{"id":3932,"date":"2024-06-26T14:59:00","date_gmt":"2024-06-26T14:59:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=3932"},"modified":"2025-10-01T11:38:22","modified_gmt":"2025-10-01T19:38:22","slug":"usmle-step-2-question-of-the-day-hiv-positive","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive","title":{"rendered":"USMLE\u00ae Step 2 Question of the Day: HIV positive"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_2_CK_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 2 CK Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em><strong>Explore a crucial aspect of HIV management with this scenario-based\u00a0<em>USMLE Step 2 CK<\/em>\u00a0question. Learn about recommended screening tests for newly diagnosed HIV-positive patients.<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 32-year-old biologically female patient presents to the primary care office for an initial visit after learning she is HIV-positive from a screening test. The patient does not have symptoms. Her past medical history is otherwise unremarkable, and she does not take medication. The patient is sexually active with one male partner. Temperature is 37.0\u00b0C (98.6\u00b0F), pulse is 90\/min, blood pressure is 128\/82 mmHg, and respiratory rate is 16\/min. Physical examination is within normal limits. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which of the following screening tests should be performed at this time?\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A.&nbsp;Nucleic acid amplification testing for trichomoniasis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.&nbsp;Hepatitis B e-antigen<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.&nbsp;Vaginal culture for bacterial vaginosis<br><\/strong><br><strong>D.&nbsp;Treponema pallidum&nbsp;passive particle agglutination<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Anti-Hepatitis A IgM antibodies<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down for the correct answer!<\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_2_CK_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 2 CK Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A.\u00a0Nucleic acid amplification testing for trichomoniasis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s see why the answer wasn&#8217;t B, C, D, or E. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.\u00a0Hepatitis B e-antigen<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;The recommended screening tests included in the hepatitis B screening panel are: hepatitis B surface antigen, antibody to hepatitis B surface antigen, and total antibody to hepatitis B core antigen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.&nbsp;Vaginal culture for bacterial vaginosis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Routine screening for bacterial vaginosis (BV) is not recommended. When indicated based on symptoms, the preferred tests for BV are saline microscopy or nucleic amplification testing.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D.&nbsp;Treponema pallidum&nbsp;passive particle agglutination&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>This patient should be screened for syphilis (caused by&nbsp;Treponema pallidum)&nbsp;with a non-treponemal test first, either a Venereal Disease Research Laboratory (VDRL) or Rapid Plasma Reagin (RPR). If that testing is positive, it should be followed by a treponemal test, such as the&nbsp;T. pallidum&nbsp;passive particle agglutination (TP-PA) test.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Anti-Hepatitis A IgM antibodies<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Patients with HIV should be screened for hepatitis B and C and vaccinated against hepatitis A and B. This patient does not have an indication to check hepatitis A antibodies.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" height=\"558\" width=\"1024\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/hiv-positive.png?w=1024\" alt=\"HIV POSITIVE\n1ST EVALUATIONS AFTER HIV Dx\n* Gonorrhea &amp; Chlamydia\n* Trichomoniasis \n* Syphilis\n* Hepatitis B &amp; C\n* HPV &amp; Cervical Cancer (routine guidelines for HIV)\n* Herpes Serology (may be considered)\" class=\"wp-image-3937\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/hiv-positive.png 1244w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/hiv-positive.png?resize=300,164 300w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/hiv-positive.png?resize=768,419 768w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/hiv-positive.png?resize=1024,558 1024w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">This patient who has been newly diagnosed with&nbsp;HIV infection&nbsp;should have screening for&nbsp;trichomoniasis&nbsp;using&nbsp;nucleic acid amplification testing, as well as a baseline screening for other infectious diseases. Continued&nbsp;annual screening&nbsp;for trichomoniasis should be considered for patients with HIV infection.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The testing for a patient presenting for&nbsp;sexually transmitted infection (STI) screening&nbsp;varies depending on the patient\u2019s&nbsp;risk factors&nbsp;for STIs.&nbsp;HIV infection&nbsp;is an indication to increase the frequency&nbsp;of testing from what is recommended for the general population, as well as to expand the types of tests done beyond what is needed for low-risk patients. Screening for STIs is indicated at the first evaluation following a new diagnosis of HIV and includes testing for&nbsp;gonorrhea, chlamydia, trichomoniasis, syphilis, and hepatitis B and C. Screening for gonorrhea and chlamydia, trichomoniasis, and syphilis are then repeated at least annually. Human papillomavirus (HPV) and cervical cancer screening is based on routine guidelines for individuals with HIV. Herpes serology testing may also be considered in this population.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Additional factors to consider include&nbsp;patient age&nbsp;(annual for under age 25),&nbsp;pregnancy status, sexual practices including having&nbsp;new or multiple partners&nbsp;and having a sexual partner who has other&nbsp;concurrent partners, as well as living in an area with a&nbsp;high prevalence&nbsp;of disease. &nbsp;Men who have sex with men&nbsp;should also be screened frequently (at least&nbsp;annually) and in some cases as often as every three to six months.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Patient risk factors determine the frequency and type of sexually transmitted infection screening indicated. Patients with HIV infection should be initially screened for gonorrhea, chlamydia, trichomoniasis, syphilis, and hepatitis B and C.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Centers for Disease Control and Prevention: STDs during Pregnancy \u2013 CDC Detailed Fact Sheet. Last Reviewed: April 11, 2023. Accessed December 19, 2023.&nbsp;<a href=\"https:\/\/www.cdc.gov\/std\/pregnancy\/stdfact-pregnancy-detailed.htm#:~:text=NOTE%3A%20Pregnant%20women%20found%20to,be%20retested%20within%20three%20months\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.cdc.gov\/std\/pregnancy\/stdfact-pregnancy-detailed.htm#:~:text=NOTE%3A%20Pregnant%20women%20found%20to,be%20retested%20within%20three%20months<\/a>&nbsp;<\/li>\n\n\n\n<li>Centers for Disease Control and Prevention: Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. Last reviewed: June 6, 2022. Accessed December 19, 2023.&nbsp;<\/li>\n\n\n\n<li>Lee, Karen C. MD\u00a0et al. Sexually Transmitted Infections: Recommendations from the U.S. Preventive Services Task Force. American Family Physician. 2016;94(11):907-915.\u00a0<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/osmosis.org\/clinical-sciences\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/10\/Blog_Display_Ads_MD3_2023.png?w=700\" alt=\"\" class=\"wp-image-5300\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/10\/Blog_Display_Ads_MD3_2023.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2020\/10\/Blog_Display_Ads_MD3_2023.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><strong>Want more \u00a0USMLE\u00ae Step 2 CK practice questions?\u00a0Try Osmosis by Elsevier today! Access your\u00a0<a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>\u00a0and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Explore a crucial aspect of HIV management with this scenario-based\u00a0USMLE Step 2 CK\u00a0question. Learn about recommended screening tests for newly diagnosed HIV-positive patients. A 32-year-old biologically female patient presents to the primary care office for an initial visit after learning she is HIV-positive from a screening test. The patient does not have symptoms. Her past [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":3934,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,1370,45],"tags":[],"class_list":["post-3932","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-2-questions","category-step-2"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 2 Question of the Day: HIV positive - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-question-of-the-day-hiv-positive\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 2 Question of the Day: HIV positive - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Explore a crucial aspect of HIV management with this scenario-based\u00a0USMLE Step 2 CK\u00a0question. 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