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Download My Case Study Solution By Amanda Moorefield John is a 28
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MyCaseStudySolution ByAmandaMoorefield Johnisa28-year-oldmalewhohasbeeninarelationshipfor5years.Theyresidein Colorado.Heisaregisterednurseandhasbeenknowntotakefrequentmission tripstodevelopingcountries.Hismostrecenttripincludedhealthcareworkin SouthAfricaaboutamonthago.Herecentlybeganexperiencingsymptomssuchas headache,diarrhea,fatigue,feverandasorethroat.Heisworriedthathemayhave contractedabugwhileoverseas.Hegoestohishealthcareprofessionalwhodoes labworkandaskshimaseriesofquestions.Onesectionofhisworkupincludes questionsabouthissexualhistory.Johnstatesthathimandhispartnerhavebeen monogamousandbothtestedforSTDswithinthepastyear. 1. WhywouldJohn’sPCPaskabouthissexualhistoryforflu-likesymptoms? WhatsortofthingmightJohnhavecontractedwhileinAfrica? John’sPCPwastryingtocoverallareasincasethesymptomswerenotlinked tohistripbutinsteadsexualhistory.JohncouldhavecontractedanSTDfrom hispartner.WhileinAfrica,Johncouldhavecontractedanumberofdiseases. SomeincludeMalaria,DengueFever,HepatitisA&E,YellowFeverandTyphoid Fever.Theseinfectiousdiseaseswouldalsomakesensebecauseofthe influenzasymptomsthatJohnisexperiencing. Afewdayslaterafterthetestresultscomeback,John’sPCPcallstosaythatallofhis bloodworklooksrelativelynormalandheprobablyisjustsufferingfromthefluas Johnadmitstonothavingaflushotyetthatyear.HerecommendsthatJohnstays hydrated,restsandtakesfever-reducingmedicationssuchasibuprofenasneeded. 2.WhatsortofbloodworkdoyouthinkthatJohn’sPCPwastestingfor? HeprobablydidbasiclabworksuchasaCBC,BMP,HemoglobinA1C,UA,CRP antibodytestingforHepatitis,DengueFeverandSTDworkup. John’ssymptomssubsideafteraweekandheassumeshisPCPwasrightaboutthe flu.Hispartneracoupleweekslaterexperiencesthesameflu-likesymptomswhich makessenseashewasthesolecaretakerduringthistime.Oncehispartnerbegins tofeelbetteraswell,bothofthemremainasymptomaticfortherestoftheyear.It’s notuntilthenextyearthatJohnreturnsforroutinetestingthathisbloodwork comesbackabnormal.John’sCD4T-cellcounthasdroppeddownto1200cellsper microliter.John’sPCPwishestorunamorespecificantibodytest. 3.WhatistheriskofthisdropinCD4cells?WhatdoyouthinkJohn’sPCPistesting for? “ForanHIV-infectedperson,thenumberofCD4T-cellssteadilydrops,making themvulnerabletootherinfections--andindangerofdevelopingAIDS”(1). Withthisbeingsaid,John’sPCPistestingforHIV. John’stestcomesbackpositiveforHIVantibodies.Headmitstohavingunprotected sexwithhispartnerbuthasbeenroutinelytestedsodoesn’tunderstandhowthis couldhavehappened.John’spartneralsogoesinforHIVtestingandhisresults comebackpositiveaswell. 4.HowdoyouthinkJohncontractedHIV?HowdoyouthinkJohn’spartner contractedHIV? JohncontractedHIVfromaninfectedpatientofhisinAfricathenspreaditto hispartnerviaunprotectedsexualintercourse. 5.Howwouldyouexplaintheflu-likesymptoms,whicheventuallyresolved? UnrelatedorrelatedtotheHIVinfection? Flu-likesymptomsarecommon2-6weeksafterinitialinfectionofHIV.Thisis consideredtheearlystageofHIVinfectionandcanlastacoupleofweeks. DuringthistimeapersonmaytestnegativeforHIVwhichexplainsJohn’s initialnegativelabresult.Aftersymptomssubside,theinfectedpersonusually goesintoalatencyperiodwheretheyremainasymptomatic.IfHIVisnot caughtduringthistimethenitcouldprogresstofullblownAIDS.Itis importanttonotethatHIVcanbecontractedatanytimefromaninfected personduringtheprogressionthrougheachofthesestages. 6.WhatwouldbethenextstepintreatmentforbothJohnandhispartner? ThenexttreatmentstepwouldbetostartonHIVmedicinaltreatment.“HIVis treatedusingacombinationofmedicinestofightHIVinfection.Thisiscalled antiretroviraltherapy(ART).ARTisn’tacure,butitcancontrolthevirusso thatyoucanlivealonger,healthierlifeandreducetheriskoftransmitting HIVtoothers”(3).Johnandhispartnerwouldprobablybereferredtoan infectiousdiseasedoctororspecialistthatcanchooseaHIVregimenthatis bestsuitableforeachoftheirneeds. WorkCited 1. "AIDSandHIVSymptomsandSigns."WebMD.WebMD,n.d.Web.12May 2016.<http://www.webmd.com/hiv-aids/guide/understanding-aidshiv-symptoms>. 2. Baron,Penny."The10MostImportantBloodTests."LifeExtension.com.Life ExtensionMagazine,2006.Web.12May2016. <http://www.lifeextension.com/Magazine/2006/5/report_blood/Pag e-01>. 3. "OverviewofHIVTreatments."OverviewofHIVTreatments.Aids.gov,13Aug. 2015.Web.11May2016.<https://www.aids.gov/hiv-aidsbasics/just-diagnosed-with-hiv-aids/treatment-options/overview-ofhiv-treatments/>. 4. "SouthAfricaMajorInfectiousDiseases."IndexMundi.CIAWorldFactbook, 2015.Web.10May2016. <http://www.indexmundi.com/south_africa/major_infectious_diseas es.html>. 5. "WhatHappensWhenYouGetTestedforHIV?"HIVInsight.UCSF,3Aug. 2011.Web.10May2016. <http://hivinsite.ucsf.edu/insite?page=basics-00-18>.
