Chat with us, powered by LiveChat The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months | WriteDen

The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months

PLEASE SEE ATTACHED THE 2 CASE STUDIES.

ANSWER EACH CASE STUDY IN A DIFFERENT WORD DOCUMENT, NOT IN THE SAME DOCUMENT.

2 PAGES FOR EACH CASE STUDY , TOTAL 4 PAGES

NO PLAGIO ACCEPTED MORE THAN 10 %

PROPER GRAMMAR 

4 REFERENCES NO OLDER THAN 5 YEARS OLD

DUE DATE JANUARY 20, 2023

Copyright © 2018 by Elsevier Inc. All rights reserved.

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 Results

Complete blood cell count (CBC), p. 156

Hemoglobin (Hgb), p. 251 12 g/dL (normal: 14–18 g/dL)

Hematocrit (Hct), p. 248 36% (normal: 42%–52%)

Chest x-ray, p. 956 Right-sided consolidation affecting the posterior

lower lung

Bronchoscopy, p. 526 No tumor seen

Lung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP)

Stool culture, p. 797 Cryptosporidium muris

Acquired immunodeficiency syndrome

(AIDS) serology, p. 265

p24 antigen Positive

Enzyme-linked immunosorbent assay

(ELISA)

Positive

Western blot Positive

Lymphocyte immunophenotyping, p. 274

Total CD4 280 (normal: 600–1500 cells/L)

CD4% 18% (normal: 60%–75%)

CD4/CD8 ratio 0.58 (normal: >1.0)

Human immune deficiency virus (HIV)

viral load, p. 265

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.

Case Studies

Copyright © 2018 by Elsevier Inc. All rights reserved.

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 Result

Electrocardiogram (EKG), p. 485 Ischemia noted in anterior leads

Chest x-ray study, p. 956 No active disease

Complete blood count (CBC), p.

156

Red blood cell (RBC) count, p.

396

2.1 million/mm (normal: 4.7–6.1 million/mm)

RBC indices, p. 399

Mean corpuscular volume

(MCV)

72 mm 3 (normal: 80–95 mm

3 )

Mean corpuscular hemoglobin

(MCH)

22 pg (normal: 27–31 pg)

Mean corpuscular hemoglobin

concentration (MCHC)

21 pg (normal: 27–31 pg)

Red blood cell distribution width

(RDW)

9% (normal: 11%–14.5%)

Hemoglobin (Hgb), p. 251 5.4 g/dL (normal: 14–18 g/dL)

Hematocrit (Hct), p. 248 18% (normal: 42%–52%)

White blood cell (WBC) count, p.

466

7800/mm 3 (normal: 4,500–10,000/mcL)

WBC differential count, p. 466 Normal differential

Platelet count (thrombocyte

count), p. 362

Within normal limits (WNL) (normal: 150,000–

400,000/mm 3 )

Half-life of RBC 26–30 days (normal)

Liver/spleen ratio, p. 750 1:1 (normal)

Spleen/pericardium ratio <2:1 (normal)

Reticulocyte count, p. 407 3.0% (normal: 0.5%–2.0%)

Haptoglobin, p. 245 122 mg/dL (normal: 100–150 mg/dL)

Blood typing, p. 114 O+

Iron level studies, p. 287

Iron 42 (normal: 65–175 mcg/dL)

Total iron-binding capacity

(TIBC)

500 (normal: 250–420 mcg/dL)

Transferrin (siderophilin) 200 mg/dL (normal: 215–365 mg/dL)

Transferrin saturation 15% (normal: 20%–50%)

Case Studies

Copyright © 2018 by Elsevier Inc. All rights reserved.

2

Ferritin, p. 211 8 ng/mL (normal: 12–300 ng/mL)

Vitamin B12, p. 460 140 pg/mL (normal: 100–700 pg/mL)

Folic acid, p. 218 12 mg/mL (normal: 5–20 mg/mL or 14–34 mmol/L)

Diagnostic Analysis

The patient was found to be significantly anemic. His angina was related to his anemia. His

normal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis..

His RBCs were small and hypochromic. His iron studies were compatible with iron deficiency.

His marrow was inadequate for the degree of anemia because his iron level was reduced.

On transfusion of O-positive blood, his angina disappeared. While receiving his third unit of

packed RBCs, he developed an elevated temperature to 38.5°C, muscle aches, and back pain.

The transfusion was stopped, and the following studies were performed:

Studies Results

Hgb, p. 251 7.6 g/dL

Hct, p. 248 24%

Direct Coombs test, p. 157 Positive; agglutination (normal: negative)

Platelet count, p. 362 85,000/mm 3

Platelet antibody, p. 360 Positive (normal: negative)

Haptoglobin, p. 245 78 mg/dL

Diagnostic Analysis

The patient was experiencing a blood transfusion incompatibility reaction. His direct Coombs

test and haptoglobin studies indicated some hemolysis because of the reaction. His platelet count

dropped because of antiplatelet antibodies, probably the same ABO antibodies that caused the

RBC reaction.

He was given iron orally over the next 3 weeks, and his Hgb level improved. A rectal

examination indicated that his stool was positive for occult blood. Colonoscopy indicated a right-

side colon cancer, which was removed 4 weeks after his initial presentation. He tolerated the

surgery well.

Critical Thinking Questions

1. What was the cause of this patient's iron-deficiency anemia?

2. Explain the relationship between anemia and angina.

3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale for

the answer

4. What other questions would you ask to this patient and what would be your rationale for

them?

HOW OUR WEBSITE WORKS

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of 
HIGH QUALITY & PLAGIARISM FREE.

Step 1

To make an Order you only need to click ORDER NOW and we will direct you to our Order Page at WriteDen. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.
 Deadline range from 6 hours to 30 days.

Step 2

Once done with writing your paper we will upload it to your account on our website and also forward a copy to your email.

Step 3
Upon receiving your paper, review it and if any changes are needed contact us immediately. We offer unlimited revisions at no extra cost.

Is it Safe to use our services?
We never resell papers on this site. Meaning after your purchase you will get an original copy of your assignment and you have all the rights to use the paper.

Discounts

Our price ranges from $8-$14 per page. If you are short of Budget, contact our Live Support for a Discount Code. All new clients are eligible for 20% off in their first Order. Our payment method is safe and secure.

Please note we do not have prewritten answers. We need some time to prepare a perfect essay for you.