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HIV AIDS Clinical Care: Neuropsychiatric Disorders

Pain Syndrome and Peripheral Neuropathy

1. Patients with peripheral neuropathy may complain of which of the following?

A. Numbness or burning

B. A pins-and-needles sensation

C. Shooting or lancinating pain

D. All of the above


2. Factors associated with increased risk of peripheral neuropathy include all of the following, except:

A. CD4 count of less than 300 cells/uL

B. Vitamin B12 deficiency

C. Diabetes mellitus

D. Exposure to stavudine or didanosine


3. Screening for numbness and delayed or absent ankle reflexes has the highest sensitivity and specificity among the clinical evaluation tools.

A. True

B. False


4. According to the WHO, all of the following are acceptable pharmacologic approaches to mild pain management, except for:

A. Aspirin

B. Acetaminophen

C. Tramadol

D. Nonsteroidal anti-inflammatory drugs


5. SSRIs are more effective than TCAs in treating chronic pain.

A. True

B. False


6. Which of the following is considered first-line for HIV sensory neuropathy for its tolerability?

A. Gabapentin

B. Pregabalin

C. Lamotrigine

D. Carbamazepine


HIV-Associated Neurocognitive Disorders

7. Which of the following is not an AIDS-defining condition?

A. Asymptomatic neurocognitive impairment

B. Mild neurocognitive disorder

C. HIV-associated dementia

D. Both (A) and (B)


8. Risk factors for developing an HIV-associated neurocognitive disorder include all of the following, except:

A. Older age

B. Male gender

C. Comorbid conditions

D. History of injection drug use


9. For patients with severe depression or substance dependence who are suspected of having HAD, the neurocognitive assessment should be deferred until the depression or substance use is in remission.

A. True

B. False


10. ARVs with the best CNS penetration include which of the following?

A. Abacavir

B. Nevirapine

C. Indinavir / ritonavir

D. All of the above


Major Depression and Other Depressive Disorders

11. Which of the following is not one of the cardinal symptoms associated with major depression?

A. Diminished interest or pleasure in activities

B. Depressed mood, sadness

C. Recurrent thoughts of death or suicide

D. All of the above are cardinal symptoms


12. Which of the following is the initial effect of antidepressants?

A. Improved hopelessness

B. Improved sadness

C. Improved energy

D. Improved appetite


13. Tricyclics can be fatal in overdose, and lower dosages may be needed for patients taking which of the following due to levels being increased by the medication?

A. Trimethoprim

B. Ritonavir

C. Abacavir

D. Rilpivirine


14. St. John’s wort is contraindicated for use by patients taking PIs, NNRTIs, or maraviroc.

A. True

B. False


Suicide Risk

15. It is recommended to make a contract with a patient against suicide as research shows that it is effective and provides a sense of security.

A. True

B. False


Anxiety Disorders

16. Midazolam (Versed) and triazolam (Halcion) are contraindicated for use with which of the following?

A. All PIs

B. Cobicistat

C. Delavirdine

D. All of the above


Panic Disorder

17. Major depressive disorder occurs in 90% of people with panic disorder, therefore patients with panic disorder should be screened for depression initially and periodically thereafter.

A. True

B. False


Posttraumatic Stress Disorder

18. PTSD may impair an individual’s psychological and physical functioning, decreasing immune system function and increasing susceptibility to illness.

A. True

B. False


19. Untreated PTSD can increase the risk of HIV transmission or acquisition and worsen the course of HIV treatment.

A. True

B. False


Insomnia

20. Which of the following has been predicted to have few drug interactions with ARVs?

A. Flurazepam

B. Lorazepam

C. Quazepam

D. Estazolam


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