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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?
* Ask about cd4 and viral load and last test
* Ask about he of opportunistic infections
* Ask about medication side effects
* What else?
* Labs - rapid testing, 4th gen, viral load and cd4, etc
* 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)
* 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
* Psychiatric table 3
* Special Circumstances