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Instructions
Students must review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.
Case Study 1 & 2. See document attached.
The answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use past students’ work as all files submitted in this course are registered and saved in turn it in the program.
Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. No Straight forward / Simple answer will be accepted.
Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.
All answers to case studies must have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study
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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
Complete blood cell count (CBC), p. 156
Hemoglobin (Hgb), p. 251
Hematocrit (Hct), p. 248
Chest x-ray, p. 956
Bronchoscopy, p. 526
Lung biopsy, p. 688
Stool culture, p. 797
Acquired immunodeficiency syndrome
(AIDS) serology, p. 265
p24 antigen
Enzyme-linked immunosorbent assay
(ELISA)
Western blot
Lymphocyte immunophenotyping, p. 274
Total CD4
CD4%
CD4/CD8 ratio
Human immune deficiency virus (HIV)
viral load, p. 265
Results
12 g/dL (normal: 14–18 g/dL)
36% (normal: 42%–52%)
Right-sided consolidation affecting the posterior
lower lung
No tumor seen
Pneumocystis jiroveci pneumonia (PCP)
Cryptosporidium muris
Positive
Positive
Positive
280 (normal: 600–1500 cells/L)
18% (normal: 60%–75%)
0.58 (normal: >1.0)
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.
Copyright © 2018 by Elsevier Inc. All rights reserved.
Case Studies
2
Critical Thinking Questions
1. What is the relationship between levels of CD4 lymphocytes and the likelihood of
clinical complications from AIDS?
2. Why does the United States Public Health Service recommend monitoring CD4
counts every 3–6 months in patients infected with HIV?
3. 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?
4. Is this a reportable disease in Florida? If yes. What is your responsibility as a
provider?
.
Copyright © 2018 by Elsevier Inc. All rights reserved.
Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition
Iron-Deficiency Anemia
Case Study
A 72-year-old man developed chest pain whenever he was physically active. The pain ceased on
stopping his activity. He has no history of heart or lung disease. His physical examination was
normal except for notable pallor.
Studies
Electrocardiogram (EKG), p. 485
Chest x-ray study, p. 956
Complete blood count (CBC), p.
156
Red blood cell (RBC) count, p.
396
RBC indices, p. 399
Mean corpuscular volume
(MCV)
Mean corpuscular hemoglobin
(MCH)
Mean corpuscular hemoglobin
concentration (MCHC)
Red blood cell distribution width
(RDW)
Hemoglobin (Hgb), p. 251
Hematocrit (Hct), p. 248
White blood cell (WBC) count, p.
466
WBC differential count, p. 466
Result
Ischemia noted in anterior leads
No active disease
Platelet count (thrombocyte
count), p. 362
Half-life of RBC
Liver/spleen ratio, p. 750
Spleen/pericardium ratio
Reticulocyte count, p. 407
Haptoglobin, p. 245
Blood typing, p. 114
Iron level studies, p. 287
Iron
Total iron-binding capacity
(TIBC)
Transferrin (siderophilin)
Transferrin saturation
Within normal limits (WNL) (normal: 150,000–
400,000/mm3)
26–30 days (normal)
1:1 (normal)
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