Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)

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A 25 year old female, known to be infected with HIV and a CD4 count 90 presented with
complaints of altered sensorium following a partial seizure. Gadolinium enhanced MRI
scan showed multiple ring enhancing lesions in both hemispheres, thalamus, pons, basal
ganglia and cerebellum. The most probable diagnosis in this scenario is?
A: Mycobacterium tuberculosis
B: Multiple brain metastases
C: Cryptococcal meningitis
D: Pneumocystis infiltration of brain
Correct Ans:A
Explanation
HIV patients with low CD 4 counts if presents with multiple ring
enhancing lesions is suggestive of Tuberculoma, Primary CNS
lymphoma and Toxoplasmosis. In this scenario only TB is the given
choice and hence the answer.
Sample Previous Year Question on HIV based on previous Year Questions of NEET PG,
USMLE,PLAB,FMGE (MCI Screening). Please visit www.medicoapps.org for more such
Quizzes
A preterm baby developed bullous lesion on the skin soon after birth. The X ray shows
periostitis. What should be the next investigation?
A: VDRL for mother & baby
B: ELISA for HIV

C: PCR for TB
D: Hepatitis surface antigen for mother
Correct Ans:A
Explanation
The baby described in the question stem is most likely suffering from the early
manifestations of congenital syphilis. As per the choices given VDRL is the test done to
diagnose syphilis.
Ref: Harrison’s Principles of Internal Medicine, 16th Edition, Page 981; Skin Diseases &
Sexually Transmitted Infections, Uday Khopkar – 6th Edition, Page 257; Nelson 17th
,COGDT 10th Edition, Page 667;CPDT 18th Edition, Page 56.
Quizzes
Thalidomide can be used in all of the following conditions, EXCEPT:
A: Behcet's syndrome
B: HIV associated peripheral neuropathy
C: HIV associated mouth ulcers
D: Erythema nodosum leprosum
Correct Ans:B
Explanation
Thalidomide has been used for many years in the treatment of some manifestations of
leprosy and has been used for erythema nodosum leprosum; it is also useful in
management of the skin manifestations of lupus erythematosus.
The most important toxicity is teratogenesis. Because of this effect, thalidomide
prescription and use are closely regulated by the manufacturer. Other adverse effects of

thalidomide include peripheral neuropathy, constipation, rash, fatigue, hypothyroidism,
and increased risk of deep vein thrombosis.
In more serious cases of Behcet syndrome, thalidomide (100 mg/d) is effective.
Ref: Lake D.F., Briggs A.D., Akporiaye E.T. (2012). Chapter 55. Immunopharmacology. In
B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.
Quizzes
All are drugs used against HIV, EXCEPT:
A: Elvucitabine
B: Bevirimat
C: Maraviroc
D: Tegaserod
Correct Ans:D
Explanation
New therapies are continually being sought for HIV that exploit new viral targets, have
activity against resistant viral strains, have a lower incidence of adverse effects, and offer
convenient dosing.
New agents of existing classes that are currently in advanced stages of clinical
development include the NRTI agent elvucitabine, the NNRTI agents TMC278 and
IDX899, the PI agent bracanavir, entry inhibitors such as the CCR5 receptor antagonists
vicriviroc and PRO 140, and integrase inhibitors such as elvitegravir. In addition, new
drug classes such as maturation inhibitors (bevirimat) and the CD4 receptor inhibitor
TNX355 are under investigation.
Ref: Katzung 11th edition Chapter 49.
Quizzes

Maraviroc is used in treatment of:
A: CMV
B: HSV
C: HIV
D: Measles
Correct Ans:C
Explanation
Maraviroc binds specifically and selectively to CCR5, one of two coreceptors necessary for
entrance of HIV into CD4+ cells, thus blocking entry of CCR5tropic HIV into these cells.

Quizzes
Lamivudine acts against which of the following viruses?
A: HIV
B: HBV
C: Both of the above
D: None of the above
Correct Ans:C
Explanation

Lamivudine inhibits HBV DNA polymerase and HIV reverse transcriptase by competing
with deoxycytidine triphosphate for incorporation into the viral DNA, resulting in chain
termination. Lamivudine achieves 3–4 log decreases in viral replication in most patients
and suppression of HBV DNA to undetectable levels in about 44% of patients.

