HIV Prevention and Management

A 29-year-old individual, aware of a high-risk sexual encounter 60 hours prior, seeks post-exposure prophylaxis (PEP). Which of the following factors is MOST critical in determining the effectiveness of PEP in this scenario?

Which of the following scenarios BEST exemplifies the 'community prevention' level of HIV prevention strategies?

Consider the UNAIDS 95-95-95 targets. If a country has achieved the first 95 (95% of people living with HIV know their status) and the second 95 (95% of those diagnosed are on ART), but is lagging on the third 95 (90% of those on ART achieve viral suppression), which of the following interventions would be MOST effective in addressing this gap?

People Living With HIV (PLWH) often face barriers to accessing healthcare. Which of the following scenarios BEST represents a 'legal and policy barrier'?

Certain groups are disproportionately affected by HIV. Which of the following factors is MOST likely to contribute to the higher HIV prevalence among adolescent girls and young women in certain regions?

Social determinants of health significantly impact the health of PLWH. Which of the following interventions BEST addresses the 'economic stability' determinant to improve health outcomes for PLWH?

A patient with confirmed Plasmodium falciparum malaria exhibits impaired consciousness (GCS score of 9), severe anaemia (Hb 6.8 g/dL), and is hyperparasitaemic (parasite density >10%). According to the WHO definition of severe malaria, which of these findings is LEAST directly indicative of severity?

In the initial management of severe malaria, the 'Sepsis 6' bundle is often recommended. If a resource-limited setting has a delay in obtaining blood culture results, which intervention from the 'Sepsis 6' bundle should be prioritized and administered MOST promptly?

A venous blood gas result from a patient with suspected severe malaria shows: pH 7.32, PaCO2 4.6 kPa, HCO3- 19 mmol/l, Lactate 5 mmol/l. Which of the following physiological derangements is BEST indicated by these results?

Genetic factors influence susceptibility to malaria. Which of the following red blood cell genetic variants is thought to provide the MOST significant protective effect against severe malaria, particularly against Plasmodium falciparum?

Microscopy of a thick blood film is performed for malaria diagnosis. What is the PRIMARY advantage of using a thick film compared to a thin film?

Rapid Diagnostic Tests (RDTs) for malaria detect parasite antigens. Which of the following antigens is SPECIFICALLY targeted by Plasmodium falciparum-specific RDTs and can sometimes lead to false-positive results even after parasite clearance?

In a low-resource setting with limited access to advanced diagnostics, which of the following investigations would be MOST appropriate and readily available for the initial diagnosis of malaria?

A returned traveller from sub-Saharan Africa presents with fever, headache, and myalgia 10 days after arrival. Considering malaria in the differential diagnosis, what is the MOST critical INITIAL step in managing this patient?

According to the HPSC guidelines for Viral Haemorrhagic Fever (VHF) risk assessment, which of the following factors would classify a patient with fever and recent travel to West Africa as 'HIGH RISK' for VHF, necessitating immediate isolation and further investigation?

The 'ABCD approach' is a mnemonic for malaria prevention in travellers. What does the 'C' in ABCD specifically stand for?

Seasonal Malaria Chemoprevention (SMC) is a strategy recommended by WHO for children in areas with seasonal malaria transmission. What is the PRIMARY goal of SMC?

Which of the following antimalarial chemoprophylaxis options is GENERALLY considered the MOST suitable for pregnant women travelling to malaria-endemic regions, especially in areas with chloroquine resistance?

The RTS,S/AS01 (Mosquirix) malaria vaccine is now recommended for use in children in some malaria-endemic areas. What is the PRIMARY target of this vaccine to prevent malaria infection?

An individual newly diagnosed with HIV has a CD4 count of 550 cells/mm³ and is asymptomatic. According to current guidelines, when should antiretroviral therapy (ART) be initiated for this patient?

In the HIV life cycle, reverse transcriptase is a crucial enzyme. What is the PRIMARY function of reverse transcriptase inhibitors (NRTIs and NNRTIs) in antiretroviral therapy?

Which class of antiretroviral drugs is known to be associated with metabolic side effects, including insulin resistance, hyperlipidemia, and lipodystrophy, requiring careful monitoring?

Abacavir, a Nucleoside Reverse Transcriptase Inhibitor (NRTI), carries a risk of hypersensitivity reaction. Pharmacogenomic testing for which HLA allele is recommended BEFORE starting abacavir to mitigate this risk?

A patient on ART initially achieves viral suppression, but after several months, viral load becomes detectable again. Which of the following is the MOST likely underlying mechanism for this virological rebound?

Immune Reconstitution Inflammatory Syndrome (IRIS) is a potential complication after starting ART in HIV-infected individuals. What is the PRIMARY underlying mechanism of IRIS?

