Paediatric HIV Infection

1 HIV and its Mode of transmission

1. The leading way of HIV transmission is
a. Blood
b. Sexual route
c. IDU
d. Mother to child
Ans: b
2. The most effective way of HIV transmission is
a. Blood borne
b. Sexual route
c. IDU
d. Mother to child
Ans: a
3. Sexual transmission occurs mainly among
a. High risk
b. General population
c. Bridge population
d. All
Ans: a
4. High risk groups comprises of
a. MSM
b. CSWs
c. Haemophiliacs
d. Truckers
e. All
Ans: e
5. In sexual transmission the virus can enter through
a. Mucosal lining of vagina
b. Rarely via the mouth
c. Through intact skin
d. All
e. Only a and b
Ans: e
6. AIDS was first defined in
a. CSWs
b. Homosexual men
c. Lesbian females
d. IDUs
Ans: b
7. The predominant mode of transmission in most industrialized countries is

a.
b.
c.
d.

Male to male sex

Female to male sex
Female to female sex
Oral sex
Ans: a
8. 75% of total spread occurs due to
a. Heterosexual contact
b. Homosexual contact
c. Blood borne
d. IDU
Ans: a
9. Risk factors associated with heterosexual transmission are
a. Lack of circumcision
b. High virus load
c. Decreased cd4 cell count
d. All
Ans: d
10. STDs increases the risk of HIV. True or False
Ans. True
11. All are true except
a. Sex during menses increases risk of HIV
b. Bleeding during intercourse is a risk factor for HIV
c. Receptive anal intercourse is not a risk factor for HIV
d. High viral load is a risk factor for HIV
Ans: c
12. Risk of sexual transmission is in direct relationship with
a. Amount of trauma
b. Laceration of recipients genital mucosa
c. STIs that causes ulcers increases the risk
d. All
Ans: d
13. True or false. Virus cannot pass through undamaged skin
Ans: true
14. HIV can enter through mucous membranes of all except
a. Vagina
b. Rectum
c. Urethra
d. Mouth
Ans: d
15. HIV has been consistently isolated from
a. Semen
b. Vaginal secretions
c. Breast milk
d. All

Ans: d
16. True or false. A component of saliva helps inactivate HIV. Ans: true
17. The presence of ulcerative and inflammatory nonulcerative STDs may promote the
infectiousness of HIV and susceptibility to it by
a. disrupting normal mucosal barriers, which allows HIV into the bloodstream;
b. facilitating HIV shedding in the genital tract; and
c. recruiting HIV inflammatory cells to the genital tract
d. all
ans: d
18. low levels of HIV seen in all except
a. saliva
b. tears
c. sweat
d. cervical secretions
ans: d
19. The risk of contracting HIV infection from transfusion of a unit of infected blood is
estimated to be over
a. 90%
b. 95%
c. 80%
d. 85%
Ans: b
20. True or false. The HIV transmission through blood is not dose dependent.
Ans: false
2 Prevention and Control of HIV
1. Discordant couples are
a) Wife or husband infected while partner remains HIV negative
b) Both are infected
c) Both are HIV negative
d) Wife infected and husband in window period
Ans: a
2. Discordant Couples who wish to have child must go for
a) Adoption
b) Safer sex using condoms
c) Should not think of children
d) A + b
Ans: d
3. the risk of cross infection with potential mutant viruses could be minimized by
limiting unprotected intercourse to the most fertile period.
a) True
b) False
Ans: a
4. Safer sex
a) Reduces risk of passing HIV infection
b) Reduces risk of contracting STIs