Quizzes
A 15 yr female with HIV infection on anti retroviral therapy presents with nausea
vomiting and flank pain. Urine microscopy showed rectangular plate and needle shaped
crystals. Serum creatine was raised. What will be the likely cause?
A: Indinavir
B: Ritonavir
C: Nevirapine
D: Zidovudine
Correct Ans:A
Explanation
Crystal induced nephropathy: Indinavir has been commonly associated with crystal
induced nephropathy. Crystallization of the HIV protease inhibitor indinavir within the
renal tubules is associated with a range of urinary tract manifestations, including
nephrolithiasis, asymptomatic crystalluria, crystalluria with dysuria (or renal colic), and
crystal nephropathy, is influenced by alkaline urine. Other drus that may cause crystal
nephropathy are acyclovir, atazanavir and sulfazadine methotrexate
Ref: CURRENT Diagnosis & Treatment Nephrology & Hypertension Page 125.
Quizzes

Metformin is used as a antihyperglycemic agent in DM, but there are some other uses for
this drug. All the following are such uses of the drug, except:
A: PCOD
B: Nonalcoholic fatty liver disease
C: Alcoholic fatty liver disease
D: Metabolic abnormalities associated with HIV disease
Correct Ans:C
Explanation
Other uses of metformin:
PCOD
Impaired glucose tolerance
Obesity
Metabolic abnormalities associated with HIV disease
Non alcoholic fatty liver disease
Ref: Harrison, 18th Edition, Page 2995
Quizzes
Thalidomide is used in all, EXCEPT:
A: Erythema nodosum leprosum
B: HIV neuropathy
C: HIV associated ulcer

D: Multiple myeloma
Correct Ans:B
Explanation
Thalidomide is indicated for the treatment of patients with erythema nodosum leprosum
and multiple myeloma. In addition, it has orphan drug status for mycobacterial infections,
Crohn's disease, HIVassociated wasting, Kaposi sarcoma, lupus, myelofibrosis, brain
malignancies, leprosy, graftversushost disease, and aphthous ulcers.
Also Know:

Thalidomide should never be taken by women who are pregnant or who could become
pregnant while taking the drug.It is best known for the severe, lifethreatening birth
defects it caused when administered to pregnant women.

Quizzes
The important coreceptors for HIV to bind with CD4 receptors are:
A: CCR4 and CXCR3
B: CCR5 and CXCR4
C: CCR4 and CXCR5
D: CCR4 and CXCR2
Correct Ans:B
Explanation
The primary cellular receptor for HIV is CD4 (Helper subset of T cells). HIV has two major
coreceptors: CCR5 and CXCR4 (for fusion and entry)
ALSO KNOW:
Kaposi's sarcoma cannot be explained completely by the immunodeficiency caused by HIV

infection.
Ref: Harrison, Edition18, Page1519.

Quizzes
Neurologic abnormalities have been noted in about onethird of patients with AIDS. Which
of the following is NOT seen in HIV involvement of CNS?
A: Perivascular giant cell
B: Vacuolar degeneration of post column
C: Microglial nodule formation
D: Inclusion bodies
Correct Ans:D
Explanation
The main cell types that are infected in the brain in HIV infection are the perivascular
macrophages and the microglial cells. A diffuse and multifocal rarefaction of the cerebral
white matter accompanied by scanty perivascular infiltrates of lymphocytes and clusters
of a few foamy macrophages, microglial nodules, and multinucleated giant cells. Vacuolar
degeneration of posterior column is associated with the AIDS dementia complex.

Ref: Ropper A.H., Samuels M.A. (2009). Chapter 33. Viral Infections of the Nervous
System, Chronic Meningitis, and Prion Diseases. In A.H. Ropper, M.A. Samuels (Eds),
Adams and Victor's Principles of Neurology, 9e.

Quizzes

Which of the following disease cause modification of finger prints?
A: Leprosy
B: HIV
C: Hypertension
D: Acromegaly
Correct Ans:A
Explanation
Leprosy can modify finger prints. Electrical injury and radiation can also modify finger
prints.

In criminal cases impression of all 10 fingers are taken but in civil cases left thumb
impression is taken in case of males and right thumb impression in case of females.

Dactylography or finger print system consist of taking the impression of the pulp of the
fingers and thumb with printers ink on an unglazed white paper. The fingerprints of even
identical twins are different. The chances of two persons having identical finger prints is
about one in thirty times the population of the world.

