4.1 of 7 Ratings
A 27-year-old HIV positive female presents to your office with fatigue, fever, and a non-productive cough that started 2 weeks ago. She states that she gets very tired while walking short distances. Vital signs are as follows: T 103.2 F, HR 84 bpm, BP 116/72 mmHg, RR 19 bpm. Physical examination reveals light rales in the base of of the lungs bilaterally. Chest radiography is shown in Figure A. Bronchoalveolar lavage results are shown in Figure B. An ABG is performed and reveals a PaO2 of 64 mmHg. HAART therapy and IV trimethoprim-sulfamethoxazole are initiated. What other treatment is recommended for this patient?
Intubation and mechanical ventilation
Select Answer to see Preferred Response
A 35-year-old man presents to the emergency department with a complaint of shortness of breath over the past 5 days. He has had a worsening dry cough over the past 4 weeks and has also noted a 12 lb weight loss. He was diagnosed with HIV two years ago but is unable to afford the medications he was prescribed. Vital signs are as follows: T 102.8 F, HR 78 bpm, BP 122/78 mmHg, RR 14 bpm, SpO2 96%. Physical examination is unremarkable. Chest radiography is obtained and shown in Figure A. Bronchoalveolar lavage is performed and reveals the findings in Figure B. Apart from starting HAART therapy, what other treatment is recommended for this patient?
Pyrimethamine and sulfadiazine
Rifampicin, isoniazid, pyrazinamide, and ethambutol
A 33-year-old male presents to the emergency room with fatigue and a non-productive cough that started a month ago. Review of systems is positive for chills, fevers, and dyspnea on exertion. Vital signs are as follows: T 102.7 F, HR 90 bpm, BP 124/85 mmHg, RR 16 bpm. Physical examination reveals cervical lymphadenopathy. An HIV test returns positive. Chest radiography is performed and results are shown in Figure A. Which of the following diagnostic modalities is the most appropriate for this patient?
Purified protein derivative (PPD)
Chest CT scan
Lymph node biopsy
Acid-fast microscopy of sputum
Fiberoptic bronchoscopy with bronchoalveloar lavage