Madison Sohl, HAN312.

01, Case Study Part B, HIV/AIDS

Signs (Observed):

● Aphthous Stomatitis: oral ulceration, also commonly called “Canker Sores”

● Dermatitis: A rash/ inflammation of the skin

● Nodule: Skin lesions greater than 0.5cm in diameter

Review of Systems:

● Immune System:

○ Have you been excessively tired the past few weeks?

■ Yes, I actually have been. I thought it was because i was getting

burnt out from work, but when I took a week off, I was still so tired…

maybe even worse than when it started.

○ Have you been experiencing yourself getting sick more often, or

experiencing flu-like symptoms?

■ Yes, I actually had a cold that has lasted about two weeks now and

it has only gotten worse. I have been taking over the counter

medicine to try to get it to go away, but I had no luck.

○ Have you been having night sweats or anything unusual you would like to

talk to me about?

■ Yes, about every night I have been waking up in the middle of the

night, in a pool of sweat. It is so frustrating, I have never

experienced anything like this before.

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.
Madison Sohl, HAN312.01, Case Study Part B, HIV/AIDS

● Digestive System:

○ Are you feeling constipated?

■ Actually no, quite the opposite. I have diarrhea and can not stop

going to the bathroom. I haven't eaten anything different to make

my stomach feel this way. I have also recently been seeing a little

bit of blood in it.

○ I see from your charts in the past that you have recently lost a lot of

weight… about 50 pounds. Was this intentional? Are you on a diet?

■ No it was not intentional actually. I haven't changed my eating

habits or working out, it kinda just happened all of a sudden.

○ Have you been having a lot of unusual cramping?

■ Yes I actually have. They have been very painful. I am not on my

period so it is not menstrual cramping.

Past Medical History:

● Medical:

○ Asthma (2024)

● Surgical:

○ ACL reconstruction surgery on right knee (2020)

● Social:

○ Works as a bartender

○ Lives in an apartment alone and has no kids

○ Denies tobacco use; denies illicit substance use

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.
Madison Sohl, HAN312.01, Case Study Part B, HIV/AIDS

○ Occasional HTOH use (3 alcoholic beers on the weekends)

● Family:

○ Mother, age 65, alive, hypertension

○ Father, age 68, alive, diabetes, hypertension

○ Sister, age 24, alive, no existing medical conditions

● Current medications:

○ Acetaminophen 325 mg every 6 hours while symptoms last orally

○ Celecoxib 200 mg 2 times a day as needed orally

○ Naproxen 220 mg every 12 hours if needed orally

● Allergies:

○ Anaphylaxis to peanuts (hives and itchy skin)

○ Carries an EpiPen with her just in case

● Vaccinations:

○ The patient is up to date on all her vaccinations. Yearly flu vaccine,

01/2024; covid vaccine series x2 (Pfizer, 2021)

Physical Exam:

● Immune System:

○ Temperature: I checked the patient's temperature orally, as fevers are

common in people who have HIV, even when no other symptoms are

present. As suspected the patient has a 100 degree fever.

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.
Madison Sohl, HAN312.01, Case Study Part B, HIV/AIDS

○ Lymph nodes: I checked the patients Lymph nodes by touching the

patient's neck with my fingers to see if there were any abnormalities to it.

The patients Lymph nodes were enlarged and swollen

(lymphadenopathy). A biopsy may be considered if your lymph nodes are

getting larger or if some are different sizes.

○ Blood pressure: checked the patient's blood pressure using a

sphygmomanometer. Hypotension was present.

● Digestive System:

○ Abdomen: I used a stethoscope, and placed it on the abdomen. I listened

to sounds that might be abnormal. The patients stomach had high-pitched,

gurgling sounds which are very abnormal.

○ Weight: I checked the patient's weight. I used a scale. A loss of 10% or

more of your body weight may be a sign of AIDS. As stated before, the

patient has lost more than 50 pounds in a short period of time.

○ Abdomen: Hepatomegaly may be detected by checking the abdomen.

Hepatomegaly is an enlarged liver. I performed palpitations on the

abdomen and the patient did in fact have an enlarged liver. This can

reflect liver involvement from opportunistic infections or HIV-associated

malignancies.

Diagnostics:

● Antigen-antibody tests: These tests most often use blood from a vein. Antigens

are substances on the HIV virus itself. I am ordering this test because the

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.
Madison Sohl, HAN312.01, Case Study Part B, HIV/AIDS

immune system makes antibodies when it's exposed to HIV. The only downside

is that It can take weeks to months for antibodies to show up in blood.

○ The patient's test for antibodies came back negative. This might have

occurred because the exposure happened more recently, and the test can

take months to detect.

● Antibody tests: These tests look for antibodies to HIV in blood or saliva. Most

rapid HIV tests are antibody tests. This includes self-tests done at home. It may

not show a positive result on an antibody test until 3 to 12 weeks after the patient

has been exposed to HIV.

○ The patient came back negative for this test. The patient liked how it was

not blood work and that it can be done at home for convenience purposes.

This test can give us a clue that the patient was exposed very recently.

● Nucleic acid tests (NATs): These tests look for the virus in blood, called viral

load. They use blood from a vein. I am ordering this test because the patient may

have been exposed to HIV within the past few weeks. She has several sexual

partners so she does not know when it exactly happened. This test will be able to

detect HIV/AIDS the quickest, in about 2 weeks after the exposure.

○ The patient's results came back positive. This result with this test makes

sense, because the exposure happened more recently. This certain test

can show the results the fastest. This now can give us a good idea when

the contact with HIV has happened, since the other tests came out

negative.

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.
Madison Sohl, HAN312.01, Case Study Part B, HIV/AIDS

● Rapid diagnostic tests (RDTs): are so called as they produce a test result quickly,

usually in less than 30 minutes.They do not require any additional equipment

and, thus, do not need to necessarily be performed in a laboratory. This means

that RDTs are suited for use in both community- and facility-based settings,

including sites with limited infrastructure that process low numbers of specimens

daily.

○ The patient's test came back positive. Having multiple tests that came

back positive proves that the patient has HIV and that it was very recent.

Catching it early is good because not we can proceed to medication that

can keep it under control.

● Simple assays: This type of HIV assay typically requires 30 minutes to 2 hours to

produce results. Simple assays are designed for use with a serum/plasma

specimen and require phlebotomy to collect an appropriate specimen.

○ The patient's test came back positive. Having multiple tests that came

back positive proves that the patient has HIV and that it was very recent.

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.
Madison Sohl, HAN312.01, Case Study Part B, HIV/AIDS

References

French, M., & Crock , E. (2019, November 27). Signs and symptoms. HIV

Management Guidelines. https://hivmanagement.ashm.org.au/hiv-

associated-neurocognitive-disorder/signs-and-symptoms/

Sands, A. (n.d.). Diagnostics for HIV diagnosis. Consolidated Guidelines on HIV

Testing Services: 5Cs: Consent, Confidentiality, Counseling, Correct

Results and Connection 2015.

https://www.ncbi.nlm.nih.gov/books/NBK316033/#:~:text=Rapid

%20diagnostic%20tests%20(RDTs)%20are,and%2For%20HIV

%20p24%20antigen

Staff, M. C. (2024, February 9). HIV/AIDS. https://www.mayoclinic.org/diseases-

conditions/hiv-aids/diagnosis-treatment/drc-20373531

This is a class assignment and is for educational purposes only. This is not a real patient case

study. The name and disease are not real or based on a real person.