1) A 45-year-old man HIV positive known more than 5 years without treatment was brought to the infectious disease department with a three-week history of headache, fever, and Coma GCS 10/15. A lumbar puncture with yellowish CSF and an increasing intracranial opening pressure up to 30 cmH2O and total lymphocytes count 600 cells/mm3. What is your decision?

2) (CS) A 19-year-old man has donated blood for the first time. Despite having no risk factors for human immunodeficiency virus (HIV) infection, his blood tests positive for HIV by enzyme immunoassay (EIA). Which of the following statements is correct?

3) (CM).A 44-years patient HIV + develops severe cough and shortness of breath on exertion. On examination, he appears dyspneic, respirations24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse peri-hilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver (silver staining). Which of the following is the most appropriate next step in management?

4) Quelles sont les antigènes spécifiques du virus VIH-1 ? : (CM)

5) (CS) la fenêtre virologique de détection virus est de (temps pendant lequel de détection du virus est impossible)

6) (CS). A34-year-old man HIV +/under HAART, presents with diarrhea 3 weeks after returning from a trip to kg SOM. Over the past few weaks, he has gradually developed severe head ache, and lower abdominal pain and diarrhea. Now the symptoms are much worse with malaise, and a severe head ache, confusion. . He is afebrile, the abdomen is tender in left lower quadrant, and his stools tests show tinea solium.Which offollowing the initial

7) (CS).A 19-year-old woman HIV+ , CD4 = 450/mm3 was traveling in a rural Kandal. She returned 3 weeks ago and, over the past few days, has gradually developed lower abdominal pain and diarrhea. Now the symptoms are much worse with 10 stools a day consisting mostly of mucus and blood. She is febrile, the abdomen is tender in left lower quadrant, and the remaining examination is normal. Her stool is mostly comprised of blood and mucus. Which of the following is the most likely causative organism?

8) Le risque de transmission du VIH d`une mèreà son enfanten absent de traitement :

9) (C S).A 25-year-old HIV+ patient known more than 10 years without Anti Retro Viral treatment . On day he develops severe head ache and right hemiplesia. On examination, he appears malaise, head ache and right hemiplesia, BP: 14/8 mm/Hg, pulse 80/min, and his CD4 count 57 cells /mm3 Which of the following is the most appropriate next step in diagnosis?

10) Le risqué de transmission du VIH d`une mère à son enfant en l`absent de traitement :

11) (CS). A24-year-old woman complains of pain every time she eats or drinks anything. She is HIV positive, but currently not on any antiretroviral therapy. Her last CD4 count was 250/mm3. Select the most likely pathogen causing infection.

12) (CS).A31-year-old woman presents with symptoms of vulvar itching and burning made worse by urinating. She has no fever or frequency, but has noticed a recent whitish vaginal discharge. Clinical examination reveals vulvar erythema, edema, and fissures. On speculum examination, there is a white discharge with small white plaques loosely adherent to the vaginal wall. Which of the following treatments is appropriate for her asymptomatic HIV+ male sexual partner?

13) (CS). A22-year-old woman HIV+ complains of vulvar itching, burning, and pain when voiding urine. She has no other symptoms of fever, vaginal discharge, or urinary frequency. Physical examination reveals some vulvar ulceration but no vaginal discharge. The ulcers are small 2–3-mm lesions with an erythematous base. Which of the following is the most likely diagnosis?

14) A 40-year-old HIV positive woman was brought to the infectious disease department with a one week of severe headache, fever, and altered mental status. A lumbar puncture with CSF clear an intracranial opening pressure is 35 cmH2O. He was treated as Cryptococcal meningitis and 5 days after she completely improved. One week CSF analysis showed Cyto-biochemistry is normal. No organisms were observed on Gram stain of the CSF. Negative of India Ink test and Culture of the CSF also negative. What is your decision?

15) (CS) Une jeunne fille ayant de VIH> 5ans avec CD4 : 45/mm3, et encours de traitement par des TB et ARV (anti- rétroviral débuté 2 semaines après les Anti- TB) avec une bonne réponde aux traitements : CD4 =250/mm3, Charge Viral HIV : indétectable . Mais au J45, elle se présent : Fièvre, asthénie, céphalée et toux. Que pensez- vous dans cette situation?

16) A 40-year-old HIV positive woman was brought to the infectious disease department with a one week of severe headache, fever, altered mental and focal neurological signs. After completed patient examination, you think that the first diagnosis is Cryptococcal neuro meningitis but the patients not allow you to do the LP. What is your further tests?

17) (CM).A 44-years patient HIV + develops severe cough and shortness of breath on exertion. On examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse peri- hilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver (silver staining). Which of the following is the most appropriate next step in management?

18) (CS). A24-year-old woman complains of pain every time she eats or drinks anything. She is HIV positive, but currently not on any antiretroviral therapy. Her last CD4 count was 250/mm3. Select the most likely pathogen causing infection.

