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  #1  
Old 08-06-2012
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Question Cause of Diarrhea in this HIV patient!

A 37-year-old woman with AIDS comes to the physician because of a 1-month history of progressive diarrhea and a 1.8-kg weight loss. During the past week, she has had six large watery stools daily. She is currently receiving triple antiretroviral therapy. She is employed as a flight attendant and works regularly on domestic flights throughout the USA. She also flies to Asia at least once monthly. She is 163 cm (5 ft 4 in) tall and weighs 59 Kg (130 lb); BMI is 22 kg/m2. Her temperature is 37C (98.6F), pulse is 88/min, and blood pressure is 112/64. The abdomen is sacphoid. The remainder of the examination is normal. Her CD4+ T-lymphocyte count is 400/mm3 (Normal >500). Which of the following is the most likely causal organism?

A. Cryptosporidium parvum
B. Cytomegalovirus
C. Mycobacterium avium-intracellulare complex
D. Salmonella enteritidis
E. Strongyloides stercoralis
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  #2  
Old 08-06-2012
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Cruptosporidium parvum, acid fast cysts in stool will confirm the diagnosis. especially when CD count is less than 200. the best choice here.
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Quote:
Originally Posted by tyagee View Post
plz see thumbnail for q
plz give expln along
Cryptosporidium parvum since she has no fever and h/o travel to asia.
It causes chronic watery diarrhea with malabsorption in AIDS patients.
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Old 08-06-2012
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kinda remember that C.parvum would be the case if T-lymphocytes were below 200... Looking for a "tricky question on here"
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Ans is E ........ Strongyloides stercoralis it causes watery diarrhea and malabsorption and wt loss .....and found in ASIA .....pts CD4 is not low for cryptosporidium to act .........
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Old 08-06-2012
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Answer is A
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Old 08-07-2012
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Quote:
Originally Posted by Hitman View Post
Ans is E ........ Strongyloides stercoralis it causes watery diarrhea and malabsorption and wt loss .....and found in ASIA .....pts CD4 is not low for cryptosporidium to act .........
it also causes pulmonary symp ..isnt ?
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Quote:
Originally Posted by tyagee View Post
it also causes pulmonary symp ..isnt ?
yes but only 10 % patients have symptomatic pulmonary lesion ...

so the patient can present with GIT symptoms only ....... plus it causes malabsorption and chronic diarrhea and seen in african and asian population ..

whats the ans ??
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Old 08-07-2012
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wats the ans to this Q and others ??
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ans is cryptosporidium
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Quote:
Originally Posted by tyagee View Post
ans is cryptosporidium

but does it not cause diarrhea when CD4 less than 200 .....

i thought it was a tricky Qs ... but turned out to be a simple one

still i got it wrong due to my over smartness ...
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Old 08-07-2012
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Another answer can be Isospora i.e diarrhea in a aids pt
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Old 08-07-2012
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@ hitman Wat up ,so when u taking the test ,u finished UW ? ,u r doing rotations or just studying .i guess i have asked too many Qs hehe
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Quote:
Originally Posted by step_enhancer View Post
@ hitman Wat up ,so when u taking the test ,u finished UW ? ,u r doing rotations or just studying .i guess i have asked too many Qs hehe
taking it on early october ....:sorry:
done with only 50 % UW ......
mostly studing only few days of rotation ...
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Quote:
Originally Posted by Hitman View Post
but does it not cause diarrhea when CD4 less than 200 ....
The fact you need to keep in mind is that Cryptosporidium parvum can cause chronic watery diarrhea in normal as well as in HIV patients. Only difference being is that in a normal person it is self limiting but an HIV patient needs treatment.
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Gastroenterology-, Infectious-Diseases, Internal-Medicine-, Step-2-Questions

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