c) Using condoms
d) All
Ans:d
5. Genital cancers are caused by
a) HPV virus
b) Bacteria
c) Fungi
d) Rhabdovirus
Ans: a
6. Standard precautions adequate for care of patients with HIV include
a) Hand washing before patient contact
b) Hand washing after patient contact
c) Use of gloves
d) All
Ans: d
7. Personal protective equipment includes all except
a) Gowns
b) Eye shields
c) Masks
d) Lens
Ans: d
8. Preventing HIV from IDU includes
a) Avoiding Needle and syringe sharing
b) Opiod substitution therapy
c) Avoiding drug abuse
d) All
Ans: d
9. To reduce transmission from mother to child
a) Caesarean section should be preferred
b) Vaginal section should be preferred
c) Vaginal section with forceps should be preferred
d) Vaginal section with vacuum should be preferred
Ans: a
10. Which drug is used to prevent MCTC
a) Paracetamol
b) Diclofenac
c) Ketoconazole
d) Zidovudine
Ans:d
11. ART should be given
a) Before labour
b) After delivery
c) During pregnancy
d) All
Ans: d
12. ART prophylaxis reduces risk of HIV transmission
a) True
b) False
Ans: a
13. An occupational exposure is

a.
b.
c.
d.

Percutaneous injury
Contact of skin with blood
Contact of mucous membrane with blood
all
ans: d
14. Mother who test positive during delivery should be followed up every
a) 6 months
b) 9 months
c) 3 months
d) 4 months
Ans: a
15. HIV vaccine are
a) Subunit
b) Recombinant
c) DNA vaccines
d) All
Ans: d
16. Occupational exposure is a
a) Percutaneous injury
b) Contact of mucous membrane with infected blood
c) Contact of abraded skin with infected blood
d) All
Ans: d
17. Action to be taken on occurrence of occupational exposure to HIV includes
a) HIV testing
b) Tab ziduvudine and tab lamivudine
c) Taking drugs Within 24 hours
d) All
Ans:d
18. Small volume exposure over intact skin from a low risk individual requires
a) No drugs
b) 2 drug regimen
c) 3 drug regimen
d) All
Ans: a
19. - Small volume exposure over non intact skin /mucous membrane from a high risk
individual requires
a) No drugs
b) 2 drug regimen
c) 3 drug regimen
d) All
20. Severe injury (Large bore, deep injury, visible blood in device, needle in patient
artery/vein) from either a low risk or high risk individual requires
a) No drug
b) 2 drug regimen
c) 3 drug regimen
d) None
Ans: c
Ans: b

3 Prevention of Parent to child Transmission of HIV/AIDS

1. PPTCT is important as it is
a. Basic need of positive couple to have a negative child
b. Provides unique opportunity to prevent vertical transmission from mother to child
c. Prevention is always better
d. All
Ans: d
2. More than 80% transmission of HIV occurs through
a. Blood & blood products
b. Perinatal
c. Sexual
d. IDU
Ans:c
3. PTCT accounts for about __% of infection
a. 30%
b. 15%
c. 7%
d. 10%
Ans: a
4. The risk of HIV transmission is related to breast feeding. True or false
Ans: true
5. Transmission rates among non breast feeding infants is __%
a. 15-30%
b. 10-15%
c. 5-10%
d. 30-40%
Ans: a
6. The risk of HIV transmission is increased by
a. Placenta infections
b. Trophoblastic transcytosis
c. Co receptor expression
d. All
Ans: d
7. Risk determinants in PTCT are
a. Advanced HIV disease
b. Low viral load
c. High CD4 count
d. All

Ans: a
8. Which type of delivery increases the risk of PTCT
a. Vaginal
b. C-section
c. Forceps
d. All
Ans: a
9. Which infections increases the risk of PTCT
a. STDs
b. Placental infections
c. Mastitis
d. All
Ans: d
10. Vitamin A deficiency increases the risk for PTCT. True or false
Ans: true
11. Obstetric factors which should be accounted while PPTCT are
a. Mode of delivery
b. Duration of rupture of membrane
c. Non invasive procedure during labour
d. A and b
e. A , b and c
Ans: d
12. Fetal factors which increases the risk of PTCT are
a. Maturity
b. Non breast feeding
c. Oral thrush
d. All
Ans: c
13. In order to reduce the risk of PTCT
a. Efforts should be made to reduce viral load
b. Treatment of infections
c. Support optimal nutrition
d. All
Ans: d
14. After delivery, which efforts should be done for PPTCT
a. Replacement feeding, avoiding mixed feeding
b. Replacement feeding, mixed feeding
c. Exclusive breastfeeding
d. Avoiding breast problems
Ans: a
15. Prong 1 of PPTCT is
a. Prevention of HIV in young people
b. Prevention of infection in women of child bearing age
c. Prevention of unintended pregnancies