19) La prévention de la pneumocystose pulmonaire chez un VIH

20) (CS).A 19-year-old woman HIV+ , CD4 = 450/mm3 was traveling in a rural Kandal. She returned 3 weeks ago and, over the past few days, has gradually developed lower abdominal pain and diarrhea. Now the symptoms are much worse with 10 stools a day consisting mostly of mucus and blood. She is febrile, the abdomen is tender in left lower quadrant, and the remaining examination is normal. Her stool is mostly comprised of blood and mucus. Which of the following is the most likely causative organism?

21) (CS) A 22-year-old married woman has an High risk factors for human immunodeficiency virus (HIV) infection, ( her husband died of HIV+ 1 years ago) her blood tests for many times was Negative for HIV by enzyme immunoassay (EIA) . Which of the following statements is correct?

22) (CS) Une jeunne fille ayant de VIH> 5ans avec CD4 : 45/mm3, et encours de traitement par des TB et ARV (anti-rétroviral débuté 2 semaines après les Anti- TB) avec une bonne réponde aux traitements. Mais au J35, elle se présent : Fièvre, asthénie et toux. Quel l`examen nécessaire pour diagnostiquer PARADOXAL syndrome ?

23) A 45-year-old HIV positive man was brought to the infectious disease department with a week history of headache, fever, and Coma GCS 10/15. A lumbar puncture with turbid CSF and an increasing intracranial opening pressure up to 25 cmH2O. What is your decision?

24) (CS) La positivité de l `Antigen p 24 est possible à partir de :

25) Le diagnostic de la méningite à cryptococcose ? :

26) (CS). A34-year-old man HIV +/under HAART, presents with diarrhea 3 weeks after returning from a trip to kg SOM. Over the past few weaks, he has gradually developed severe head ache, and lower abdominal pain and diarrhea. Now the symptoms are much worse with malaise, and a severe head ache, confusion. . He is afebrile, the abdomen is tender in left lower quadrant, and his stools tests show tinea solium. Which of following the initial?

27) Parmi les propositions suivantes, lequel est correct :

28) Quelles infections opportunistes sont plus rencontrées au Cambodge : (CM)

29) A 27-year-old HIV positive factory worker was brought to the infectious disease department with a 2-week history of headache, fever, and altered mental status. A lumbar puncture with clear CSF and an increasing intracranial opening pressure up to 47 cmH2O. What is the most likely diagnosis with this finding?

30) La positivité d`un test ELISA est possible à partir de :

31) (C S).A 25-year-old HIV+ patient known more than 10 years without Anti Retro Viral treatment . On day he develops severe head ache and right hemiplesia. On examination, he appears malaise, head ache and right hemiplesia, BP: 14/8 mm/Hg, pulse 80/min, and his CD4 count 57 cells /mm3 . Which of the following is the most appropriate next step in diagnosis?

32) (CS) Parmi les manifestation suivantes, le quelle sont classante pour le stade de SIDA?

33) La fenêtre virologique de détection du virus VIH est de :

34) Parmi les propositions suivantes lequel est correcte ?

35) (CS) A 19-year-old man has donated blood for the first time. Despite having no risk factors for human immunodeficiency virus (HIV) infection, his blood tests positive for HIV by enzyme immunoassay (EIA). Which of the following statements is correct?

36) Au Cambodge le diagnostic de VIH est posé formellement sur :

37) En ce qui concerne le délai d`introduction des antirétroviraux lors d`une infection opportuniste : (S) : semaine

38) (CS). A22-year-old woman HIV+ complains of vulvar itching, burning, and pain when voiding urine. She has no other symptoms of fever, vaginal discharge, or urinary frequency. Physical examination reveals some vulvar ulceration but no vaginal discharge. The ulcers are small 2–3mm lesions with an erythematous base. Which of the following is the most likely diagnosis?

39) (CS) A 22-year man HIV+ under HAART with viral load of HIV underdetected is back travel from Kampong som. Ten days after arriving, she develops symptoms of anorexia, malaise, and abdominal cramps followed by a sudden onset of watery diarrhea. There are no symptoms of fever or chills, and the stools are nonbloody.The most likely pathogen causing infection.

40) (CS) A 22-year man HIV+ under HAART with viral load of HIV underdetected is back travel from Kampong Som. Ten days after arriving, she develops symptoms of anorexia, malaise, and abdominal cramps followed by a sudden onset of watery diarrhea. There are no symptoms of fever or chills, and the stools are non bloody. The most likely pathogen causing infection?

41) (CS).A31-year-old woman presents with symptoms of vulvar itching and burning made worse by urinating. She has no fever or frequency, but has noticed a recent whitish vaginal discharge. Clinical examination reveals vulvar erythema, edema, and fissures. On speculum examination, there is a white discharge with small white plaques loosely adherent to the vaginal wall. Which of the following treatments is appropriate for her asymptomatic HIV+ male sexual partner?