PBL Sessions: AIDS

Page 4

Further History (Celeste):

Celeste returns a month later. She feels fine. The HIV by EIA is still positive, and the Western blot assay appears the same. The p24 antigen assay is positive. A fetal ultrasound shows no abnormalities. The fetus measures 19 weeks gestational age.

You raise the issue of risk factors. You suggest that, though there are certainly family issues that will be difficult, and consent must be obtained, testing of other family members may be of importance. She is still shocked by the result. She has never had any major illnesses. The last time she was sick for more than a day was in college, when she thought she had "mono" for several weeks with fever, sore throat, a very mild diffuse erythematous skin rash, and tender lymph nodes.

Further History (Mike):

Mike's cold agglutinin titer was found to be increased. He was treated with erythromycin and improved.

Tasks

• What do these findings indicate?

• What are the reporting requirements for HIV/AIDS?

• What is necessary to do if the fetus is to be protected?

• What hypotheses explain these findings?

• Explain your reasoning for the hypotheses you choose.

• What learning issues are being identified?

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