Which of the following antiretroviral drug classes MUST be 'boosted' with another agent (like ritonavir or cobicistat) to achieve adequate therapeutic drug levels?

Consider a patient with HIV and latent tuberculosis infection who starts ART. What is the MOST likely clinical manifestation of IRIS related to tuberculosis in this scenario?

Which of the following HIV antiretroviral drug classes is generally considered to have a 'neutral effect on cholesterol and triglycerides', making it a favourable option in patients with pre-existing cardiovascular risk factors?

For event-based PrEP (pre-exposure prophylaxis) dosing, which of the following regimens is typically recommended for men who have sex with men (MSM)?

Which of the following is NOT a recognized strategy for 'national prevention' of HIV?

Which of the following statements accurately describes the relationship between sickle cell trait (HbAS) and malaria?

Which Plasmodium species, when visualized on a thin blood film, is often characterized by 'banana-shaped' gametocytes?

In the context of malaria epidemiology, 'incidence' and 'prevalence' are distinct measures. Which of the following BEST describes 'incidence'?

Which of the following is the currently recommended first-line treatment for uncomplicated Plasmodium falciparum malaria in most malaria-endemic regions?

For severe Plasmodium falciparum malaria, which of the following is the recommended first-line parenteral antimalarial treatment according to WHO guidelines?

Primaquine is often used in the treatment of malaria caused by certain Plasmodium species. What is the PRIMARY indication for the use of primaquine in malaria therapy?

Which of the following is NOT a characteristic feature of protozoa?

Plasmodium parasites belong to which class of protozoa, based on their primary mode of movement?

A public health initiative aims to enhance HIV prevention at the 'national' level. Which of the following interventions would be MOST indicative of a national-level strategy?

In a region with a concentrated HIV epidemic among men who have sex with men (MSM), a new community-based HIV prevention program is being designed. Which of the following approaches would be MOST effective in addressing the specific needs and challenges of this population?

An individual is considering event-based PrEP for HIV prevention. Which of the following scenarios BEST aligns with the recommended event-based PrEP dosing strategy for men who have sex with men (MSM)?

Several interconnected factors contribute to an individual's susceptibility to malaria. Which of the following scenarios BEST illustrates the interplay between genetic and environmental factors in malaria susceptibility?

In the context of malaria, haemoglobinopathies such as sickle cell trait and thalassaemia are known to confer a degree of protection. What is the MOST likely evolutionary basis for this phenomenon?

A patient presenting with fever and recent travel history to sub-Saharan Africa is suspected of having malaria. In a resource-limited setting, which diagnostic approach would be the MOST pragmatic and readily available for initial malaria diagnosis?

Microscopy remains a cornerstone in malaria diagnosis. What is the PRIMARY advantage of using a thick blood film over a thin blood film in malaria microscopy?

A patient diagnosed with Plasmodium vivax malaria is being treated with chloroquine. Why is it crucial to consider adding primaquine to their treatment regimen, particularly in regions outside of chloroquine resistance?

According to the WHO guidelines for severe malaria, which of the following clinical findings is the MOST critical indicator of severity requiring immediate parenteral antimalarial treatment?

In the management of severe malaria, the 'Sepsis 6' bundle is often advocated as part of the initial resuscitation. Which of the following interventions within the 'Sepsis 6' bundle directly addresses the primary parasitic infection in severe malaria?

A patient with confirmed severe malaria exhibits signs of metabolic acidosis. Which of the following venous blood gas findings would be MOST consistent with metabolic acidosis secondary to severe malaria?

Seasonal Malaria Chemoprevention (SMC) is a targeted strategy recommended by the WHO for malaria-endemic regions with highly seasonal transmission. What is the PRIMARY objective of SMC?

When advising a pregnant woman traveling to a malaria-endemic region, which of the following chemoprophylaxis options is GENERALLY considered the MOST suitable, particularly in areas with chloroquine resistance?

The RTS,S/AS01 (Mosquirix) malaria vaccine is now recommended for children in certain malaria-endemic areas. What is the PRIMARY immunological target of this vaccine to prevent malaria infection?

An individual newly diagnosed with HIV has a CD4 count of 600 cells/mm³ and is asymptomatic. According to current international guidelines, when should antiretroviral therapy (ART) be initiated for this patient?

In the HIV lifecycle, reverse transcriptase is a key enzyme. What is the PRIMARY function of reverse transcriptase inhibitors (NRTIs and NNRTIs) in antiretroviral therapy?

Which class of antiretroviral drugs is MOST strongly associated with metabolic complications, including lipodystrophy, insulin resistance, and hyperlipidemia, requiring careful metabolic monitoring?