Ref: Concise Textbook Of Forensic Medicine & Toxicology By Sharma, page 19.
Quizzes
Identify the CORRECT description of Molotov cocktail:
A: Petrol bomb
B: Mixture of alcohol and Cocaine

C: Combination of drugs used for HIV treatment
D: Combination of drugs used by Cocaine addicts
Correct Ans:A
Explanation
A Molotov cocktail is also known as a petrol bomb or alcohol bomb. It is a simple type of
improvised incendiary device. The simplest form consists of a stoppered bottle filled with
a combustible liquid, such as gasoline or highproof alcohol, with a fuelsoaked rag
stuffed in the neck of the bottle.
Quizzes
Sentinel laboratories are mainly involved in:
A: External Quality Assessment of laboratories
B: Diagnosis of HIV infection
C: Control of Bioterrorism
D: Diagnosis of Tuberculosis
Correct Ans:C
Explanation
Because communication between clinical and public health laboratories is so critical in
the post2001 era, Centre for Disease Control (CDC) created an organizational structure
whereby isolates and lines of communication flow freely among numbers. The
Laboratory Response Network (LRN) was originally designed as a fourtier system.
Clinical laboratories (Level A) were at the bottom of a triangle, sending specimens to a
public health laboratory (level B) or Level C (state public health laboratory) for
confirmation. Isolates were ultimately sent to CDC or United States Army Medical
Research Institute for Infectious Diseases (USMRIID)Level D, for archiving ang
sophisticated molecular testing. This original system has now been changed to a three
tier system in which Level A laboratories are now called Sentinel laboratories; Level B &
C laboratories are called Reference laboratories & Level D are called National

laboratories.

The main role of Sentinel Microbiology laboratories is to raise suspicion when a targeted
agent is suspected in a human specimen. Detection of a possible bioterrorism event will
depend on:
A laboratory having an active microbial surveillance and monitoring program
Vigilant technologists looking for a disease that does not occur naturally in a
particular geographic region (eg: Plague in New York city); is transmitted by an
aerosol route of infection; is a single case of disease caused by an unusual agent (eg:
Burkholderia mallei usually only seen in the far east); Good communication with
infection control practitioners, infectious disease Physicians and local or regional
public health laboratories.
Ref: Bailey & Scott’s Diagnostic Microbiology; 12th edition; Page: 954955
Quizzes
One of the most common causes of diarrhea in HIV infected patients is cryptosporidiosis.
Which of the following is the method used for diagnosis of cryptosporidiosis in fecal
matter?
A: ZiehlNeelsen stain of the stool
B: Gram stain of the stool
C: Normal saline suspension of stool
D: Iodine suspension of stool
Correct Ans:A
Explanation
Cryptosporidiosis is a protozoan which is most commonly involved in the pathogenesis of
diarrhea in HIV infected patients. The cysts for cryptosporidiosis are best demonstrated by
ZiehlNeelsen stain of fecal mater.
Other important clinical laboratory tests for stool are summarized as follows.
Analysis of Stool:
1. Physical examination for color, frank blood, undigested food, worms etc.
2. Chemical examination of Reducing substance for lactose intolerance, of Fecal fat for

malabsorption syndrome, of Protein content for Protein losing enteropathy. Occult blood
test.
3. Direct light microscopy for demonstration of RBC, WBC,Crystals and Ova of different
types of helminths. Demonstration of protozoan like E. histolytica and Giardia.
4. Culture of stool for Salmonella, Shigella, Campylobacter, etc.
5. Assay for demonstration toxins in stool in cases of patients suffering from
Pseudomembranous colitis (toxin of Cl. difficile).
6. ELISA This test it is able to find viral antigens (Rotavirus) as a causative agent for
infantile diarrhea. 7. Electron microscopy for demonstration of virus (Rotavirus).
8. Gram/ZN stain. ZN staining of stool smear is highly diagnostic for demonstration of
Cryptosporidiosis (protozoa) responsible for diarrhea in an immunocompromised host
(AIDS).

Ref: Brooks G.F. (2013). Chapter 46. Medical Parasitology. In G.F. Brooks (Ed),Jawetz,
Melnick, & Adelberg's Medical Microbiology, 26e.
Quizzes
Which of the following causes highest risk of nosocomial infection to a patient?
A: Patient admitted for elective surgery
B: HIV patient coming in follow up OPD
C: Patient undergoing endoscopy
D: Patient admitted for normal delivery
Correct Ans:A
Explanation
The fact that at least 25–50% of nosocomial infections are due to the combined effect of
the patient's own flora and invasive devices highlights the importance of improvements
in the use and design of such devices. Urinary tract infections (UTIs) account for ~34%
of nosocomial infections. Pneumonia accounts for ~13% of nosocomial infections. Wound
infections account for ~17% of nosocomial infections
UTI is the most common cause of nosocomial infection. Other common cause is
pneumonia and surgical procedures. Contaminated surgical equipments and from health
care workers can be the cause of infection in surgical wound.

