AIDS Update

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.

1.	Through research the ways in which HIV can be transmitted have been clearly identifed. Of the followingmodes of transmission, which is the least common now?

a) sexual contact with an infected person
b) sharing needles with someone who is infected
c) through transfusion of infected blood
d) from HIV-infected mother to the baby

2.	How many instances have there been of patients being infected by a healthcare worker in the United States?

a) only one
b) a few
c) numerous

3.	HIV, albeit in very low quantities, has been found present in all of the following body fluids of HIV-infected persons except

a) saliva
b) tears
c) sweat

4.	There are many common misconceptions about HIV transmission. Which of the following has the potential for HIV transmission?

a) food-service establishments
b) French" or open-mouth kissing
c) mosquito or insect bites
d) contact with an environmental surface
e) all of the above

5.	HIV does not survive well in the environment.

a) 'true
b) false

6.	One of the following clinical conditions in an HIV-infected person is considered AIDS-defining:

a) constitutional symptoms: fever, diarrhea lasting more than 1 month
b) Kaposi's sarcoma
c) listeriosis
d) peripheral neuropathy

7.	Case definition for AIDS among adults and adolescents in the U.S. requires the following:

a) CD4 < 200 cells/mm3
b) category C clinical manifestations
c) both of the above
d) either a or b

8.	Primary or acute infection generally occurs within______ after a recognized exposure to HIV.

a) a few hours
b) 5-30 days
c) 6 months
d) 5-10 years

9.	Within a few months after infection with HIV, in most patients a relatively stable viral load is attained. Is this viral set point predictive of the rate of future progression of the illness?

a) 'true
b) false

10.	In patients with undetectable plasma HIV-RNA, intracellular and tissue HIV-RNA can still be detected.

a) 'true
b) false

11.	Which of the following tests best measures the prognosis and staging of illness in an HIV infection?

a) HIV-RNA level
b) CD4 cell count
c) lymphocyte count
d) P24 antigen

12.	CD4 cell count depletion and higher HIV-RNA level are two predictors of HIV disease progression and survival in men and women. However, women experienced______ rapid CD4 cell depletion and_______ progression to AIDS and death than men at similar HIV-RNA levels.

a) more, faster
b) less, slower

13.	Characteristics of the uninfected individual may increase the likelihood of infection for a given exposure to HIV. Which of the following would increase the likelihood of infection?

a) presence of sexually transmitted diseases and trauma
b) uncircumcised male
c) sex during menstruation
d) ulcerative and non-ulcerative STDs
e) all of the above

14.	In the African American community, which category represents the highest percent of AIDS cases?

a) men who have sex with men
b) injection drug users
c) heterosexuals
d) children born to HIV-infected women

15.	In 1999, the AIDS incidence rate was the highest among

a) whites
b) African Americans
c) Hispanics

16.	The HIV/AIDS epidemic among U.S. Hispanics reflects to a large extent the exposure modes and cultural modes of the individuals' birthplaces. High-risk behaviors associated with drug abuse is more predominant among

a) Puerto Rico-born Hispanics
b) Hispanics born in Mexico, Cuba, and Central and South America

17.	In young people between the ages of 13 and 19, a much greater proportion of HIV infection was reported among females than among males.

a) 'true
b) false

18.	Concerning HIV antibody testing, which of the following statements is not true?

a) HIV antibody tests are extremely accurate.
b) HIV testing is mandatory for inmates of federal prisons, applicants to the armed services and immigrants.
c) HIV antibody test is not recommended for pregnant women in their last tnmester.
d) Tuberculosis patients should routinely take HIV antibody tests. Rapid HIV Tests

19.	Which statement is false concerning the routine test for HIV antibody testing (EIA)?

a) This test requires that a blood specimen be drawn from a vein.
b) Because EIA requires specialized equipment, the specimen must be sent to a laboratory.
c) Test results are usually available several days to several weeks later.
d) A negative screening test does not mean a person is not infected with HIV;further tests are required for confirmation.

20.	With the rapid HIV test, what you gain in time (resultsin 5 to 30 minutes) you lose in terms of sensitivity and specificity.

a) 'true
b) false

21.	A negative rapid HIV test result means that (selectone)

a) the person is not infected;
b) the person may have been tested too soon after infection;
c) both of the above.

22.	When a person has tested positive on the rapid HIV test, the partner notification process should be initiated immediately; waiting for the confirmatory HIV test creates the risk of transmitting HIV infection to others.

a) 'true
b) false

23.	Which of the following is not an advantage of rapid HIV testing?

a) results in less than 30 minutes;
b) eliminates the need for a second visit;
c) the rapid HIV test is just as accurate as an EIA;
d) if the rapid HIV test is reactive, confirmatory test is not required.

