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What is the duration of treatment for a patient with HIV+ who is prescribed acyclovir for herpes infection?
For daily suppressive therapy in HIV+ patients, which of the following dosages is NOT appropriate for acyclovir?
In the treatment of neonatal herpes with disseminated/CNS infection, which of the following dosing regimens is correct?
What is the recommended treatment for suspected acyclovir resistance in herpes infections?
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Which statement about herpes encephalitis caused by HSV is accurate?
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What is a common complication of chickenpox that requires attention?
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What is the recommended dose for children aged 12 months to 12 years receiving the Varicella vaccine?
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What occurs as a result of the reactivation of the Varicella Zoster Virus (VZV)?
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Which medication is proven effective for treating localized and disseminated VZV?
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Which of the following is NOT FDA-approved for treating post-herpetic neuralgia (PHN)?
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What vaccine is currently recommended in the U.S. as the preferred shingles vaccine?
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What is the dose of Acyclovir for treating disseminated VZV?
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What role does Varizig® play in the management of Varicella Zoster Virus exposure?
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Which virus is included in the egg-based flu vaccine recommendations for the year 2021?
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What is the primary mode of transmission for hantavirus infection based on the content provided?
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Which of the following is a characteristic symptom of Hantavirus Pulmonary Syndrome (HPS)?
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What is the current treatment approach for Hantavirus infections mentioned in the content?
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Which virus is identified as a vector-borne disease transmitted by mosquitoes?
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What is the recommended supportive treatment for West Nile Virus according to the content?
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What symptom is commonly associated with severe cases of West Nile Virus?
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Which of the following viruses has no approved protocols for treatment according to the provided content?
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What is the primary mode of COVID-19 transmission?
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Which vaccine is primarily used against mpox during the current outbreak in the United States?
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What is a common characteristic of the spread of COVID-19?
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Which treatment is NOT listed for managing mpox disease?
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What additional route of COVID-19 transmission is indicated aside from person-to-person spread?
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Which of the following vaccines is used under an Expanded Access Investigational New Drug protocol for mpox?
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What type of droplets are responsible for the spread of COVID-19?
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Which of the following statements about the COVID-19 pandemic is true?
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What is the primary mechanism by which ganciclovir and valganciclovir exert their effect?
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Which adverse effect is common with the use of foscarnet?
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What percentage of Americans over the age of 35 are CMV positive?
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Which treatment is specifically indicated for the prevention of CMV infection in allogeneic stem cell transplant patients?
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What is the likely onset of symptoms for influenza compared to a common cold?
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What differentiates Type A influenza from Type B regarding the evolution of the virus?
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Which gastrointestinal condition is commonly associated with CMV in immunocompromised patients?
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What is a common lab diagnostic method to identify CMV infection?
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Which antiviral agent needs to be administered with caution due to its potential for renal toxicity?
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How is cytomegalovirus typically transmitted?
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In terms of drug interactions, what is a major consideration when using cidofovir?
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Which of the following adverse effects is less commonly associated with ganciclovir treatment?
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In patients with AIDS, which condition is the most common manifestation of CMV?
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What should be done if a patient's CD4 count exceeds 100 for three to six months regarding secondary prophylaxis for CMV?
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Study Notes
Herpes Treatment in HIV+ Patients
- Acyclovir dosing for infections: 400 mg PO tid for 5-10 days, or 200 mg PO five times daily, or Famciclovir 500 mg PO bid, or Valacyclovir 1 g PO bid for the same duration.
- Daily suppressive therapy options include Acyclovir 400-800 mg PO bid-tid, Famciclovir 500 mg PO bid, or Valacyclovir 500 mg PO bid.
- If resistance is suspected, options include Foscarnet 40 mg/kg IV every 8 hours until clinical resolution or topical Cidofovir 1% gel daily for 5 days.
Herpes Encephalitis
- Associated with both HSV-1 (in adults) and HSV-2 (in newborns).
- Diagnosis via cultures for HSV-2 in CSF, PCR preferred for rapid results.
- Mortality ranges from 50-85%; early diagnosis is crucial.