Also Know:
The most common pathogens in postoperative wound infections are S. aureus, coagulase
negative staphylococci, and enteric and anaerobic bacteria. In rapidly progressing
postoperative infections, which manifest within 24–48 h of a surgical procedure, the level
of suspicion regarding group A streptococcal or clostridial infection should be high.
Ref: Weinstein R.A. (2012). Chapter 131. Health Care–Associated Infections. In D.L.
Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's
Principles of Internal Medicine, 18e.
Quizzes
FALSE statement ragarding HIVassociated TB is:
A: Extrapulmonary TB is common among HIVinfected patients
B: The diagnosis of TB in HIVinfected patients may be difficult
C:
Immune reconstitution inflammatory syndrome (IRIS) is more common among
patients with advanced immunosuppression and extra pulmonary TB
D:
Patients with both HIV infection and TB are more infectious than persons
without HIV coinfection
Correct Ans:D
Explanation
The most infectious patients have cavitary pulmonary disease. Patients with sputum
smear–negative and those with culturenegative pulmonary TB and extrapulmonary TB
are essentially noninfectious. Because persons with both HIV infection and TB are less
likely to have cavitations, and they are less likely to be smear positive they may be less
infectious than persons without HIV coinfection.
Ref: Harrisons principles of internal medicine, 18th edition, Page: 1342.

Quizzes
Regarding HIV infection, not true is:
A: p24 is used for early diagnosis
B: Lysis of infected CD4 cells is seen
C: Dendritic cells do not support replication
D: Macrophage is a reservoir for the virus
Correct Ans:C
Explanation
Follicular dendritic cells from tonsils, can be infected with HIV even without the
involvement of CD4.

Ref: Text Book of Microbilogy By Ananthanarayan, 6th Edition, Page 546
Quizzes
'H5 Nl' may be best described as a:
A: Bird flu virus
B: Vaccine for HIV
C: Agent for Japanese encephalitis
D: New strain of Plasmodium falciparum
Correct Ans:A

Explanation
H5N1 is the Avian Flue a type of Influenza A virus, also called the Bird Flu Virus.
Ref: Molecular Medicine: An Introductory Text By Trent, 3rd Edition, Pages 20910;
Clinical Infectious Disease By Schlossberg, 2008, Page 1290
Quizzes
The genome of HIV virus contains which of the following?
A: Single stranded DNA
B: Single stranded RNA
C: Double stranded DNA
D: Double stranded RNA
Correct Ans:B
Explanation
HIV is an enveloped icosahedral sphere. It has 2 identical, non complementary strands of
RNA and 3 enzymes (reverse transcriptase, integrase and protease) packed in a cone
shaped protein core. This core is surrounded by a protein coat called capsid. This capsid
along with the enclosed nucleic acid is called nucleocapsid. Capsid acts as a protective
shell around the nucleic acid core and helps to introduce the viral genome into host cell
by adsorbing readily to host cell surfaces.
Most RNA viruses are single stranded except reoviridae which is double stranded. Most
DNA virus are double stranded except poxviridae which is single stranded.
Ref: HIV and AIDS: Basic Elements and Priorities By S. Karthikeyan, Pages 413

Quizzes
Regarding HIV which of the following statement is not TRUE?
A: It is a DNA retrovirus
B: Contains Reverse Transcriptase
C: May infect host CD4 cells other than Tlymphocytes
D: Causes a reduction in host CD4 cells at late stage of disease
Correct Ans:A
Explanation
The genome of HIV is diploid, composed of 2 identical single stranded positive sense
RNA copies. In association with viral RNA is the reverse transcriptase enzyme which is
the characteristic feature of retroviruses.
Pathogenesis:
When virus infects a cell RNA, viral RNA is transcribed by the enzyme, first to single
stranded DNA and then to double stranded DNA which is integrated into the host cell
chromosome. The provirus initiate viral replication by directing synthesis of viral RNA
and other components.
When naked virus buds outs through host cell surface membrane, it acquires a
lipoprotein envelope which consist of lipid derived from the host cell membrane and
glycoprotein which are virus coded. The spikes which constitute the major surface
component of the virus, binds to CD4 receptors on susceptible host cells. The
transmembrane pedicle cause cell fusion.
Ref: Ananthanarayan and Panicker’s Textbook of Microbiology, 8th Edition, Page 395
Quizzes
CMV retinitis in HIV occurs when the CD4 counts fall below which of the following
levels?

