HIV-case study

You will submit your assignment to this page.

The case study paper is an exercise for the student to explain the pathophysiology of a disease process at the cellular level. The student will be presented with a case study in Week 6 (not before). The case study paper will be due in Week 7. This paper may be written in paragraph, bulleted, or a combination of both formats. APA citations, paper formatting, and references must be utilized throughout the assignment. Students are to use the textbook and reputable academic sources as supportive evidence for their analysis. Typical case study paper length is 4-8 pages. Rubric and instructions posted below.” Remember: You must define the disease process down to the cellular level. At least 5-6 references are required.

You must provide citations and paraphrase. No direct quotes allowed.

Remember, anything that is not common knowledge must be cited and referenced.

When you save your assignment, the file name should be “First Name_Last Name_Assignment Name.”

Case Study Below:

CASE STUDY PAPER

The following case study presents a scenario regarding a young male with HIV.

M.C. is a 27-year-old male who tested positive for HIV 2.5 years ago. He visits the HIV clinic at regular 2 to 3-month intervals for routine follow-up, most recently six weeks prior. M.C. has been stable on antiretroviral treatment consisting of tenofovir, emtricitabine, and lopinavir-ritonavir for the last 11 months. Prior to that the patient had developed drug resistance to his initial combination regime of zidovudine, lamivudine, and efavirenz. He presents today complaining of moderate dyspnea, persistent and non-productive cough, and fatigue.

His PMH is significant for RSV infection as an infant, Seroconversion to PPD 11 years ago, treated for 12 months with isoniazid, Perianal ulceration that cultured positive for herpes simplex, topically treated with acyclovir and zinc oxide, 3 years ago; Oral candidiasis, resolved with fluconazole, 2.5 years ago; Tested positive for HIV with both ELISA and Western blot, 2.5 years ago; Oral candidiasis, resolved with fluconazole, 20 months ago; Two episodes of anemia, treated with erythropoietin, 10 months and 14 months ago; CMV retinitis in right eye treated, Hospitalized for Pneumocystis pneumonia, developed allergic reaction to trimethoprim-sulfamethoxazole, effectively treated with IV pentamidine for 14 days and discharged 6 weeks ago.

No PSH

Social History: M.C. admits to several different male partners and practices both protected and unprotected anal and oral intercourse since the age of 20, one of his partners recently died 8 months ago from AIDS-related complications. He is currently unemployed and receiving Social Security disability checks, used to work as a forest ranger for 5 years, lives with his 51-year-old mother, and smoked 3 ppd for 10 years before quitting 2 years prior. His past history is also significant for alcohol abuse, cocaine niffing and IVDU.

Physical Exam is significant for:

General: Thin, slightly anxious, acutely ill-appearing, young white male with tachypnea

VS: BP 130/87, P 90, RR 30, Temp 101.9, HT 6 ft-2in, WT 155 lbs

Neuro: A & O x 3, GCS 15, Normal DTRs nonfocal exam

HEENT: PERRLA, Funduscopic exam of left eye significant for fluffy, white retinal patches with focal hemorrhages consistent with CMV retinitis, right eye no new lesions, Ears clear, Sinuses non-tender, oral cavity unremarkable

Resp: Mild axillary lymphadenopathy, bibasilar crackles with auscultation

Laboratory Values:

Today

3 mo ago

Hb

10.9

11.5

HCT

32

33.4

PLT

260

287

WBC

3.8

3.3

Lymphs

18.2

36.4

Monos

11.4

10.2

Eos

1.5

3.7

Basos

1.1

1.0

Neutros

67.8

48.7

CD4 cells (%)

15

26

CD4 cells/mm

119

359

CD 8 cells (%)

29

35

CD8 cells/mm

214

350

HIV RNA (copies/mL)

67,600

<500

Today

3 mo ago

Na

136

135

K

4.3

3.5

Cl

108

103

BUN

10

7

Cr

0.9

0.7

Glu

115

104

T Bili

0.5

1.2

T Prot

6.1

6.0

Alb

2.7

3.0

AST

34

28

ALT

51

54

Ca

7.8

8.9

Phos

3.8

3.9

Mg

2.0

1.8

Other Tests obtained:

Sputum specimen obtained: positive for Pneumocystis infection

ABG:

pH: 7.45/ PaO2 69 mm Hg/ PaCO2 30 mm Hg/ SaO2 91%

Refer to Chapter 10 in McCance & Huether, pages 291-298: Infectious Viruses-HIV to analyze this case study and disease process. Discuss the epidemiology, pathogenesis, pathophysiology, and clinical manifestations of HIV. You may use the latest epidemiology data from the CDC, utilizing the Library website. You should also utilize the library website to find other reputable sources for this disease process. At a minimum of 6 sources.

When discussing the pathophysiology of the disease process above, discuss at the cellular level, including what the HIV genome is made of: DNA or RNA? How does it replicate? What is the life cycle of HIV? HIV requires two host cell receptors for infection. what cell membrane proteins are involved in these two steps? What specific type of immune cell does HIV infect? How does the virus get released from the cell? What is that process? What is the role of MHC I, MHC II, TH (CD4) Cells, and TC (CD8) Cells? In looking at the patients labs, what is happening to his viral load and CD4 T cells? What other infection does this patient have, and why? Is there an acid-base disturbance? If so, what? Explain. What are the stages of HIV? How is pediatric HIV different?

When discussing the pathophysiology of disease processes, always keep in mind to explain what is happening at the cellular level, how the cells adapt and change, and become dysfunctional.

Begin your paper with an overview or introduction to the disease process.

Then describe the epidemiology and pathogenesis, and spend most of your time explaining the pathophysiology behind the disease process itself. Describe the clinical manifestations of the disease and relate them back to the case study above. Utilize the case study evidence to describe the disease process. Discuss treatment options for this patient briefly. End with a conclusion on HIV.

Make sure you utilize APA.

DO NOT use direct quotes. Everything should be in your own words, cite!