Guest guest Posted July 7, 2007 Report Share Posted July 7, 2007 I'm in the mood to think up scenarios, so here's another one for y'all who find yourselves bored and just waiting for the tones to drop tonight. is a 21 year old who was diagnosed with HIV 2 1/2 years ago. Since he was not experiencing any symptoms at that time, he elected not to start drug therapy since he did not have insurance and could not afford the medications. His T-cell count was 419 and his viral load was 11,000 then. After 2 1/2 years returned to the clinic for a routine visit. His T-cell count had dropped to 304 and his viral load was now 203,000. HIV therapy was started through a free clinic. Shortly after that he began to experience visual symptoms, specifically blurriness on one side and some redness and pain in the eye. His ophthalmologist diagnosed him with iritis. He was given anti-inflammatory eye drops and an eye muscle relaxant. His eye redness and pain improved but his vision continued to decline. One morning he woke up to find near complete loss of vision. He was determined to have signs of necrosis in both retinae and one retina was also detached. He was placed on IV cortisone and his problems got better but did not resolve. Taking into consideration this patient's history, can you name at least 5 differential diagnoses as to the cause of his eye problems? And can you name one blood test that should be done? Gene G. ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2007 Report Share Posted July 7, 2007 , That's a great question. The answer is no. Gene > Does 's history include diabetes, by any chance? > > Sgt. Adler #100, NREMT-P > Police Administration- Staff Services > City of Philadelphia Housing Authority Police Department > 3111 S. 23rd Street > Philadelphia, PA 19145 > .Adler@... > __________________________________________________ > Sent from my BlackBerry Wireless Handheld > > > Puzzler No. 2 > > > I'm in the mood to think up scenarios, so here's another one for y'all who > find yourselves bored and just waiting for the tones to drop tonight. > > is a 21 year old who was diagnosed with HIV 2 1/2 years ago. Since > he was not experiencing any symptoms at that time, he elected not to start > drug > therapy since he did not have insurance and could not afford the > medications. > His T-cell count was 419 and his viral load was 11,000 then. > > After 2 1/2 years returned to the clinic for a routine visit. His > T-cell count had dropped to 304 and his viral load was now 203,000. HIV > therapy was started through a free clinic. > > Shortly after that he began to experience visual symptoms, specifically > blurriness on one side and some redness and pain in the eye. His > ophthalmologist > diagnosed him with iritis. He was given anti-inflammatory eye drops and an > eye muscle relaxant. > > His eye redness and pain improved but his vision continued to decline. One > morning he woke up to find near complete loss of vision. > > He was determined to have signs of necrosis in both retinae and one retina > was also detached. > > He was placed on IV cortisone and his problems got better but did not > resolve. > > Taking into consideration this patient's history, can you name at least 5 > differential diagnoses as to the cause of his eye problems? And can you name > one blood test that should be done? > > Gene G. > > ************************************** See what's free at http://www.aol.com. Quote Link to comment Share on other sites More sharing options...
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