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