Y6_Théra-Méd_Pr. Hak Chanroeun

1. (CS) Une jeunne fille ayant de VIH> 5ans avec CD4 : 45/mm3, et encours de traitement par des TB et ARV (anti-rétroviral débuté 2 semaines après les Anti- TB) avec une bonne réponde aux traitements. Mais au J35, elle se présent : Fièvre, asthénie et toux. Quel l`examen nécessaire pour diagnostiquer PARADOXAL syndrome ?
Hémoculture
Examen de crachat contrôle
Tx CD4 et charge viral
Radio pulmonaire
Autre examens pour chercher des infections
2. (CS) A 19-year-old man has donated blood for the first time. Despite having no risk factors for human immunodeficiency virus (HIV) infection, his blood tests positive for HIV by enzyme immunoassay (EIA). Which of the following statements is correct?
. EIA is currently the most specific test for HIV
He might have a false-positive secondary to an unsuspected collagen vascular disease
He has a 75% chance of truly being infected with HIV
EIA is an excellent screening test
A Western blot test would be more Sensitive
3. (CS). A24-year-old woman complains of pain every time she eats or drinks anything. She is HIV positive, but currently not on any antiretroviral therapy. Her last CD4 count was 250/mm3. Select the most likely pathogen causing infection.
Staphylococcus aureus
Candida
P. carinii
Streptococcus pneumoniae
Gram-negative enteric bacilli
4. (CM).A 44-years patient HIV + develops severe cough and shortness of breath on exertion. On examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse peri-hilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver (silver staining). Which of the following is the most appropriate next step in management?
Amphotericin B
Cephalosporins
Trimethoprim-sulfamethoxazole
Aminoglycosides
High O2
5.(CS). A34-year-old man HIV +/under HAART, presents with diarrhea 3 weeks after returning from a trip to kg SOM. Over the past few weaks, he has gradually developed severe head ache, and lower abdominal pain and diarrhea. Now the symptoms are much worse with malaise, and a severe head ache, confusion. . He is afebrile, the abdomen is tender in left lower quadrant, and his stools tests show tinea solium. Which offollowing the initial
Cerebral MRI
Cerebral scanner with radio contrass
Lombar puncture
Serology test of T. Solium antibody
Abdominal ultrasound
6.(CS).A31-year-old woman presents with symptoms of vulvar itching and burning made worse by urinating. She has no fever or frequency, but has noticed a recent whitish vaginal discharge. Clinical examination reveals vulvar erythema, edema, and fissures. On speculum examination, there is a white discharge with small white plaques loosely adherent to the vaginal wall. Which of the following treatments is appropriate for her asymptomatic HIV+ male sexual partner?
Azole cream to the penis
Oral fluconazole
Standard urethritis investigation
No investigation or treatment
Azithromycin plus cefixime
8. (CS). A22-year-old woman HIV+ complains of vulvar itching, burning, and pain when voiding urine. She has no other symptoms of fever, vaginal discharge, or urinary frequency. Physical examination reveals some vulvar ulceration but no vaginal discharge. The ulcers are small 2–3-mm lesions with an erythematous base. Which of the following is the most likely diagnosis?
HSV infection
Trichomonas vaginalis infection
N. Gonorrhoeae infection
C. Trachomatis infection
M. Genitalium infection
9. (CS).A 19-year-old woman HIV+ , CD4 = 450/mm3 was traveling in a rural Kandal. She returned 3 weeks ago and, over the past few days, has gradually developed lower abdominal pain and diarrhea. Now the symptoms are much worse with 10 stools a day consisting mostly of mucus and blood. She is febrile, the abdomen is tender in left lower quadrant, and the remaining examination is normal. Her stool is mostly comprised of blood and mucus. Which of the following is the most likely causative organism?
