Which of the following individuals would most likely be placed on ...

[Engineer]

Which of the following individuals would most likely be placed on highly active antiretroviral therapy (HAART) if he or she were not yet receiving the treatment? Select all that apply.
 
  A)
  A 35-year-old female sex trade worker who is HIV negative but who has a documented history of sharing needles for heroin use
  B)
  A 46-year-old male with long-standing HIV and a CD4+ count of 125 cells/mL
  C)
  A 16-year-old female who was diagnosed with HIV 2 days prior and is asymptomatic with normal CD4+ levels
  D)
  A 38-year-old woman who has a CD4+ count of 250 cells/mL and is keen to begin HAART
  E)
  Prophylactically to a health care worker who incurred a laceration from a scalpel used in surgery but has no abnormal lab results

Question 2

A new nursing student is taking a tuberculin (TB) skin test as part of her preparation for beginning clinical placement in the hospital. The student is unclear of the rationale or physiology involved in this test.
 
  Which of the following is the correct explanation?
  A)
  The cell-mediated hypersensitivity associated with Mycobacterium tuberculosis remains detectable for several years.
  B)
  Formation of contact dermatitis lesions confirms prior TB contact.
  C)
  Previous TB exposure forms sensitized Th1 cells that are long-lived.
  D)
  This type of delayed-type hypersensitivity (DTH) is a response to latent Mycobacterium tuberculosis bacteria.

[raili21]

Answer to Question 1

Ans:
B, D

Feedback:

All symptomatic patients should be treated with antiretroviral therapy. If the individual is asymptomatic, therapy is recommended for CD4+ cell counts less than or equal to 160/mL. For those who have a CD4+ cell count greater than 350 cells/mL, antiretroviral therapy is generally not recommended. For those whose CD4+ cell count is 160 to 350 cells/mL, then antiretroviral therapy should be considered, and a decision individualized to the patient should be made. HAART is not begun prophylactically in the absence of HIV.

Answer to Question 2

Ans:
C

Feedback:

Sensitized Th1 cells form DTH response to introduced antigens. This is not an example of cell-mediated hypersensitivity or contact dermatitis, and it is not a response to latent Mycobacterium tuberculosis.

[Engineer]

TYSM

[cici]

Gracias!