Why does the united states public health service recommend

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Assignment

Textbook: Pagana: Mosby's Manual of Diagnostic and Laboratory Tests, 6th Edition

AIDS (Acquired Immunodeficiency Syndrome)

Case Studies

The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months. Physical examination revealed right-sided pneumonitis. The following studies were performed:

Studies	Results
Complete blood cell count (CBC), p. 156
Hemoglobin (Hgb), p. 251	12 g/dL (normal: 14-18 g/dL)
Hematocrit (Hct), p. 248	36% (normal: 42%-52%)
Chest x-ray, p. 956	Right-sided consolidation affecting the posterior lower lung
Bronchoscopy, p. 526	No tumor seen
Lung biopsy, p. 688	Pneumocystis jiroveci pneumonia (PCP)
Stool culture, p. 797	Cryptosporidium muris
Acquired immunodeficiency syndrome (AIDS) serology, p. 265
p24 antigen	Positive
Enzyme-linked immunosorbent assay (ELISA)	Positive
Western blot	Positive
Lymphocyte immunophenotyping, p. 274
Total CD4	280 (normal: 600-1500 cells/L)
CD4%	18% (normal: 60%-75%)
CD4/CD8 ratio	0.58 (normal: >1.0)
Human immune deficiency virus (HIV) viral load, p. 265	75,000 copies/mL

Diagnostic Analysis

The detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP is an opportunistic infection occurring only in immunocompromised patients and is the most common infection in persons with AIDS. The patient's diarrhea was caused by Cryptosporidium muris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stool culture. The AIDS serology tests made the diagnoses. His viral load is significant, and his prognosis is poor.

The patient was hospitalized for a short time for treatment of PCP. Several months after he was discharged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventually and died 18 months after the AIDS diagnosis.

Task

Question A. What is the relationship between levels of CD4 lymphocytes and the likelihood of clinical complications from AIDS?

Question B. Why does the United States Public Health Service recommend monitoring CD4 counts every 3-6 months in patients infected with HIV?

Question C. This is patient seems to be unaware of his diagnosis of HIV/AIDS. How would you approach to your patient to inform about his diagnosis?

Question D. Is this a reportable disease in Florida? If yes. What is your responsibility as a provider?

Reference no: EM133521475

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