- Empirical treatment: Acyclovir 5-10 mg/kg every 8 hours for 2-3 weeks; Foscarnet indicated for resistant cases.
Neonatal Herpes
- Transmission occurs during pregnancy, leading to significant morbidity and mortality.
- Acyclovir 20-60 mg/kg IV every 8 hours for 21 days for disseminated/CNS infections, or 14 days for limited skin/mucous membrane infections.
Oral-Facial Herpes
- Treatment varies based on immune status; common complication post-chickenpox is bacterial infection of blisters.
Chicken Pox Management
- Supportive care: cool baths, calamine lotion, topical antipruritic; aspirin is contraindicated.
Varicella Zoster Virus (VZV)
- Reactivation of latent virus causes Herpes-Zoster; affects ~67% of individuals over 40.
- Symptoms include erythematous macules and grouped vesicles; resolves in 2-4 weeks.
- Common treatment includes Acyclovir, Famciclovir, and Valacyclovir; corticosteroids use is controversial.
Drug Dosing for Herpes-Zoster
- Acyclovir: 800 mg PO five times daily for 7-10 days.
- Famciclovir: 500 mg PO three times daily for 7 days.
- Valacyclovir: 1 g PO three times daily for 7 days.
Post-Herpetic Neuralgia (PHN)
- Lasts over 30 days post-rash onset; FDA-approved treatments include topical capsaicin, lidocaine patches, gabapentin, and pregabalin.
- Recombinant zoster vaccine (Shingrix) recommended for shingles prevention.
Cytomegalovirus (CMV) Infections
- High prevalence: 53% in 18-25 age group, 81% in >35, with >90% in MSM.
- Transmitted through congenital routes, sexual contact, and blood products; often remains asymptomatic until immunosuppression.
- Common manifestations include chorioretinitis, GI infections, pneumonia, CNS infections, and retinitis.
Treatment for CMV
- Primary agents: Ganciclovir, Valganciclovir, Foscarnet, Cidofovir.
- Ganciclovir: Induction with 900 mg BID for 14-21 days, maintenance with 900 mg daily.
- Foscarnet: Reserved for resistant strains; can cause renal impairment.
Prophylaxis for CMV
- Secondary prophylaxis recommended; may discontinue if CD4 count >100 for 3-6 months. Primary prophylaxis is not recommended.
Influenza Overview
- Seasonal virus (peak in winter); mortality highest in individuals over 65, particularly those with comorbidities.
- Transmission primarily via respiratory droplets; incubation averages 2 days.
Types of Influenza
- Type A: Defined by hemagglutinin/neuraminidase variations (e.g., H1N1, H3N2); pandemics result from antigenic shifts.
- Type B: Prone to mutations; epidemics occur every 5 years.
Influenza Treatment
- Antivirals (Amantadine, Rimantadine) not recommended according to current guidelines.
- Vaccination key; includes egg-based and cell-based composition tailored to circulating strains.
Hantavirus Infections
- Primarily rodent-borne; manifests as Hemorrhagic Fever, Nephropathia Epidemica, or Hantavirus Pulmonary Syndrome (HPS).
- Supportive treatment; no FDA-approved drugs; IV ribavirin under study.
West Nile Virus
- Transmitted by mosquitoes; symptoms range from mild febrile illness to severe encephalitis.
- Treatment is largely supportive; no effective antivirals available.
COVID-19 Transmission and Prevention
- Primarily person-to-person via respiratory droplets; also possible via contaminated surfaces.
- Vaccines available: Moderna, Pfizer, J&J, Novavax, contributing to preventive strategies against the disease.
Monkey Pox Virus
- Outbreak caused by Clade IIb; treatment options include Tecovirimat, Brincidofovir, and Vaccinia Immune Globulin.
- JYNNEOS vaccine is commonly used for prevention during outbreaks.
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Description
This quiz covers the treatment options for herpes in HIV-positive individuals, including acute and suppressive therapies. It outlines dosages for medications such as Acyclovir, Famciclovir, and Valacyclovir. Additionally, the quiz discusses treatment options in cases of resistance.