24.	The results of an HIV antibody test performed on an infant less than 15 months of age are not accurate.

a) 'true
b) false

25.	People with high levels of HIV-RNA in their blood are more likely to rapidly progress to AIDS than people with low levels of the virus.

a) 'true
b) false

26.	There are three different viral load tests currently being used. Which one is approved by the FDA?

a) PCR
b) bDNA
c) NASBA

27.	When a person has "undetectable" level of virus in the blood as a result of combination therapy, it means

a) the person is "cured;"
b) the person is no longer infectious;
c) the person does not need to be monitored by his or her healthcare provider regularly;
d) the person does not need to practice risk free behaviors;
e) the current tests are not sensitive enough to measure very low levels of virus in the blood.

28.

Measurements of HIV-RNA blood levels are increasingly being used by healthcare providers to determine when to start antiretroviral therapy and when to change current therapies. However, there are substantial fluctuations in the viral load on a daily basis.Say, a person's baseline viral load is 20,000 copies. Which of the following measurementswould be considered a significant increase or decrease?

a) 10,000
b) 5,000
c) 80,000
d) b and c
e) a, b and c

29.	There's now strong evidence that other STDs increase the risk of HIV transmission.

a) 'true
b) false

30.	The sexual spread of HIV runs parallel to that of other STDs. Which of the following statements is correct?

a) Risk behaviors which place individuals at risk for other STDs also increase a person's risk of becoming infected with HIV.
b) STDs that cause genital lesions can create a portal of entry for HIV.
c) Co-infection with HIV and other STDs results both in more shedding of HIV and in greater concentrations of HIV being shed.
d) People are 2-5 times more likely to become infected with HIV when other STDs are present.
e) all of the above

31.	For effective protection against HIV, the following types of condoms must be used:

a) latex
b) synthetic
c) lambskin
d) all of the above
e) a and b only

32.	The risk of HIV transmission through oral sex is minimal or non-existent.

a) 'true
b) false

33.	Which of the following groups reported the highest number of AIDS cases in 1999?

a) intravenous drug users
b) men having sex with men
c) heterosexual couples
d) women who have sex with women

34.	Research among gay and bisexual men suggests that some individuals are now less concerned about becoming infected than in the past and may be inclined to take more risks.

a) 'true
b) false

35.	Female-to-female transmission of HIV is very uncommon.

a) 'true
b) false

36.	Approximately what percent of all AIDS cases reported in the United States are directly or indirectly associated with injection drug use?

a) 10
b) 33
c) 50
d) 70

37.	Disinfecting previously used needles and syringes with bleach is as safe as using a new, sterile needle and syringe.

a) 'true
b) false

38.	IDU-associated AIDS accounts for a larger proportion of cases among men than women.

a) 'true
b) false

39.	Which of the following statements correctly reflects the CDC recommendation on universal precautions?

a) Universal precautions call for blood and body fluid precautions when a patient is known or suspected to be infected with bloodborne pathogens.
b) Universal precautions mean that blood and body fluid precautions be consistently used for all patients regardless of their bloodborne infection status.
c) Universal precautions are not necessary if the healthcare worker has been immunized with HBV vaccine.
d) Universal precautions apply only in hospital settings.

40.	Select the body fluids to which universal precautions do not apply:

a) blood and other body fluids containing visible blood
b) semen and vaginal secretions
c) amniotic fluid
d) sweat, tears
e) peritoneal fluid

41.	Universal precautions apply only to blood and other body fluids containing visible blood.

a) 'true
b) false

42.	Semen and vaginal secretions have been implicated in occupational transmission of HIV and HBV from patient to healthcare worker.

a) 'true
b) false

43.	Gloves need not be worn when feeding patients and when wiping saliva from their skin.

a) 'true
b) false

44.	Universal precautions do not apply to breast milk.

a) 'true
b) false

45.	Universal precautions do not apply to urine unless it contains visible blood.

a) 'true
b) false

46.	With respect to the glove use for phlebotomy, select the correct response:

a) In volunteer blood donation centers, the prevalence of infection with HIV and HBV is known to be very low.
b) In many institutions the routine use of gloves for all phlebotomies is not mandated.
c) both of the above
d) none of the above

47.	Latex gloves are just as good as vinyl gloves in barrier effectiveness.

a) 'true
b) false

48.	Which of the following procedures is not recommended in the selection and use of gloves?

a) Use sterile gloves for procedures involving contact with normally sterile areas
b) the body.
c) Change gloves between patients.
d) Rubber household gloves can be used for housekeeping chores involving potential blood contact and for instrument cleaning.
e) Disinfect surgical or examination gloves after procedures involving contact with blood before reusing them. Occupational Exposures to Blood

49.	All of the following factors determine the overall risk for occupational transmission of a bloodborne pathogen except

a) the immune system status of the healthcare worker;
b) the number of infected individuals in the patient population;
c) the chance of becoming infected after a single blood contact from an infected patient;
d) the type and number of blood contacts.

