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HIV Disease Clinical Vignettes


Case 1
22 year old lady presents with a 3 day history of fever, chills, fatigue, night sweats, tender lymphadenopathy, pruritic macular rash Name 4 differential diagnosis What further question would you as the patient!

Case 1
"he had unprotected se# with a new partner 4 wee s ago$ %er %&' anti(ody test negative What could (e happening to this patient! %ow should the patient (e evaluated!

Case 2
24)year)old %&' positive woman with a past history of *+B which has (een treated ,urrent pro(lems ) chronic fever ) chronic diarrhoea ) - 1./ weight loss ) mild dry cough 0intermittent1 What is the W%2 clinical stage !

%er ,34 is 4 cells5mm6$

"hould she ta e cotrimo#a7ole prophyla#is!

Would you start 8R+ or not and why!


Case 3
91 year old %&' positive patient (eing treated for *+B develops sudden onset of left hemiparesis What are the differential diagnosis! %ow will you investigate the patient!

Case 3
8 ,+ head scan done for patient shows a single ring enhanced lesion$ What is the most li ely diagnosis! What is the W%2 clinical stage! %ow will you treat this patient!

Case 4
8 3. year old teacher diagnosed with %&' infection : years ago complains of difficulty in swallowing What are the possi(le differential diagnosis!

Case 4
%e has loss of weight and a history of herpes 7oster 9 years ago 2n physical e#amination he has oral candidiasis and dar plaques on his s in What is his dermatological diagnosis! What is his W%2 clinical stage! %ow will investigate him!

Case 4
%is haemoglo(in level is 9gm5dl, ,34 count is 1.. cells5mm6 %ow should this patient (e managed! 3oes he need antiretroviral therapy! What antiretroviral drug will you avoid in this patient!


Case 5
8 33 year old %&' positive man complains of left thoracic pain *hysical e#amination reveals vesicular lesions on the thoracic wall where he feels the pain What is the diagnosis and how will you manage the patient!

Case 6
8 young %&' positive woman has fever for over a month$ =rom her previous record she weighed 94 g, now weighs 42 g$ "he has a history of herpes 7oster %ow will you stage this patient!

Case 7
8 24 year old woman was raped a month ago, she presents with fever malaise, fatigue and swollen lymph nodes What is the most li ely diagnosis! %ow will you investigate this patient! What could have (een done for this patient to prevent her current medical condition!

Case 8
8 34 year old %&' positive patient presents with severe weight loss, une#plained prolonged fever and has had 3 episodes of (acterial pneumonia last year all responding well to anti(iotics %er ,34 count is 249 ,ells5mm6 %ow should this patient (e managed!

Case 9
8n %&' positive patient with a history of recurrent herpes 7oster, angular cheilitis and pruritic papular eruptions now has une#plained intermittent diarrhea -1 month What is the clinical stage! %ow will you manage this patient!

Case 10
8 42 year old %&' positive man has (een on +B treatment for 2 months$ %e started 8R's 2 wee s ago (ut now has huge enlargement of lymph nodes in nec > mediastinum What is the possi(le diagnosis! %ow should this patient

+hese patients were all started on 8R's What is the most li ely cause of the rashes

Case 12
What is the diagnosis of the s in lesion! What is the clinical stage!

Case 13
8 34)year)old %&' 0?1 man with wasting, chronic diarrhea and (lurred vision in one eye =undoscopy as shown What are occular complications of %&' What is the diagnosis! What is the W%2 clinical stage! What drugs are used for treatment of eye

Case 14
8n %&' ? woman with non productive cough -2 wee s, gradual onset of (reathlessness > fever ,34 cell count 1.. cells5mm3 ,hest #)ray as shown What are the causes of (reathlessness in %&'? patients! What is the diagnosis! %ow would you manage


Case 15
8 24 year old %&' positive patient has (een ta ing 8R's for the past 3years @ou o(serve over the past 3 months that patient has (een presenting with recurrent diarrhoea, fever, weight loss and now has AaposiBs sarcoma lesions on palate What could (e happening to this patient!


8n %&'? man presents with a 2 wee s history of a productive cough, fever, night sweats, weight loss and swollen lymph nodes ,hest #)ray shows massive pleural effusion What other investigations will you request! What is the most li ely diagnosis! What is the W%2 clinical stage!

Case 16

Case 17
8 33 year old %&'? man has an %( of 4g5dl for - a year, measured on several occasions$ %is wor out of the anaemia has not resulted in any diagnosis$ 8naemia has not improved on haematinics %ow will you stage this patient! What would (e your management of this patient!

Case 18
8n %&' ? man with a monthBs history of headache and fever, now has altered level of consciousness (ut no signs of meningeal irritation What are the differential diagnosis! %ow will you investigate this patient! What is the most li ely diagnosis! %ow will you manage patient !

What are the diagnoses?


Case 20
8 fourth year medical student reports to you immediately after having a needle stic inCury from a very ill loo ing patient diagnosed with tu(erculosis What advise would you give the student! %ow should this student (e investigated! What treatments will this student