d. A and b
Ans: d
16. Prong 3 of pptct is
a. Prevention of unintended pregnancies
b. Prevention of transmission from a HIV infected woman to her infant
c. A and b
d. None of the above
Ans: b
17. ABCs of prevention of primary HIV infection are
a. Abstinence
b. Be faithful
c. Condom
d. All
Ans: d
18. PPTCT core interventions are
a. HIV counselling and testing
b. ARV prophylaxis
c. Safer delivery practices
d. All
Ans: d
19. ECS SHOULD ALWAYS PERFORMED AT 38 WEEKS BEFORE THE ONSET
OF LABOR OR RUPTURE OF MEMBRANE. True or false
Ans: true
20. During labor and delivery, PTCT risk can be reduce by
a. Minimizing cervical examinations
b. Using partogram to monitor labour
c. Using clean techniques
d. All
Ans: d

4 Specific Interventions to Prevent PTCT of HIV

1. Antenatal Management: Goal are
a. Reduces risk of MTCT during pregnancy
b. Provides linkages to treatment, care and support services
c. Help HIV-positive women stay healthier for longer
d. All
Ans: d
2. Routine Antenatal Care includes
a. Diagnosing and treating STIs
b. Counselling and testing for HIV
c. Immunization
d. All

Ans: d
3. ANC and women with HIV infection needs
a. Access to PPTCT interventions
b. Prophylaxis of OIs when indicated
c. Non access to PPTCT interventions
d. A and b
Ans: d
4. Need of confidentiality in HIV is obsolute now. True or false
Ans: false
5. Initial investigations for all pregnant women includes
a. Urine
b. Hb
c. HIV tes
d. All
Ans: d
6. Initial investigations for HIV infected women includes
a. Test for viral load
b. CD 8 count
c. CD4 count
d. All
Ans: d
7. Clinical features for women with HIV infection are
a. Weight loss
b. Persistent diarrhoea
c. Tuberculosis
d. A and b
e. A, b and c
Ans:e
8. OIs in HIV are
a. Herpes zoster
b. Tuberculosis
c. Vaginal candidiasis
d. All
Ans: di
9. Care of pregnant women with HIV infection includes
a. Prevention of anaemia, dengue and vitamin deficiency
b. Prevention of anaemia, pneumonia and tuberculosis
c. Prevention of anaemia, tetanus and malaria
d. All
Ans: d
10. Care of pregnant women with HIV includes
a. Treatment of STI
b. Treatment of UTI
c. Treatment of URTI

d. A and b
e. A , b and c
Ans: e
11. Vitamin supplements are needed by pregnant women who is HIV infected. True or
false
Ans: true
12. ARV prophylaxis do not provide long term benefit. True or false
Ans: true
13. ARV treatment works by
a. Reducing viral load
b. Increasing CD4 count
c. Treats maternal infection
d. A and c
e. A, b and c
Ans: d
14. Foetus is susceptible to teratogenic effects of ARV drugs during first __ weeks of
gestation
a. 10
b. 20
c. 14
d. 24
Ans: a
15. Simplest regimen for PPTCT includes
a. Single dose nevirapin
b. Single dose effavirenz
c. Single dose zidovudin
d. All
Ans: a
16. Zidovudine can cause
a. Anaemia
b. UTI
c. STI
d. All
Ans: a
17. Nevirapine is a
a. Nucleoside reverse transcriptase inhibitor
b. Non nucleoside reverse transcriptase inhibitor
c. Protease inhibitor
d. Newer drug
Ans: b
18. Immediate Postpartum Care of
HIV-Infected Women includes
a. ARV prophylaxis for infant
b. Safer feeding options

c. Family planning
d. All
Ans: d
19. Immediate care of newborn includes
a. Clean injection site
b. Determining feeding choice
c. Dont handleinfant with gloves
d. A and b
Ans:d
20. Dont
a. Milk the cord
b. Suction unless meconium stained
c. Use mouth operated suction
d. All
Ans: d