Abacavir, a Nucleoside Reverse Transcriptase Inhibitor (NRTI), carries a risk of hypersensitivity reaction. Pharmacogenomic testing for which specific HLA allele is recommended BEFORE initiating abacavir to mitigate this risk?

A patient on a stable ART regimen initially achieved viral suppression, but after several months, their viral load becomes detectable again. What is the MOST common underlying reason for this virological rebound in a patient previously well-controlled on ART?

Immune Reconstitution Inflammatory Syndrome (IRIS) is a potential complication following ART initiation in HIV-infected individuals. What is the PRIMARY immunological mechanism driving the pathogenesis of IRIS?

Which class of antiretroviral drugs generally REQUIRES 'boosting' with a pharmacokinetic enhancer (such as ritonavir or cobicistat) to achieve adequate therapeutic drug concentrations?

Consider a patient with HIV and latent tuberculosis infection who initiates ART. What is the MOST typical clinical manifestation of IRIS related to tuberculosis (TB-IRIS) in this scenario?

Which HIV antiretroviral drug class is generally considered to have a relatively 'neutral effect on cholesterol and triglycerides', making it a potentially more favorable option in patients with pre-existing cardiovascular risk factors?

Which of the following is NOT a recognized strategy for 'national prevention' of HIV infection?

Which Plasmodium species is characterized by the presence of 'banana-shaped' gametocytes when visualized on a thin blood film under microscopy?

In malaria epidemiology, 'incidence' and 'prevalence' are distinct measures. Which of the following statements BEST describes 'incidence' in the context of malaria?

What is the currently recommended first-line treatment for uncomplicated Plasmodium falciparum malaria in most malaria-endemic regions, considering widespread resistance to older antimalarials?

For severe Plasmodium falciparum malaria, which of the following parenteral antimalarial treatments is the recommended first-line option according to WHO guidelines?

Primaquine is frequently used in malaria therapy for specific indications. What is the PRIMARY clinical reason for using primaquine in the treatment of malaria caused by Plasmodium vivax or Plasmodium ovale?

Which of the following is NOT a characteristic feature generally attributed to protozoa?

Plasmodium parasites, the causative agents of malaria, are classified into which class of protozoa based on their PRIMARY mode of movement or locomotion?

According to the HPSC (Health Protection Surveillance Centre) guidelines for Viral Haemorrhagic Fever (VHF) risk assessment, which factor would classify a patient with fever and recent travel to West Africa as 'HIGH RISK' for VHF, necessitating immediate isolation and further investigation?

The 'ABCD approach' is a mnemonic for malaria prevention in travelers. What does the 'C' specifically stand for in this mnemonic?

A public health initiative aims to reduce new HIV infections by focusing on pre-exposure prophylaxis (PrEP) uptake. Which of the following strategies, if implemented in isolation, would be LEAST effective in achieving sustained high PrEP adherence and population-level impact?

In a region with limited healthcare infrastructure and high HIV prevalence, community health workers (CHWs) are tasked with expanding HIV prevention efforts. Which of the following CHW-led interventions would MOST effectively address both individual and community-level HIV prevention?

National HIV prevention programs often incorporate 'harm reduction' strategies. Which of the following scenarios BEST exemplifies a harm reduction approach within national HIV prevention efforts?

Consider a country aiming to achieve the UNAIDS 95-95-95 targets. If this country has successfully achieved the first two 95s (diagnosis and treatment) but is struggling with the third 95 (viral suppression), which of the following interventions would be MOST crucial to prioritize to close the 'viral suppression gap'?

Which of the following scenarios BEST illustrates a 'legal and policy barrier' hindering healthcare access for people living with HIV (PLWH)?

Adolescent girls and young women (AGYW) in certain regions are disproportionately affected by HIV. Which of the following complex interplay of factors MOST significantly contributes to this disparity?

Social determinants of health significantly impact the health outcomes of people living with HIV (PLWH). Considering the 'economic stability' determinant, which intervention would be MOST effective in improving long-term health outcomes for PLWH?

A patient with confirmed Plasmodium falciparum malaria presents with hyperparasitemia (5% parasitemia) and hypoglycemia (blood glucose 2.8 mmol/L). While both are concerning, which of these findings represents a more IMMEDIATE and life-threatening risk in severe malaria, requiring the most urgent intervention?

In managing severe malaria in a resource-limited setting with delayed laboratory turnaround times, which initial intervention from the 'Sepsis 6' bundle is MOST critical to prioritize and administer empirically, even before confirming a malaria diagnosis?

