MBchB study guide

Apr 25th, 2015
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UNIT 3:PREVENTION AND TREATMENT OFOPPORTUNISTIC INFECTIONSDr.John KinuthiaMedical specialist ,KNHFollowing infection with HIV the immunityprogressively declines over timeAs a result of the decline in immunity,opportunistic diseases (esp. infections)become more frequentPreventive interventionsKeep the patient stableReduce the risk of early death from theopportunistic infectionsOpportunistic diseasesTuberculosisHerpes zoosterCandidiasisPneumocystis carinii pneumonia (PCP)MalariaCryptococcal meningitisCryptosproridium induced diarrhoeaKaposi sarcomaLymphomaCervical cancerPrevention of OIsGood personal hygieneGood nutritionAvoidUnpasteurised milkUnder cooked food (meat, poultry)Salads (streets)Unclean waterProtective clothingAvoid catsdrugsMultivitamins to provide necessary micronutrientsHaematinics to prevent anaemiaChemoprophylaxisNutritionSmall but frequent feedsBalanced diet (energy,protein rich)Micronutrientsfound in green leafy vegetables,carrots,avocado,tomatoesprophylaxisDecision on when to start prophylaxis can be mademore precisely when the immune status is monitoredthrough regular CD4 counts (3-6 months)In absence of CD4 counts, physical examination atregular intervals may give useful guidelinesPrimary prophylaxis is started before a certain illnessis clinically evidentSecondary prophylaxis is employed to preventrel

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