PBL Sessions: AIDS


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Laboratory Findings (Celeste):

A CBC shows Hgb 13.3 g/dL, Hct 40%, MCV 85 fL, platelet count 244,400/microliter, and WBC count 9070/microliter with differential count of 65 segs, 3 bands, 22 lymphs, 9 monos, and 1 baso. Serum chemistries show sodium 143 mmol/L, potassium 4.3 mmol/L, chloride 107 mmol/L, CO2 27 mmol/L, creatinine 1.0 mg/dL, and glucose 110 mg/dL. The HBsAg test is negative. She is rubella immune. CMV IgG titer is increased, but CMV IgM is not increased. Toxoplasma and HSV I and II titers are not increased. Her HIV EIA test is positive, with the Western blot assay as shown in lane A:

Figure 1: Western blot

Laboratory Findings (Mike):

A CBC shows Hgb 14.7 g/dL, Hct 44%, MCV 88 fL, platelet count 271,900/microliter, and WBC count 6005/microliter with differential count of 61 segs, 7 bands, 18 lymphs, 12 monos, and 2 eosinophils. Serum chemistries show sodium 145 mmol/L, potassium 4.4 mmol/L, chloride 109 mmol/L, CO2 28 mmol/L, creatinine 1.1 mg/dL, and glucose 94 mg/dL.

Radiologic Findings (Mike):

A chest x-ray shows bilateral patchy infiltrates, mainly in lower lung fields. The cardiac size is normal. No effusions are noted.

Tasks

  • What do these findings indicate?

  • What hypotheses explain these findings?

  • Explain your reasoning for the hypotheses you choose.

  • What learning issues are being identified?

  • What additional information might you request?

Stop !! Complete discussions and tasks before moving to the next page.