5 Infant Feeding Practices

1. Recommendations for infant feeding in HIV exposed includes

a. EBF for atleast 6 months
b. Avoiding mixed feeding
c. Considering mothers choice
d. All
Ans: d
2. Exclusive breastfeeding is the preferred feeding option for HIV-exposed infants <6
months of age. True or false.ans: true
3. Counselling improves
a. Feeding practices, prevents malnutrition
b. Prevents HIV transmission to infants
c. Has no effect on HIV transmission
d. A and b
Ans: d
4. Infant feeding for HIV negative mothers includes
a. EBF for 6 months
b. Continued BF for 2 years or beyond
c. Safe complementary food after 6 months
d. All
Ans: d
5. EBF is
a. Giving an infant only breast milk,
b. with the exception of drops or syrups consisting of vitamins, mineral
supplements, or drugs

c. No food or drink other than breast milk

d. All
Ans: d
6. Replacement feeding should be
a. Avoidable
b. Acceptable
c. Affordable
d. B and c
Ans: d
7. AFASS stands for
a. Acceptable, feasible, affordable, sustainable and safe
b. Avoidable, feasible, affordable, sustainable and safe
c. Acceptable, feasible, affordable, suitable and safe
d. Acceptable, feasible, affordable, suitable and sustainable
Ans: a
8. True is
a. . All HIV infected pregnant women should have PPTCT interventions provided
early in pregnancy as far as possible.
b. No PPTCT interventions are needed in early pregnancy
c. Mixed feeding can be done
d. Breast feeding does not affect the risk of getting HIV
Ans: a
9. Exclusive breastfeeding is the recommended infant feeding choice after first 6
months, irrespective of the fact that mother is on ART early or infant is provided with
ARV prophylaxis for 6 weeks. True or false
Ans: false
10. Mother should be receiving ___ during the whole duration of breastfeeding
a. ART
b. Treatment for OIs
c. Treatment for UTI
d. Treatment for STI
Ans: a
11. For breastfeeding infant diagnosed as HIV negative, breastfeeding should be
continued until
a. 6 months
b. 12 months
c. 3 months
d. 9 months
Ans: b
12. Confirmation test for HIV has to be done at __ months irrespective of the earlier EID
status
a. 20 months
b. 24 months
c. 18 months

d. 12 month
Ans: c
13. Breast feeding should be
a. Continued ideally for 2 yers
b. Should not be stopped abruptly
c. Should be stop once a nutritionally adequate diet can be provided
d. All
Ans: d
14. Advantage of BF are
a. Easily digestible
b. Available
c. No preparation needed
d. All
Ans: d
15. Mother requires additional calories to support breastfeeding. True or false
Ans: true
16. Advantage of wet nurses are
a. Same as breast feeding
b. Wet nurse is not required to be HIV negative
c. Must not be always available
d. All
Ans: a
17. Expressed Heat-treated Breast Milk can be used within
a. 1 hour
b. 2 hour
c. 3 hour
d. 4 hour
Ans: a
18. Replacement feeding, infant is
a. More likely to getsick
b. Formula is cheap
c. Must not be made fresh each time
d. All
Ans: a
19. Infant-feeding counselling, education, and support should
a. Be provided before and after birth
b. Be based on national protocol
c. Be based on a womans circumstances
d. All
Ans: d
20. Infant-Feeding Counselling Steps
a. Step 1 Explain risks of MTCT
b. STEP 2: Explain advantages and disadvantages of different feeding options,
starting with mothers initial preference

c. STEP 3: Explore mothers home and family situation

d. All
Ans: d
6 Counseling and its importance in HIV
1. Counselling is an __ communication
a. Inter personal
b. International
c. Immense
d. Inert
Ans: a
2. In counselling, a person makes use of his/her
a. Time
b. Knowledge
c. A and b
d. Skill
e. All
Ans: e
3. Aims of counselling are
a. Empowering
b. Taking decisions
c. Taking actions
d. All
Ans: d
4. Objective of counselling are
a. Behavioural change
b. Social change
c. Physical change
d. All
Ans: a
5. Counselling improves
a. Affect
b. Effectiveness
c. Mental health
d. B and c
e. All
Ans: d
6. Counselling should be done when
a. Person needs it
b. Situation demands
c. Behaviour needs
d. All
Ans: d

