EMplify – July 2021

Announcements: Be on the lookout for an announcement regarding the new EB Medicine app, coming to an App Store near you this month !!

HIV- An Interview With Dr. Daniel Egan

See the EB Medicine Article @ https://www.ebmedicine.net/topics/infectious-disease/HIV

Why HIV?
2018 , 1,2 million people living with HIV, almost 40k new infections
People living with HIV visit the ED 3 x per year on average
HIV infected patients accounted for 6 in 1000 ED visits in 2017
New Transmission of HIV, Figure 1
What does acute infection look like ?
What about chronic infection ?The chronic phase can last 10 years or more and be asymptomatic.
Are people with HIV more likely to develop: CAD, COPD, DVT and why?
What if they are on medication for HIV?
Screening in the ED, everyone? Do they have to have symptoms or risks?
What does universal screening mean?
What does risk based screening mean?
What are the risk factors? What if I see someone on PrEP who is in the ED for an unrelated complaint?
History
Ask about cd4 and viral load and last test
Ask about he of opportunistic infections
Ask about medication side effects
What else?
Exam
Labs – rapid testing, 4th gen, viral load and cd4, etc
Imaging
Treatment
Table 1
Highly effective and reduces transmission
Medication side effects (we don’t have to dwell on each Med and side effect and just reference the charts)
hep B virus deactivation
System Based Disease
Heart Failure and CAD
PCP (role of LDH)
TB
COPD
Renal Disease – stones , radiolucent
Neurologic- CVA, cryptococcal meningitis, toxo, progressive multi focal leukoencephalopathy, HAND
GI – diarrhea causes, c diff, hep C
Heme- cytopenia
Endocrine – metabolic syndrome
Musculoskeletal
Psychiatric table 3
Derm
Special Circumstances
PEP
PrEP

Episode 59 – HIV – An Interview With Dr. Daniel Egan

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