Escherichia coli infection
Salmonella infection
Shigella infection
Vibrio parahaemolyticus infection
Histolytica infection
10.(CS) A 22-year man HIV+ under HAART with viral load of HIV underdetected is back travel from Kampong som. Ten days after arriving, she develops symptoms of anorexia, malaise, and abdominal cramps followed by a sudden onset of watery diarrhea. There are no symptoms of fever or chills, and the stools are nonbloody. The most likely pathogen causing infection.
Campylobacter
E. coli
Salmonella
Shigella
Rotavirus
10 (C S).A 25-year-old HIV+ patient known more than 10 years without Anti Retro Viral treatment . On day he develops severe head ache and right hemiplesia. On examination, he appears malaise, head ache and right hemiplesia, BP: 14/8 mm/Hg, pulse 80/min, and his CD4 count 57 cells /mm3 Which of the following is the most appropriate next step in diagnosis?
Amphotericin B
Test serology of anti body of toxoplasmosis
Cerebral scan
Lumbar puncture
Cotrimoxazole
1. (CS) Une jeunne fille ayant de VIH> 5ans avec CD4 : 45/mm3, et encours de traitement par des TB et ARV (anti-rétroviral débuté 2 semaines après les Anti- TB) avec une bonne réponde aux traitements : CD4 =250/mm3, Charge Viral HIV : indétectable . Mais au J45, elle se présent : Fièvre, asthénie, céphalée et toux. Que pensez- vous dans cette situation?
Nouveau infection opportuniste
Echec du traitement par des anti-TB
Réaction paradoxale
Pneumocystose infection
Méningite à cryptocoque
2. (CS) A 19-year-old man has donated blood for the first time. Despite having no risk factors for human immunodeficiency virus (HIV) infection, his blood tests positive for HIV by enzyme immunoassay (EIA). Which of the following statements is correct?
EIA is currently the most specific test for HIV
He might have a false-positive secondary to an unsuspected collagen vascular disease
He has a 75% chance of truly being infected with HIV
EIA is an excellent screening test
A Western blot test would be more Sensitive
3.(CS) A 22-year-old married woman has an High risk factors for human immunodeficiency virus (HIV) infection, ( her husband died of HIV+ 1 years ago) her blood tests for many times was Negative for HIV by enzyme immunoassay (EIA) . Which of the following statements is correct?
EIA test is not so sensitive
She might have a false-Negative
She has a 50% chance of truly being non infected with HIV
She might have a completed CCR5 mutation
A Western blot test would be more Sensitive
4. (CS) Parmi les manifestation suivantes, le quelle sont classante pour le stade de SIDA?
Cachexie
Carcinoma insitu
Cancer du sein
Cancer anal
Lymphome de Hodgkin
5. (CS) La positivité de l `Antigen p 24 est possible à partir de :
7-8jours après infection
10jours après infection
12 jours après infection
20Jours après infection
Tout est faux
6. (CS) la fenêtre virologique de détection virus est de (temps pendant lequel de détection du virus est impossible)
7-8 jours
10 jours
12-15 jours
20 jours
Tout est faux
7.La prévention de la pneumocystose pulmonaire chez un VIH
CD4> 300/mm3
CD4 <200/mm3
CD4>250/mm3
CD4<300 >200/mm3
Tout est faux
8. La positivité d`un test ELISA est possible à partir de :
3 jours après infection
5 jours après infection
10jours après infection
>20 jours après infection
Tout est faux
9. Le risque de transmission du VIH d`une mèreà son enfanten absent de traitement :
Est d`environ 60-65%
Est d`environ 50-55%
Est d`environ 40-45%
Est d`environ 30-35%
Est d`environ 20-35%
10. Parmi les propositions suivantes, lequel est correct :
Au Cambodge le nombre de personnes infectés par le VIH est estimé à 300000.
L`incident du VIH en Cambodge est de 20000 par an
L`incident du VIH en Cambodge est de 10000 par an
La prévalence du VIH est estimé 0.6 (de population de 15 ans-49 ans) en 2012.
Tout est faux
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