7. Counselling is not a
a. Profession
b. Confession
c. Health education
d. Only b and c
Ans: d
8. Giving health education is counselling. True or false. Ans: False
9. Counselling means
a. Helping process
b. Face to face communication
c. Providing psychological support
d. All
Ans: d
10. Counselling helps a person to understand his own
a. Needs
b. Capabilities
c. Restrictions
d. All
Ans: d
11. All are types of counselling except
a. One to one
b. One to group
c. Casual conversation
d. One to community
Ans: d
12. Counsellor is a person with
a. Real compassion
b. Motivated
c. Skills
d. All
Ans: d
13. Counsellor should maintain all except
a. Confidentiality, non judgemental
b. Skilful, emotionally stable
c. Judgemental, confidentiality
d. Skilful, listener, easily approachable
Ans: c
14. Tips for good counselling includes all except
a. Greet your client
b. Make him comfortable
c. Interrupt while he/she is talking
d. Illicit more information from the client
Ans: c
15. Empathy Is all except

Understand a persons feeling

Listen actively
Assure how client feels
Listening to non verbal expression
Ans: c
16. HIV counselling helps in
a. Identifying HIV positive women to provide services
b. Entry point to HIV care, support and treatment
c. Helps in reducing behaviours that increase HIV risks
d. All
Ans: d
17. Guiding principles for CT In PPTCT includes
a. Confidentiality
b. Providing information on need to know basis
c. Keeping medical records in safe place
d. All
Ans: d
18. Post test CT helps in
a. Providing information
b. Providing referral
c. Dont always give results in person
d. All
e. Only a and b
Ans: e
19. Preferred strategy for HIV CT is
a. Opt in
b. Opt out
c. Both
d. Physician referred
Ans: b
20. Pre test information in HIV CT
a. Prepares a woman & partner for the CT process
b. Explore personal risk
c. Protect confidentiality
d. All
Ans: d
a.
b.
c.
d.

7 laboratory tests for HIV in newborn

1. The benefit of prophylaxis decreases if give after
a. 48 hours
b. 72 hours
c. 96 hours
d. 36 hours

Ans: a
2. Peripartum period is the ideal time for HIV CT. True or False. Ans: False
3. All are true except
a. Peripartum period is the final opportunity to provide ARV prophylaxis to
HIV exposed infant
b. Positive antibody result establish infection in children < 18 months of age
c. Assays to detect virus should be used for diagnosis
d. Peripartum period should be viewed as a safety net to screen a small
number of women
Ans: b
4. In children older than 18 months of age, HIV can be diagnosed by
a. ELISA test
b. RIA
c. Immunoblot
d. All
Ans: a
5. Because a child with end-stage HIV disease may become HIV-antibody
seronegative as a result of severe humoral immunodeficiency, children who
are clinically suspected to be HIV-infected yet test HIV antibody negative
should be tested by
a. ELISA
b. DNA PCR
c. Western blot
d. RIA
Ans: b
6. Most HIV test looks for
b) Antibody
c) Antigen
d) Virus
e) Cd4 cells
Ans: a
7. children born to HIV positive women are born with passively acquired maternal
a. IgM
b. IgG
c. IgE
d. IgD
ans: b
8.
a)
b)
c)
d)

Window period is the interval between

Entry of HIV and exit
Entry of HIV and appearance of antibodies
Appearance of antibodies and exit
None
Ans: b

9.
a)
b)
c)
d)