A: 50
B: 100
C: 200
D: 150
Correct Ans:A
Explanation
CMV Retinitis is the most common cause of loss of vision in AIDS patients. Majority of
cases of CMV retinitis occur in patients with a CD4+ T cell count <50/micro L.
Therefore, patients at high risk of CMV retinitis (CD4+ T cell count <100/micro L)
should undergo an ophthalmologic examination every 3–6 months.
CMV retinitis usually presents as a painless, progressive loss of vision. Patients may also
complain of blurred vision, floaters and scintillations. It is usually bilateral. The
characteristic retinal appearance is presence of perivascular hemorrhage and exudate.
Treatment consists of oral valacyclovir, ganciclovir, IV ganciclovir, or IV foscarnet, with
cidofovir as an alternative.
Ref: Textbook of Microbiology By Ananthanarayan and Panicker, 8th Edition, Page 573
; Harrison’s Principles of Internal Medicine, 18th Edition, Chapter 189
Quizzes
Most common genital lesion in HIV patient is:
A: Chlamydia
B: Herpes
C: Syphilis

D: Candida
Correct Ans:B
Explanation
Herpes simplex virus is the is the most common opportunistic infection causing genital
lesions in HIV patients. Herpes simplex virus type I and Type II cause recurrent oral,
labial, genital and perianal herpes simplex lesions in HIV infected individuals. Herpes
simplex virus type II (HSV2) is associated with genital lesions.

Ref: Diagnosis and Management of HIV/AIDS : A Clinician's Perspective By Usha K.
Baveja, B. B. Rewari, Page 93; Centers for Disease Control and Prevention. 2006
Sexually Transmitted Diseases Treatment Guidelines. MMWR Recomm Rep 2006;
55(RR11), Pages 1 94.
Quizzes
Which of the following has the highest chance of transmission of HIV?
A: Anal intercourse
B: Transfusion of blood products
C: Kidney transplant
D: Transplacental transmission
Correct Ans:B
Explanation
The approximate chance of infection/exposure is given below of various scenario

a) Sexual intercourse i.e oral, anal or vaginal : 0.1 – 1.0 %
b) Blood and blood product transfusion : >90%
c) Tissue and organ donation : 5 to 90 %
d) Sharing needles by drug addicts : 0.5 – 1.0 %
e) Mother to baby : 30 %

Ref: Textbook of microbiology By Ananthanarayanan, 6th Edition, Page 551

Quizzes
A 28yearold HIVpositive male complains of pain on swallowing. Physical examination
is remarkable for white plaquelike material on his tongue and buccal mucosa, which is
scraped and sent to the laboratory. Based on these findings, and on the laboratory
results, the man is diagnosed with acquired immunodeficiency syndrome (AIDS). With
which of the following agents is the man most likely infected?
A: Candida albicans
B: Cytomegalovirus
C: Herpes simplex I
D: Human herpesvirus 8
Correct Ans:A
Explanation
Candida albicans produces oral thrush, an AIDSdefining lesion, which is common in
acute HIV disease, and becomes increasing common as the CD4 + cell count falls. The
lesions are usually painless. Diagnosis is by demonstration of pseudohyphae using a wet
smear with confirmation by culture.
Although cytomegalovirus is associated with numerous clinical scenarios in the AIDS
population, including odynophagia (painful swallowing), it would not produce white
plaques on the oral mucosa.

Herpes Simplex Iproduces vesicular lesions occurring in clusters in the oral cavity. There
is an increased risk of herpes infections in the AIDS group, but the lesions do not
resemble those described in the question.

Human herpesvirus 8 is the causative agent of Kaposi's sarcoma, a malignancy arising
from endothelial cells that appears as hemorrhagic nodules in different organ systems. It
is the most common cancer in the HIV infected population.

Quizzes

Hiv aids sample questions based on neet pg , usmle, plab and fmge pattern (mci screening)

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