TMC Staff Nurse - 2019
Medical & Surgical Nursing
Easy
Most common opportunistic infection in HIV positive patient is?
Appeared in: TMC Staff Nurse - 2019
Explanation
- Tuberculosis (TB) is the most frequent opportunistic infection (OI) in people living with HIV (PLHIV) worldwide.
- The risk of developing active TB is estimated to be 16-27 times greater in PLHIV than in those without HIV infection.
- TB is a leading cause of mortality among PLHIV, accounting for about one-third of all AIDS-related deaths globally.
- In resource-limited settings and countries with a high TB burden, such as India, the co-epidemic of HIV and TB is a major public health challenge.
Why Other Options Were Wrong
- Option A: While Pneumocystis jirovecii pneumonia (PCP) is a significant and common OI in HIV, its incidence has been surpassed by TB globally, especially since the widespread use of antiretroviral therapy (ART) and specific prophylaxis.
- Option C: Cryptococcal meningitis is a severe and life-threatening fungal infection, but its overall incidence is lower than that of tuberculosis in the global HIV-positive population.
- Option D: Kaposi's Sarcoma is a type of cancer (a malignancy), not an infection. It is caused by a virus (HHV-8) and is an AIDS-defining condition, but the question asks for the most common opportunistic infection.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Most common opportunistic infection in HIV-positive individuals to guide bedside assessment, documentation, and the next nursing action.
- Nurses must be vigilant in screening all HIV-positive patients for TB at every clinical visit using the 4-symptom screen (cough, fever, weight loss, night sweats).
- A key nursing role is patient education on the importance of adherence to both ART and TB treatment (or preventive therapy) to prevent drug resistance and improve outcomes.
- What if? If a patient with HIV has a CD4 count below 200 cells/μL but no symptoms of TB, the priority action changes from investigation for active TB to initiating TB Preventive Therapy (TPT) alongside prophylaxis for other OIs like PCP.
How to Approach the Question
- First, identify the core of the question: it asks for the 'most common' 'opportunistic infection' in 'HIV positive' patients.
- Recall the major opportunistic infections associated with HIV/AIDS. Your mental list should include TB, PCP, Candidiasis, Cryptococcosis, etc.
- Differentiate between types of conditions. Notice that 'Kaposi's Sarcoma' is a cancer (neoplasm), not an infection, which immediately makes it a less likely answer to a question about infections.
- Compare the prevalence of the remaining infections. While PCP is very common, especially in certain regions or historical contexts, global and current data consistently show Tuberculosis as the leading OI, particularly in resource-limited settings.
- Select Tuberculosis based on its high global prevalence and strong association with HIV co-infection.
Concept Tested & Keywords
- Concept Tested: Most common opportunistic infection in HIV-positive individuals.
- Stem keywords: opportunistic infection, HIV positive, most common
- Lead-in keywords: Most common
- Negative lead-in flag: false
Question ID
Q9b-R4WbTrzLd0mW7XSFF4
Reference Book
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 263-265
E6 Medicine Harrison 22e Part 1 p. 1637-1639
Practise the full TMC Staff Nurse - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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