AAzad
Forum Guru
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HI Guys,
while I was studying I came up with some questions that I need to ask you for the best answer, i could not find any good explanation in any of my books , so please enlight if you can
In case that you have a case of HIV+ patient for counseling or P.E.
is there any chance that SP is a real HIV +,( since in the book says that patient might actualy have the mur mur or rale or bruits or lymphadenopathy or other signs in other cases).if yes , besides universal precautious and a good counseling for patient what else do you need to do and not being impolite or judgmental .
I appreciate any comment.
Good Luck
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AAzad
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| Rasul
Forum Guru
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Posts: 485
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Hi, AAzad!
I doubt that they'll give us a real HIV+/AIDS patient. But if so(and the case says in on the door, or the pt tells You so), don't freak out:It's just a human being, like everybody else, who needs Your help,or will need Your help pretty soon, but doesn't know about it yet. Universal precautions ( which You assume with every patient reagardless of their HIV status),current complaint to be addressed(HIV/AIDS specific or not?),relevant physical exam, counselling for safe sex (do it careful not to offend the person, but give him/her sense of responsibility for not infecting loved ones), checking the adhearance to the cocktail( is the patient compliant with meds), check for existing side effects of medications(maybe there's need to change some of them, coz if pt can't tolerate side effects, he or she won't be sticking to tx), current viral load and CD4 count(to prescribe preventive treatment and search for medical conditions specific to current CD4 count). Schedule f-up visit, monitor the pt closely, don't forget to schedule age specific colonscopy, screening for cancers, lipid panels and EKGs.
If You suspect pt might be HIV+, start with questions about sexual preferances (ask the questions politely,cautiously, not to be judgemnetal or obtrusive), but firmly. Ask about blood transfusion Hx, or maybe hopitalizations Hx. Then say-
" ...It might be a good idea to check You for HIV, especially since You are at higher risk compared to the rest of population (...don't specify why-if Your pt is homosexual or commercial sex worker, they'll understand what You're referring to...)/especially since You have a hx of blood transfusion...etc, just to make sure"
Just play it by ear, the core of everything is good history collection, good complaint detalization and relevant physical exam-the rest of it, well, is medicine, which I'm sure, You know, my friend, and I'm absolutely convinced You'll pull through.
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| Rasul
Forum Guru
Topics: 56
Posts: 485
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Oh, forgot-ask about IV drug use history too. Very relevant.
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| AAzad
Forum Guru
Topics: 57
Posts: 460
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Rasul
Thank you very much for your response.your response is complete and helped me with my question.
I wish you good luck with your exam
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AAzad
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