QUIZ ON HIV AIDS ( World AIDS DAY 2024 ).pdf

This quiz was conducted for members of Ettumanoor branch IMA , on the occasion of the World AIDS Day 2024.

1. QUIZ ON HIV AIDS
WORLD AIDS DAY - DECEMBER 1 2024

2. IMA ETTUMANOOR

3. Instructions
●20 Questions
●Each correct answer
carries 4 marks
●No negative marks for
incorrect answers

4. References

5. Q1
A.The first ever known case of HIV infection was diagnosed in
_______ in Los Angeles, USA.
B.The 1st case of HIV in India was reported in the year ________ .
C.The National AIDS Control Organisation (NACO) was
established in the year _________.
D.The Government of India launched the free ART initiative on
____________in eight tertiary-level hospitals across six
high-prevalence states and the National Capital Territory of
Delhi.

6. ANSWERS
A.1981
B.1986
C.1992
D.1 April 2004

7. Q2
The HIV binds to the host cell
by binding to the receptor
__________.

8. ANSWER
CD4 receptor

9. HIV-1 binds to its target cell via
the CD4 molecule, leading to a
conformational change in the
gp120 molecule that allows it to
bind to the co-receptor CCR5
(for R5-using viruses). The virus
then firmly attaches to the host
cell membrane in a
coiled-spring fashion via the
newly exposed gp41 molecule.
Virus-cell fusion occurs as the
transitional intermediate of
gp41 undergoes further
changes to form a hairpin
structure that draws the two
membranes into close
proximity.

10. Q3.
Which of the following is an incorrect statement with regard to the
transmission of HIV ?
A.The most common mode of HIV is heterosexual transmission
B.Parenteral transmission of HIV during injection drug use does not
require IV puncture; subcutaneous or intramuscular injections can
also transmit HIV
C.HIV infection can be transmitted from an infected mother to her
fetus during pregnancy, during delivery, or by breast-feeding
D.The risk of transmission by saliva is high

11. ANSWER
D. The risk of transmission by saliva is high - FALSE
Although HIV can be isolated typically in low titers from saliva of a small
proportion of infected individuals, there is no convincing evidence that saliva
can transmit HIV infection, either through kissing or through other exposures,
such as occupationally to health care workers. Saliva contains endogenous
antiviral factors; among these factors, HIV-specific immunoglobulins of IgA, IgG,
and IgM isotypes are detected readily in salivary secretions of infected
individuals. It has been suggested that large glycoproteins such as mucins and
thrombospondin 1 sequester HIV into aggregates for clearance by the host. In
addition, multiple soluble salivary factors inhibit HIV to various degrees in vitro,
probably by targeting host cell receptors rather than the virus itself.

12. Q4.
Which of the following is an incorrect statement with
regard to HIV-2 ?
A.HIV-2 is less pathogenic than HIV-1
B.Infection with HIV-2 does not protect against HIV-1 or
dual infection.
C.The vertical transmission rate of HIV-2 is low
D.Dolutegravir is ineffective against HIV-2

13. ANSWER
D. Dolutegravir is ineffective against HIV-2 - FALSE

Dolutegravir , an integrase inhibitor , is effective against
both HIV-1 & HIV-2.

14. Q5.
All HIV testing should be provided five essential Cs.

Which are the 5 Cs ?

15. ANSWER
Consent
Confidentiality
Counselling
Correct results
Connection
HTS - HIV Testing Services

17. Q6
The presence of which of the following puts an HIV patient
in the WHO clinical stage 4 ?
A.Pulmonary tuberculosis
B.Persistent oral candidiasis
C.Oral hairy leukoplakia
D. Invasive cervical carcinoma

18. ANSWER
D.INVASIVE CERVICAL CARCINOMA

The other 3 ( Pulmonary TB , Persistent oral candidiasis ,
Oral hairy leukoplakia ) come in stage 3.

19. Q7
Expand ( in the context of HIV AIDS )
A.ICTC
B.CL HIV
C. PPTCT
D.CPT

20. ANSWER
A.ICTC -Integrated Counselling & Testing Centre
B.CL HIV - Children Living with HIV
C.PPTCT - Prevention of Parent To Child Transmission of
HIV
D.CPT - Cotrimoxazole Prophylactic Therapy

21. Q8.
Which of the following is an incorrect statement ?
A.All HIV-positive pregnant women including those presenting in labour and
breastfeeding should be initiated on a triple-drug ART regardless of CD4
count and clinical stage
B.In India, normal vaginal delivery is considered unless the woman has
obstetric indications (like foetal distress, obstructed labour) for a
Caesarean section
C.The preferred choice of infant feeding for HIV-exposed infants in India is
exclusive breastfeeding
D.All infants born to HIV positive mothers should be given nevirapine &
zidovudine prophylaxis till 6 weeks of age

22. ANSWER
D. All infants born to HIV positive mothers should be
given nevirapine & zidovudine prophylaxis till 6 weeks
of age - FALSE
ARV Prophylaxis is advised to the infant based on the risk of HIV transmission.

