PBL 5 session 2

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PBL 5 session 2 by Mind Map: PBL 5 session 2

1. Step 8

1.1. Diagnostic decision

1.1.1. cryptosporidium parvum infection

1.2. Mechanism

1.2.1. reduced immunity from HIV

1.3. Presentation

1.3.1. diarrhea, abdominal pain, near fecal incontinence

1.4. Supporting data

1.4.1. culture

1.5. 10 minutes

2. Step 7

2.1. Inquiry plan and info gathering

2.1.1. History of presenting complaint watery diarrhea, abdominal pain, near fecal incontinance 2 weeks ago, diarrhea. 10 times per day watery stool, no mucus or blood pain over a week incontinace several times last week waight loss 7 kg over 6 months no tenisumus unable to carry out exercise program

2.1.2. Previous medical / surgical history appendectomy 6 y ago presented with painless lump. CD4 was 600 lymphoma was suspected fell to 300 cells side effect of treatment: diarrhea. discuntinued therapy count fell to 200 most recent count is 40 cells HIV load 480,000

2.1.3. Drug history / allergy antiretroviral therapy abacaver zalasetavin endenovir TMP SMX with azethromycin

2.1.4. Family history no malignancies seperated parents since age 10. lived with mother untill 20 no siblings didn't tell his parents about his condition

2.1.5. Social / occupational history lives with HIV positive partner homosexual. 15 partners in the past drinks socially. No drugs He was a runner. HIV reduces his capacity to exercise not smoker mainly vegetarian diet

2.1.6. Systemic review

2.1.7. Physical examination vitals PB 115 over 70 pulse 90 temp 37.4 weight 50 height 160 general inspection no juandice no lymph nodes moderately dehydrated upper arm fat loss wight plaques in the tongue and palate Respiratory few cripitations at both bases Cardiovascular normal GI old scar scaphid paplbe spleen and liver but not enlarged CNS subjective reduction in light touch at finger tips

2.1.8. investigation cbc hempoglobin 11.2 white cells 2.5 neutrophils 90% platlets 185 biochem cholesterol is 7.4 mild abnormalities in lever function triglysrides 6.5 cryptosporidium parvum cultured

2.2. 50 minutes

3. Step 6

3.1. Review session 1

3.2. Report new knowledge

3.2.1. AIDS definition stages risk factors pathophysioloy sign & symptoms complication common infections immunosupression

3.3. 30 minutes