A patient with suspected severe malaria has a venous blood gas showing metabolic acidosis. Which underlying pathophysiological mechanism in severe malaria is MOST directly responsible for this acid-base disturbance?

Several red blood cell genetic variants offer protection against severe malaria. Considering the evolutionary context, which of the following statements BEST explains the persistence of sickle cell trait (HbAS) in malaria-endemic regions despite its associated health risks?

In malaria diagnosis, thick and thin blood films are both used but serve different primary purposes. What is the MOST significant advantage of using a thick blood film over a thin blood film in resource-limited settings with high malaria prevalence?

Rapid Diagnostic Tests (RDTs) for malaria are widely used due to their simplicity and speed. However, HRP2-based RDTs, commonly used for Plasmodium falciparum detection, have a notable limitation. What is the MOST significant drawback of relying solely on HRP2-based RDTs for malaria diagnosis and monitoring, especially in regions with high malaria transmission?

In a returned traveler from sub-Saharan Africa presenting with fever and myalgia, malaria is suspected. In a resource-constrained clinic with on-site microscopy and RDTs available, but limited PCR access, which diagnostic approach is MOST appropriate for initial malaria diagnosis to guide immediate management?

According to HPSC guidelines for Viral Haemorrhagic Fever (VHF) risk assessment, which of the following clinical and travel history combinations would categorize a patient with fever as 'HIGH RISK' for VHF, necessitating immediate VHF-specific isolation and investigation protocols?

The 'ABCD approach' is a mnemonic for malaria prevention in travelers. The 'C' in ABCD stands for 'Chemoprophylaxis'. Which of the following statements accurately reflects the MOST critical consideration when choosing a chemoprophylaxis regimen for a traveler?

Seasonal Malaria Chemoprevention (SMC) is a WHO-recommended strategy for children in areas with seasonal malaria transmission. What is the PRIMARY objective of SMC programs, and how does it differ from perennial malaria chemoprevention (PMC)?

For pregnant women traveling to malaria-endemic regions, chemoprophylaxis is crucial. Considering areas with chloroquine resistance, which of the following antimalarial options is GENERALLY considered the MOST suitable and safest for prophylaxis during pregnancy?

The RTS,S/AS01 (Mosquirix) malaria vaccine is now recommended for use in children in some malaria-endemic areas. What is the PRIMARY immunological target of this vaccine, and at which stage of the malaria parasite lifecycle does it primarily act to prevent infection?

An individual newly diagnosed with HIV has a CD4 count of 580 cells/mm³ and is asymptomatic. According to current international guidelines, when should antiretroviral therapy (ART) be initiated for this patient, and what is the primary rationale for this recommendation?

In the HIV life cycle, reverse transcriptase is a crucial enzyme targeted by antiretroviral drugs. What is the MOST precise mechanism of action of Nucleoside Reverse Transcriptase Inhibitors (NRTIs) in disrupting HIV replication?

Which class of antiretroviral drugs is MOST strongly associated with long-term metabolic complications, including lipodystrophy, insulin resistance, and hyperlipidemia, requiring careful metabolic monitoring and potentially influencing drug selection, especially in patients with pre-existing cardiovascular risk factors?

Abacavir, a Nucleoside Reverse Transcriptase Inhibitor (NRTI), carries a risk of potentially severe hypersensitivity reaction (HSR). Pharmacogenomic testing for which specific HLA allele is recommended BEFORE initiating abacavir to significantly reduce the risk of this HSR?

A patient on a stable antiretroviral therapy (ART) regimen, who previously achieved and maintained viral suppression, presents with a detectable viral load after several months of undetectable levels. Assuming ART adherence is not a primary issue, what is the MOST likely underlying virological mechanism for this 'virological rebound'?

Immune Reconstitution Inflammatory Syndrome (IRIS) is a potential complication following ART initiation in HIV-infected individuals, particularly those with advanced disease. What is the PRIMARY immunological mechanism driving the paradoxical worsening of pre-existing infections or the unmasking of subclinical infections in IRIS?

Which class of HIV antiretroviral drugs generally REQUIRES 'boosting' with a pharmacokinetic enhancer, such as ritonavir or cobicistat, to achieve adequate therapeutic drug concentrations and maintain efficacy with once-daily dosing?

Consider a patient with HIV and latent tuberculosis infection who initiates antiretroviral therapy (ART). What is the MOST typical clinical manifestation of Immune Reconstitution Inflammatory Syndrome related to tuberculosis (TB-IRIS) in this scenario, differentiating it from active TB disease progression?

Which HIV antiretroviral drug class is generally considered to have a relatively 'neutral effect on cholesterol and triglycerides', making it a potentially more favorable option compared to other classes in patients with pre-existing cardiovascular risk factors or dyslipidemia?