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Old 06-02-2012
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Question sore throat with rash... what test to order ?

A 28-year-old man is evaluated at a community health center for a 10-day history of sore throat, headache, fever, anorexia, and muscle aches. Two days ago, a rash developed on his trunk and abdomen. He had been previously healthy and has not had any contact with ill persons. He has had multiple male and female sexual partners and infrequently uses condoms. He has been tested for HIV infection several times, most recently 8 months ago; all results were negative.
On physical examination, temperature is 38.6C (101.4F). There are several small ulcers on the tongue and buccal mucosa and cervical and supraclavicular lymphadenopathy. A faint maculopapular rash is present on the trunk and abdomen. A rapid plasma reagin test is ordered. Which of the following diagnostic studies should also be done at this time?

(A) CD4 cell count measurement
(B) Epstein-Barr virus IgG measurement
(C) HIV RNA viral load and HIV antibody measurements
(D) Skin biopsy
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Old 06-02-2012
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Originally Posted by tyagee View Post
A 28-year-old man is evaluated at a community health center for a 10-day history of sore throat, headache, fever, anorexia, and muscle aches. Two days ago, a rash developed on his trunk and abdomen. He had been previously healthy and has not had any contact with ill persons. He has had multiple male and female sexual partners and infrequently uses condoms. He has been tested for HIV infection several times, most recently 8 months ago; all results were negative.
On physical examination, temperature is 38.6C (101.4F). There are several small ulcers on the tongue and buccal mucosa and cervical and supraclavicular lymphadenopathy. A faint maculopapular rash is present on the trunk and abdomen. A rapid plasma reagin test is ordered. Which of the following diagnostic studies should also be done at this time?

(A) CD4 cell count measurement
(B) Epstein-Barr virus IgG measurement
(C) HIV RNA viral load and HIV antibody measurements
(D) Skin biopsy
Mononucleosis with Rash or Diarrhea (which are uncommon in IM)is seen in acute HIV
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Old 06-02-2012
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Originally Posted by tyagee View Post
A 28-year-old man is evaluated at a community health center for a 10-day history of sore throat, headache, fever, anorexia, and muscle aches. Two days ago, a rash developed on his trunk and abdomen. He had been previously healthy and has not had any contact with ill persons. He has had multiple male and female sexual partners and infrequently uses condoms. He has been tested for HIV infection several times, most recently 8 months ago; all results were negative.
On physical examination, temperature is 38.6C (101.4F). There are several small ulcers on the tongue and buccal mucosa and cervical and supraclavicular lymphadenopathy. A faint maculopapular rash is present on the trunk and abdomen. A rapid plasma reagin test is ordered. Which of the following diagnostic studies should also be done at this time?

(A) CD4 cell count measurement
(B) Epstein-Barr virus IgG measurement
(C) HIV RNA viral load and HIV antibody measurements
(D) Skin biopsy
(C) HIV RNA viral load and HIV antibody measurements

Quote:
The stages of HIV infection are acute infection (also known as primary infection), latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, lymphadenopathy (swollen lymph nodes), pharyngitis (sore throat), rash, myalgia (muscle pain), malaise, and mouth and esophageal sores.
Infection with HIV generally occurs by introduction of bodily fluids from an infected person into the body of an uninfected person. A period of rapid viral replication ensues, leading to an abundance of virus in the peripheral blood. During primary infection, the level of HIV may reach several million virus particles per milliliter of blood.[19]
This response is accompanied by a marked drop in the numbers of circulating CD4+ T cells. This acute viremia is associated in virtually all patients with the activation of CD8+ T cells, which kill HIV-infected cells, and subsequently with antibody production, or seroconversion.
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Old 06-03-2012
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Originally Posted by tyagee View Post
A 28-year-old man is evaluated at a community health center for a 10-day history of sore throat, headache, fever, anorexia, and muscle aches. Two days ago, a rash developed on his trunk and abdomen. He had been previously healthy and has not had any contact with ill persons. He has had multiple male and female sexual partners and infrequently uses condoms. He has been tested for HIV infection several times, most recently 8 months ago; all results were negative.
On physical examination, temperature is 38.6C (101.4F). There are several small ulcers on the tongue and buccal mucosa and cervical and supraclavicular lymphadenopathy. A faint maculopapular rash is present on the trunk and abdomen. A rapid plasma reagin test is ordered. Which of the following diagnostic studies should also be done at this time?

(A) CD4 cell count measurement
(B) Epstein-Barr virus IgG measurement
(C) HIV RNA viral load and HIV antibody measurements
(D) Skin biopsy
(C) acute seroconvertion stage:viral load drop to stedy state,cd4 with in normal range ,and apperance of ab.take wks to months.
-A -CONCEDER DIAGNOSTIC MEAURE IN PT WITH AIDS.
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Old 06-03-2012
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Ans is. c.
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