Cert ID(SA) Phys Practice Questions - CMSA Sub-specialty Certificate In Infectious Diseases Cert ID(SA) Phys - South Africa Exam

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A 29-year-old woman with newly diagnosed HIV infection presents for ART initiation. She is completely asymptomatic. Her CD4 count returns at 38 cells/µL. Serum Cryptococcal Antigen (CrAg) screening is positive. She has no headache, fever, neck stiffness, or altered mental status. What is the most appropriate next step in management?

Administer IV Liposomal Amphotericin B 3 mg/kg daily for 14 days as inpatient induction Perform a diagnostic lumbar puncture to measure opening pressure and rule out subclinical cryptococcal meningitis Start Dolutegravir-based ART immediately on the same day and monitor for cryptococcal symptoms Initiate oral Fluconazole 800 mg daily immediately without further investigation

Correct Answer:

Perform a diagnostic lumbar puncture to measure opening pressure and rule out subclinical cryptococcal meningitis

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