50.	What should one do immediately following an exposure to the blood of a patient?

a) flush splashes to the nose, mouth, or skin with water, and irrigate eyes with clean water;
b) squeeze the wound and wash the blood away;
c) use antiseptics or bleach at the wound site;
d) all of the above

51.	Which of the following has the lowest risk for infection after a needlestick or cut exposure to the infected blood?

a) HBV
b) HCV
c) HIV

52.	There have been no documented cases of HIV transmission due to an exposure involving a small amount of blood on intact skin.

a) 'true
b) false

53.	Vaccine or treatment to prevent infections with bloodborne exposures is available for

a) HBV
b) HCV
c) HIV
d) a and b only
e) a,bande

54.	Which of the following policies should be followed to prevent occupational HIV transmission to healthcare workers?

a) Inquire if the patient is HIV infected; if so, use barriers such as gloves and/or goggles.
b) Avoid all contacts with an HIV-infected patient.
c) Follow infection control precautions with the assumption that the blood and body fluids from all patients are potentially infectious.
d) Assign specific individuals to treat HIV-infected patients who will follow universal precautions.

55.	Using zidovudine as postexposure prophylaxis has been shown to be safe and associated with decreased risk for occupationally related HIV infection.

a) 'true
b) false

56.	Patients in a dentist's or doctor's office have a practically zero risk of getting HIV.

a) 'true
b) false

57.	Strategies for prevention of HIV infection are based on certain guiding principles. Select the correct statement from below:

a) Mandatory testing for HIV is recommended among certain population groups, such as some categories of healthcare workers, intravenous drug users,prisoners, homosexuals, etc.
b) Young people who participate in comprehensive HIV prevention programs that include access to condoms are more likely to increase sexual activity than other young people.
c) Increasing syringe availability and needle exchange programs among drug users encourage the use of illegal drugs.
d) The availability of effective drug therapies makes it more important than ever for HIV-infected persons to know their serostatus. For this reason, anonymous testing should be the cornerstone of any prevention program.

58.	Which of the following strategies is likely to be the key to slowing the spread of HIV through injection drug use?

a) toughen sanctions for illicit drug use
b) increase syringe availability
c) decriminalize dangerous drugs
d) substance abuse prevention and treatment programs

59.	Young people who have easy access to condoms are more likely to engage in sexual activity than other young people.

a) 'true
b) false

60.	Which of the following is incosistent in a comprehensive HIV prevention program?

a) mandatory HIV testing
b) voluntary HIV testing coupled with counseling
c) anonymous HIV testing
d) partner counseling

61.	Perinatally acquired AIDS cases have declined dramtically in the United States in the last few years.

a) 'true
b) false

62.	The success of the new highly active antiretroviral therapies (HAART) has resulted in a dramatic reduction in newly reported AIDS cases and deaths. Select the true statement from below:

a) The long-term effectiveness of HAART is unknown.
b) High-risk behaviors, especially unprotected sex, are continuing at far too high a rate.
c) Many gay and bisexual men believe they no longer need to use condoms because protease inhibitors are so effective in treating HIV disease.
d) While the number of AIDS cases is declining, the number of people living with HIV infection is growing.
e) all of the above

63.	New drugs called protease inhibitors were first approved in_______ .

a) 1995
b) 1996
c) 1997
d) 1998

64.	Since 1996 'cocktail' drug therapy has dramatically reduced AIDS deaths. This therapy includes

a) protease inhibitors
b) reverse transcriptase inhibitors
c) both

65.	AIDS-related death rate in the United States has dropped precipitously in the last few years which can primarily be credited to

a) increased access to care
b) highly active antiretroviral therapy (HAART)
c) our growing expertise and experience in caring for HIV-infected people
d) decrease in new HIV infections in the late 1980s due to prevention efforts

66.	Which of the following statements accurately describes the so-called "Lazarus Effect" mentioned in the FDA Consumer article?

a) highly effective HIV prevention efforts
b) rippling effect of new HIV infections and the number of people contracting
c) AIDS patients who have regained their health due to HAART
d) dramatic rise in HIV infections in the developing countries while AIDSrelated deaths plummet in the U.S.
e) drug resistance developed by HIV to antiretroviral drugs

67.	HAART regimen has made a huge impact in the treatment of HIV. It, however, has many drawbacks. Select the correct response describing these drawbacks:

a) HAART regimen reduces HIV in the body to undetectable levels, leading people to believe they no longer can infect others.
b) very expensive
c) possibility that new drug-resistant strains of HIV may emerge
d) may cause other side effects, such as diabetes
e) all of the above

68.	Triple combination therapy should not be used for HIV-infected infants.

a) true
b) false

69.	A person with HIV is considered to have progressed to AIDS when

a) the CD4 cell count is between 500 and 800;
b) when the person has lost over 40% of body weight;
c) when the CD4 cell is below 200;
d) when the person has HIV and certain diseases, such as TB or Pneumocystic carinii pneumonia (PCPMvenif the CD4 cell count is over 200;
e) c and d

70.	The chances of passing HIV from a pregnant woman (whois not being treated with Zidovudine) to her baby before or during birth are

a) 10%
b) 25%
c) 50%
d) 70%