●Single-drug ARV Prophylaxis is advised in infants with low risk for HIV
transmission for 6 weeks (regardless of type of feeding).
●Dual-drug ARV Prophylaxis is advised in infants with high risk for HIV
transmission, the duration of which depends on the type of feeding (for 6
weeks if on replacement feeding and 12 weeks if on breastfeeding).

23. Q9.
What is the 4S symptom screening for tuberculosis that
should be done in persons living with HIV (PLHIV) ?

24. ANSWER
4 symptom screening for TB
●Adults: fever, cough, weight loss, night sweats
●Children: fever, cough, poor weight gain/reported
weight loss, h/o contact with a TB case

25. Q10.
A patient who was found to have pulmonary TB tested
positive for HIV.

Which should be started first - Anti tubercular therapy
(ATT) or Anti retroviral therapy (ART) ?

26. ANSWER
Start ATT first

ART should be started as soon as possible within two
weeks of initiating TB treatment, regardless of CD4 cell
count

27. Q11.
The preferred first-line ART regimen for all persons
living with HIV (PLHIV) with age >10 years and weight
>30 kg is ?

28. ANSWER
Tenofovir (300 mg) + Lamivudine (300 mg) + Dolutegravir
(50 mg) (FDC: One tablet OD)

29. Q12
Give any two examples of
●Nucleoside reverse transcriptase inhibitors
●Non nucleoside reverse transcriptase inhibitors
Used to treat HIV patients

30. ANSWER
●Nucleoside reverse
transcriptase
inhibitors ( NsRTI ) -
Zidovudine ,
Lamivudine

●Non nucleoside
reverse transcriptase
inhibitors ( NNRTI ) -
Nevirapine , Efavirenz

31. Q13. Fill in the blank
Upon oral administration, _________ binds to the active site
of integrase, an HIV enzyme that catalyses the transfer of
viral genetic material into human chromosomes. This
prevents integrase from binding to retroviral DNA, and
blocks the strand transfer step, which is essential for the
HIV replication cycle. This prevents HIV replication.
__________ is currently the preferred drug in the first-line
and also in second-line treatment regimens.

32. ANSWER
DOLUTEGRAVIR

33. Q14.
In a patient
on ART , how
should CD4
count & viral
load be
monitored ?

34. ANSWER

35. Q15.
“The worsening of signs and symptoms due to known
infections” or “the development of disease due to occult
infections that result from an inflammatory response by a
reinvigorated immune system following the initiation of ART.

What is this phenomenon known as ?

36. ANSWER
IMMUNE RECONSTITUTION INFLAMMATORY
SYNDROME

37. Q16
A staff nurse sustained a needle prick injury while drawing
blood from an HIV patient. The patient was not taking ART
regularly.
a.What is the recommended post exposure prophylaxis ?
b.What is the duration for which PEP should be taken ?

38. ANSWER
A.Tenofovir (300 mg) + Lamivudine (300 mg) +
Dolutegravir (50 mg) (FDC: One tablet OD)
B.28 Days

Post Exposure Prophylaxis (PEP) must be initiated as soon
as possible, preferably within 72 hours.

39. Q17.
An HIV patient presented with cough &
breathlessness. Shown are the images of
his chest X ray and the Methenamine
silver stained BAL fluid.
A.The likely diagnosis is ?
B.The drug of choice is ?

40. ANSWER
A.Pneumocystis jiroveci pneumonia
B.Cotrimoxazole

●PCP infection occurs in 20%–30% of AIDS patients.
●Even with treatment, PCP is associated with a mortality
of 20%–40%.
●Approximately 90% of PCP cases occurred in patients
with CD4 T lymphocyte (CD4) cell counts <200 cells/mm

42. Q18
An HIV patient presented with
fever and altered mental status.
The CSF study showed elevated
white cell count ( lymphocyte
predominant ), high protein and
low sugars. Shown is the India ink
stain
A.What is the likely diagnosis ?
B.Mention any 3 drugs used to
treat this condition.

43. ANSWER
A.Cryptococcal meningoencephalitis
B.Amphotericin B , Flucytosine , Fluconazole

45. Q19.
An HIV patient presented with
odynophagia. An OGD scopy
was done , which is shown
below.
A.What is the likely diagnosis ?
B.What is the drug of choice ?

46. ANSWER
A.Esophageal candidiasis
B.Fluconazole


●Oesophageal candidiasis is a WHO clinical stage 4 condition.
●It is usually diagnosed clinically based on the presence of oral candidiasis
and associated subjective symptoms of difficulty in swallowing
(dysphagia) and/or painful swallowing (odynophagia).
●Treatment : Fluconazole 200 mg daily for 14–21 days and check the
response to treatment after 7 days; if there is a good response, continue
the fluconazole for 10 days to 2 weeks. If the response is poor , consider
other causes of odynophagia.

47. Q20.
An HIV patient presented with acute
watery diarrhoea associated with
lower abdominal pain.
The stool microscopy was done
( image shown )
A.What is the likely diagnosis ?
B.What is the treatment of choice
?

48. ANSWER
A.Cryptosporidiosis
B.
●Aggressive oral and/or IV rehydration and replacement
of electrolyte loss
●Nitazoxanide 500 mg to 1,000 mg Oral twice daily with
food for 14 days, or
Paromomycin 500 mg Oral four times a day for 14
days–21 days