease inhibitors have the safety issues of?
metabolic abnormalities, hepatic dysfunction, and hypersensitivity reactions
65
Will strong CYP3A4 inducers or inhibitors decreases protease inhibitor concentrations?
inducers
66
Darunavir should be cautioned in someone with what kind of allergy?
sulfa
67
Lopinavir/Ritonavir solution contains alcohol. If used with metronidazole this may cause what type of reaction?
disulfram
68
What is a warning of atazanavir that is reversible?
jaundice
69
With unboosted atazanavir which drug class should be avoided?
PPIs
70
What time should boosted atazanavir be taken after the PPI?
12 hours after
71
Should ritonavir and cobicistat be taken with or without food?
with
72
What is the dose of ritonavir?
100-200mg daily
73
Ritonavir and cobicistat inhibit which enzyme?
CYP3A4
74
Which is lower, ritonavir booster or treatment dosing?
booster
75
Are ritonavir and cobicistat interchangeable?
no
76
Which drugs should be avoided with boosted protease inhibitors?
alpha 1a blockers amiodarone, dronedarone anticoagulants/antiplatelets azole antifungals hep c protease inhibitors lovastatin and simvastatin PDE-5 inhibitors for pulmonary hypertension strong cyp3a4 inducers systemic, inhaled, and intranasal steroids
77
Which drug is a CCR5 antagonist?
Maraviroc
78
How does a CCR5 antagonist work?
blocks HIV from binding the CD4 cell in virus strains that use the CCR5 coreceptor
79
What must you have before starting someone on Maraviroc?
tropism assay
80
If a tropism assay returns and the HIV can only bind to CXCR4 or CXCR4 and CCR5, can you use mariviroc?
no
81
Ibalizumab is a post attachment inhibitor that is administered only as?
IV
82
Cabenuva is an injection given IM how often?
once monthly
83
What are the first line INSTI treatments for HIV?
Biktarvy or Dovato
84
When can cabenuva or juluca be used?
to replace a stable ART regimen in patients with virologic suppression
85
At a CrCl <50 HIV products containing what should not be started?
TDF
86
At a CrCl<30 HIV products containing what should not be started?
TAF
87
What are first line NNRTI treatments?
Truvada or Descovy
88
What are the PrEP treatment options?
Truvada or Descovy Cabotegravir IM monthly for 2 doses, then every 2 months
89
Are PrEP regimens appropriate for HIV?
no
90
If someone is going to use Truvada for PrEP, their CrCl must be higher than?
60
91
How often should follow up occur for someone on oral PrEP therapy?
every 3 months
92
Who is nPEP for?
people who were exposed to HIV after sex without a condom or had injectiohn drug use
93
Who is oPEP for?
healthcare personnel, needlestick exposure
94
How soon should PEP be started?
within 3 days of exposure
95
How long should PEP continue?
28 days
96
Do any of the meds cure HIV?
no
97
All HIV meds can cause what organ upset?
GI
RxPrep: 2026 edition
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