Window period may range between

1-6 months
1-3 months
>6 months
12-18 months
Ans: a
10. During window period person may test positive for HIV by conventional tests
a) True
b) False
Ans: b
11. Antibody testing is not reliable in
a) Testing baby born to HIV positive mother
b) Diagnosing acute retroviral syndrome
c) Research
d) All
Ans: d
12. HIV test with high sensitivity is
a) ELISA
b) Western blot
c) Rapid tests
d) PCR
Ans: a
13. HIV test with high specificity are
A ) ELISA
b) Western blot
c) Rapid tests
d) PCR
Ans: b
14. ELISA can detect
a) IGM
b) IGA
c) IGG
d) Both a + b
Ans: d
15. ELISA is most commonly used screening method
a) True
b) False
Ans: a
16. Western blot is
a) Gold standard test
b) Test with high specificity
c) Costlier than ELISA
d) All

Ans: d
17. Rapid test
a) Allow result to be ready with 30 minutes
b) Allows testing and counseling
c) Allows referral
d) All
Ans: d
18. West Africa infection with HIV 2 is common
a) True
b) False
Ans: a
19. PCR detect
a) Virus
b) Antigen
c) Antibody
d) All
Ans: a
20. To diagnose baby born to HIV positive mother with HIV
a) PCR is used
b) Rapid test used
c) Elisa used
d) Western blot is used
Ans: a

8 Clinical management and Paediatric ART

1. To diagnose a child with HIV infection, all should be there except
a. Failure to thrive
b. Acute thrush
c. Frequent otitis media
d. Chronic diarrhoea
Ans: b
2. Slowly healing chiken pox can be there in child with HIV infection. True or false.
Ans: true
3. Following put a child on high risk of perinatal infection
a. Prenatal care
b. HIV testing
c. Immigrant children from Africa
d. Immigrant children from asia
Ans: c
4. HIV targets all except
a. CD 4 cells
b. CD 8 cells

c. RBCs
d. Macrophages
Ans: c
5. HIV enter the body by attaching to
a. Dendrites
b. Macrophages
c. CD 8 cells
d. CD 4 cells
Ans: d
6. HIV requires latency to persist in the body. True or False. Ans: False
7. HIV can be diagnosed by __ in children < 18 months of age
a. DNA PCR
b. ELISA
c. Western blot
d. RIA
Ans: a
8. HIV can be diagnosed by __ in children > 18 months of age
a. DNA PCR
b. ELISA
c. Western blot
d. RIA
Ans: b
9. Clinically category E is
a. Symptomatic
b. Perinatally exposed
c. Mild symptomatic
d. Not symptomatic
Ans: b
10. Clinically category N is
a. Symptomatic
b. Perinatally exposed
c. Mild symptomatic
d. Not symptomatic
Ans: d
11. Clinically category A is
a. Symptomatic
b. Perinatally exposed
c. Mild symptomatic
d. Not symptomatic
Ans: c
12. Clinically category B is
a. Moderate Symptomatic
b. Perinatally exposed
c. Mild symptomatic

d. Not symptomatic
Ans: a
13. Clinically category C is
a. Moderate Symptomatic
b. Perinatally exposed
c. Mild symptomatic
d. severe symptomatic
ans: d
14. category A includes all except
a. lymphadenopathy
b. hepatomegaly
c. spleenomegaly
d. anaemia
ans: d
15. category B includes
a. neutropenia
b. thrombocytopenia
c. anaemia
d. all
ans: d
16. category C includes all except
a. bacterial infections
b. candidiasis
c. CMV disease
d. Toxoplamosis
Ans: d
17. Immunologically, category 1 is CD 4 count
a.>25%
b. <25%
c. >50%
d. >60%
ans: a
18. Normally cd4 count declines to adult level by __ years
a. 5
b. 6
c. 7
d. 8
Ans: b
19. A 6 month old child with generalized lymphadenopathy and hepatosplenomegaly
(mild = A) CD 4 count of 2000 (normal = 1) is
a. Stage A1
b. Stage B1
c. Stage A2
d. Stage B2

Ans: a
20. Immune reconstitution syndrome, True is all except
a. develops Within 1-8 weeks of initiation HAART
b. Due to recovery of the immune system
c. Cannot be life-threatening
d. Treatment with steroids crucial
Ans: c