Discharge counselling note

2552

34

HIV (+)

10

Pneumocytis pneumonia

56 kg 148 kg BSA 1.31 m

GA : severe dyspnea, very short of breath with poor lung

expansion and shallow rapid breathing
VS : T 39, BP 140/94, PR 130/min, RR 35/min
Lung : clear
HEENT : oral thrush
Heart : tachycardia
Ext : no pitting edema

Radiology : CXR, bilateral interstitial infiltration

ABGs (on room air) : pO2 49 (80-100), pCO2 42 (35-45), pH

7.3 (7.35-7.45)
Hematology : Plt 297, WBC 2.4, Hb 9.8, CD4 120
Sputum exam : AFB (-)
All :

Med PTA :
1. GPOvir
2.

12

3.

( Cyproheptadine)

4.

Hospital course :

1. Co-trimoxazole (20 mg TMP/kg/d) IV q 8 hr for 5 days

then 5 tab bid pc
2. Prednisolone 40 mg po bid then OD for 5 days, then 20
mg OD for 11 days
3.

MTV 13

4.

GPOvir (30) 12

5. Ketoconazole

11

PCP

Problem list

Discharge medication

1. PCP

Co-trimoxazole 5 tab bid pc

Prednisolone 40 mg po bid
then OD for 5 days, then 20
mg OD for 11 days

2. AIDs

GPOvir (30) 12

3. Oral thrush

Ketoconazole

11

1.

CD4

,HIV RNA

2. 6 serum

creatinine Nevirapine (NVP)

3.

(Lactic acidosis)


d4T, ddI, AZT
4.

d4T lactic acidosis

microvesicular macrovesicular hepatic steatosis
mitochondrial toxicity
liver enzymes 3-4

5.
6.

7.

1.

2.

3.

4.

5.

HIV
6.

7.