C P D  Q U E S T I O N S
Journal 42

Two CPD points are awarded for the correct completion and submission of the questions below.

CPD questionnaires must be completed online via www.cpdjournals.co.za.
After submission you can check the answers and print your certificate.

This programme is available free of charge to members of the HIV Clinicians Society and SAMA only.

Regarding missed opportunities to prevent HIV-related 
paediatric admissions:
1.    True (A) or false (B): 
  Gastro-enteritis was the most common reason for admission in the sample 

of 440 HIV-infected children admitted to Baragwanath Hospital. 
2. True (A) or false (B):
  In this study, most HIV-infected children admitted to hospital were known 

to be HIV-infected prior to admission. 
3. True (A) or false (B):
  Postnatal uptake of co-trimoxozole was very high in this study and was not 

commonly related to the reason for admission. 
4.  True (A) or false (B):
  Failure to receive appropriate PMTCT interventions contributes to a large 

proportion of paediatric admissions related to HIV infection. 

Regarding health services for individuals who do not yet  
require ART:
5. True (A) or false (B):
   Loss to follow-up among HIV-infected individuals who are not yet on ART 

is common, but is unlikely to be related to long-term health outcomes. 
6. True (A) or false (B):
  A simple package of services may help to improve retention in pre-ART care 

and thus facilitate regular CD4 cell count testing. 

Regarding optic neuritis in HIV-infected individuals:
7. True (A) or false (B):
  The most common cause of optic neuritis in HIV is NRTI-related 

mitochondrial toxicity. 
8. True (A) or false (B):
  There is now consensus that high-dose steroids are part of the definitive 

management of optic neuritis in HIV-infected individuals. 
9. True (A) or false (B):
  In a patient not on antiretroviral therapy (ART), initiation of ART may be 

part of the effective management of optic neuritis. 
10. True (A) or false (B):
  Cytomegalovirus, toxoplasmosis and cryptococcus are common 

opportunistic infections with ophthalmological manifestations. 

Regarding postnatal depression in HIV-infected women:
11. True (A) or false (B):
  Postnatal depression occurs in up to 40% of all HIV-infected women, and 

typically begins within 6 weeks of birth. 

12. True (A) or false (B):
  Postnatal depression does not have HIV-related risk factors (e.g. related to 

stigmatisation of HIV infection or non-disclosure of HIV status) and does 
not appear more commonly in HIV-infected compared with uninfected 
women. 

13. True (A) or false (B):
  Key symptoms of postnatal depression are fatigue, irritability and poor 

functioning, including child care. 

Regarding the development of HIV services in Khayelitsha, 
 Cape Town:
14. True (A) or false (B):
  Decentralised management of drug-resistant tuberculosis (TB) to primary 

care clinics (rather than hospital-based care for all patients with drug-
resistant TB) can decrease the average time to treatment initiation. 

15. True (A) or false (B):
  Evidence from Khayelitsha suggests that an early viral load after 3 months 

on ART is a better predictor of subsequent virological failure than viral load 
testing at 6 months. 

16. True (A) or false (B):
  Development of ‘male-friendly’ clinics located away from traditional public 

sector clinics (e.g. around taxi ranks) can help to increase the uptake of 
services as well as detection and effective treatment of men with sexually 
transmitted infections. 

Regarding the use of stavudine:
17. True (A) or false (B):
  Stavudine is appreciably more expensive than tenofovir or abacavir, and 

cost is the principal reason why tenofovir replaced stavudine in first-line 
ART regimens in South Africa. 

18. True (A) or false (B):
  Randomised controlled trials have shown that stavudine 20 mg given twice 

daily is as effective as 40 mg given twice daily. 
19. True (A) or false (B):
  Lipoatrophy related to stavudine use typically manifests within the first 

year on treatment. 
20. True (A) or false (B):
  Lipoatrophy related to stavudine use is usually dose-related, and occurs less 

frequently at lower doses.