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HIV and AIDS are conditions surrounded in stigma, these questions will help ensure you are providing evidence based care for patients.

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Positive HIV serology

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Question 1

Stem 1, question 1 of 4

A 24 year old female presents to GP with a fatigue and flu-like symptoms

What period after infection with HIV will symptoms of the seroconversion illness be present?  
A
0-7 days
B
1-3 weeks
C
2-4 weeks
D
3-5 weeks
E
4-6 weeks
Question 1 Explanation: 
2-4 weeks after infection a non-specific seroconversion illness fill appear, often this prompts a presentation to primary care. This seroconversion illness relates to a rapid increase in the viral load
Question 2

Stem 1, question 2 of 4

There are a number of tests for HIV, at what stage(s) is the P24 antigen test most reliable?
A
During acute infection only
B
During acute infection and mid stage of infection
C
During acute infection and late stage of infection
D
During mid stage of infection
E
Late stage of infection only
Question 2 Explanation: 
There are a number of different testing methods to investigating whether a person has HIV or not. P24 antigen is high during viral replication and so is detectable during acute infection and late stage of infection when the virus is rapidly replicating in the body.
Question 3

Stem 1, question 3 of 4

What is the World Health Organisation 90-90-90 principle?
A
90% of cases detected, 90% who have been detected on treatment, 90% of those on treatment to be adherent to the treatment
B
90% of cases detected, 90% who have been detected to be on post-exposure prophylaxis, 90% of those on treatment to be adherent to the treatment
C
90% of cases detected, 90% who have been detected to be on post-exposure prophylaxis, 90% of those on post-exposure prophylaxis
D
90% of cases detected, 90% who have been detected to be on post-exposure prophylaxis, 90% of those on post-exposure prophylaxis to be viral load undetectable
E
90% of cases detected, 90% who have been detected on treatment, 90% of those on treatment to be viral load undetectable
Question 3 Explanation: 
The World Health Organisation 90-90-90 principle is aiming to stop the progression of HIV to AIDS. 90% of cases to be detected, 90% of those who have been detected to be on treatment and 90% of those on treatment to be viral load undetectable.
Question 4

Stem 1, question 4 of 4

Which of the following is a integrase inhibitor?
A
Dolutegravir
B
Lopinavir
C
Tenofovir
D
Efavirenz
E
Enfurvitide
Question 4 Explanation: 
HIV treatment centres around highly active anti-retroviral therapy (HAART) which inhibit various points in the HIV life cycle. All the answer options are all used to treat HIV infections, but dolutegravir is a integrase inhibitor. iChart is an app made by the University of Liverpool which is a great resource to use formulate the right combination of HAART for patients.
Question 5

Stem 2, question 1 of 4

Steven, a 66 year old man, presents with a skin lesion on his arm to his GP.

Which of the following cancer is seen in individuals with AIDS?
A
Hogkin's lymphoma
B
Non-hodgkin's lymphoma
C
Lung cancer
D
Kaposi's sarcoma
E
Oesophageal cancer
Question 5 Explanation: 
Kaposi's sarcoma presents as red or purplish lesions anywhere on the skin or mucous membranes. It is a an AIDS defining cancer and so now given the highly successful therapies, cases are declining. Kaposi's sarcoma can also occur without AIDS.
Question 6

Stem 2, question 2 of 4

Which of the following is NOT an AIDS defining illness?
A
Pneumocystis jerovecii
B
Cryptococcal meningitis
C
Oesophageal candida
D
Disseminated histoplasmosis
E
Giardia Lamblia
Question 6 Explanation: 
Giardia Lamblia is a relatively common parasite that causes diarrheal illnesses but is not specific to AIDS infections. The other answer options are all AIDS defining illnesses as they should not occur in an immunocompetent individual
Question 7

Stem 2 Question 3 of 4

HIV is a disease still surrounded by stigma, what is the definition of a social stigma?
A
The disapproval or discrimination of a person based on perceivable social characteristics that serve to integrate them with members of society
B
The disapproval or discrimination of a person based on perceivable social characteristics that serve to distinguish them from other members of society
C
The disapproval or discrimination of a person based on their sexuality
D
The disapproval or discrimination of a person based on their religious beliefs that serve to distinguish them from other members of society
E
The disapproval or discrimination of a person based on imperceivable social characteristics that serve to distinguish them from other members of society
Question 7 Explanation: 
HIV and AIDS are still stigmatised diseases and this is very important for clinicians to understand so that patients, their families and communities are treated with dignity and respect. A social stigma is the disapproval or discrimination of someone on a perceivable social characteristic that serves to distinguish them from other members of society.
Question 8

Stem 2, question 4 of 4

Steven asks how he might have got this infection, which of the following is NOT a transmission route of HIV?
A
Breastfeeding
B
During birth or after delivery
C
Unprotected penetrative intercourse with exchange of sexual fluids
D
Salvia droplets
E
Percutaneous needle stick injury with contaminated needle.
Question 8 Explanation: 
HIV cannot be spread through salvia droplets. The only fluids though which HIV can be spread as as follows: Blood, semen, pre-seminial fluid, rectal fluids, vaginal fluid and breast milk. Unprotected penetrative sex either vaginal or anal, between partners of any gender can result in HIV transmission. A helpful resource: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/how-is-hiv-transmitted
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