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Clinical Review Quiz

HIV Lipodystrophy Syndrome

Olumuyiwa Omolayo, MD

Dr. Omolayo is a hospitalist physician, Marshfield Clinic, Wausau, WI.

The questions below are based on the article
“HIV Lipodystrophy Syndrome”.

Choose the single best answer for each question.

1. Which of the following is not a complication comprising HIV lipodystrophy syndrome?
  1. Dyslipidemia
  2. Hypertension
  3. Insulin resistance
  4. Lipoatrophy
  5. Lipohypertrophy
Click here to compare your answer.

2. Which antiretroviral drug class is most commonly associated with development of lipoatrophy and lactic acidosis?

  1. Fusion inhibitor
  2. Integrase inhibitor
  3. Nonnucleoside reverse transcriptase inhibitor
  4. Nucleoside reverse transcriptase inhibitor
  5. Protease inhibitor
Click here to compare your answer.

3. A 45-year-old man with HIV infection on PI-based antiretroviral therapy presents for routine follow-up. His low-density lipoprotein cholesterol level has increased from a pretreatment value of 84 mg/dL to 178 mg/dL. Treatment with a statin is indicated, but the patient is concerned about drug interactions. Which of the following statins is not metabolized by the cytochrome P450 isoenzyme CYP3A4 and can be safely used in this patient?

  1. Atorvastatin
  2. Lovastatin
  3. Pravastatin
  4. Simvastatin
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4. All of the following are risk factors for the development of lactic acidosis EXCEPT
  1. Advanced immunosuppression
  2. Age older than 40 years
  3. Male gender
  4. Stavudine use
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5. According to the findings of the Data Collection on Adverse Events of Anti-HIV Drugs Study Group, what is the relative increase in the rate of myocardial infarction per year of exposure to antiretroviral therapy during the first 4 to 6 years?

  1. 6%
  2. 16%
  3. 26%
  4. 36%
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6. All of the following are helpful in making a diagnosis of body fat changes associated with HIV lipodystrophy syndrome EXCEPT

  1. Anthropometric measurements
  2. Bioelectrical impedance analysis
  3. Dual energy x-ray absorptiometry
  4. Magnetic resonance imaging
  5. Technetium bone scan
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7. All of the following are potential management strategies for lipohypertrophy EXCEPT

  1. Antiretroviral substitution to a non-PI-based regimen
  2. Exercise
  3. Metformin
  4. Recombinant human growth hormone
  5. Rosiglitazone
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