A 23-year-old HIV-positive woman in the United States with ...

[KWilfred]

A 23-year-old HIV-positive woman in the United States with routinely low viral loads and robust CD4+ cell counts is planning to get pregnant. Which precaution would her care giver eliminate from her care?
 
  A)
  Offer her HAART that includes zidovudine
  B)
  Counsel her not to breast-feed
  C)
  Give her single-dose perinatal nevirapine
  D)
  Give the infant trimethoprim-sulfamethoxazole, starting at 4 to 6 weeks of age

Question 2

After several months on a waiting list, a 44-year-old male received a liver transplant 5 days ago. In the last 36 hours, he has developed a rash beginning on his palms and soles, along with abdominal pain and nausea.
 
  It has been determined by his care team that the immune response that is causing his symptoms originates not with his own compromised immune components but with those introduced with his new organ. This man's most likely medical diagnosis is
  A)
  graft versus host disease (GVHD).
  B)
  acute transplant rejection.
  C)
  hyperacute organ rejection.
  D)
  T-cell-mediated graft rejection.

[vish98]

Answer to Question 1

Ans:
C

Feedback:

Single-dose nevirapine is an appropriate alternative when zidovudine is not available. However, HAART-containing zidovudine is readily available in the United States. Avoiding breast-feeding will reduce the client's chances of transmitting HIV to her infant. Because the risk of transmission is not zero, prophylaxis with trimethoprim-sulfamethoxazole will protect her infant from PCP until its serostatus is known.

Answer to Question 2

Ans:
A

Feedback:

Rash, gastrointestinal involvement, and pernicious activity by donor immune cells are the hallmarks of GVHD. The description does not suggest acute or hyperacute transplant rejection, and T-cell-mediated rejection is not a diagnosis in and of itself, but rather one of the mechanisms of transplant rejection.

[KWilfred]

Excellent

[zacnyjessica]

Gracias!