Infectious diseases: opportunistic infection prophylaxis in HIV: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Infectious diseases: opportunistic infection prophylaxis in HIV

Sample item

A patient with HIV infection has a CD4 count of 150 per microlitre. Which drug prevents Pneumocystis pneumonia and cerebral toxoplasmosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Cotrimoxazole

Cotrimoxazole prophylaxis is started when CD4 is 350 per microlitre or below (NACO and WHO), or for WHO stage 3 or 4 disease, and it prevents Pneumocystis pneumonia, toxoplasmosis and some bacterial infections. Azithromycin was used for Mycobacterium avium complex at very low CD4. It can be stopped when CD4 recovers on antiretroviral therapy.

Option by option

  • A. Azithromycin

    Azithromycin targets Mycobacterium avium complex.

  • B. Cotrimoxazole (correct)

    Correct. Cotrimoxazole covers both Pneumocystis and Toxoplasma.

  • C. Acyclovir

    Acyclovir is for herpes viruses.

  • D. Fluconazole

    Fluconazole targets fungal infections such as cryptococcosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Cotrimoxazole. Cotrimoxazole prophylaxis is started when CD4 is 350 per microlitre or below (NACO and WHO), or for WHO stage 3 or 4 disease, and it prevents Pneumocystis pneumonia, toxoplasmosis and some bacterial infections.

Why is "Azithromycin" not the answer?

Azithromycin targets Mycobacterium avium complex.

Why is "Acyclovir" not the answer?

Acyclovir is for herpes viruses.

Why is "Fluconazole" not the answer?

Fluconazole targets fungal infections such as cryptococcosis.

What concept does this question test?

It tests Infectious diseases: opportunistic infection prophylaxis in HIV in General Medicine. Azithromycin was used for Mycobacterium avium complex at very low CD4. It can be stopped when CD4 recovers on antiretroviral therapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infectious diseases: opportunistic infection prophylaxis in HIV?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.