Question

Zach is a 28-year-old graduate student working in a laboratory that studies the genetics of the human immunodeficiency virus (HIV). He has recently noticed that he is losing weight, his lymph nodes are swollen, and that he has been experiencing night sweats. He also seems to be scratching more often than normal. Zach is concerned that he may have contracted HIV through his research project. Zach is married, monogamous, and has never received a blood transfusion or used IV drugs. His physical check reveals pallor, lymphadenopathy, splenomegaly, and an abnormal mass in his abdomen. Zach's heart and respiratory sounds are normal, but his body temperature is slightly elevated at 99°F. Blood analysis is done with the following results: Hematocrit (HCT) = 35% Hemoglobin (Hb) = 9.5 g/dL RBC count = 3.5x10^6/uL WBC count = 22,000/uL Platelet count = 450,000/uL Alkaline Phosphatase = 120 IU/L HIV antibodies = Negative IgA = 300 mg/dL IgG = 1,500 mg/dL IgM = 65 mg/dL Erythrocyte sedimentation rate = 22 mm/hr Differential WBC count: Neutrophils = 65% Eosinophils = <1% Basophils = 15% Lymphocytes = 30% Monocytes = 3% As you begin to write your response for this case study, think about any additional tests you might want to order that would help with the diagnosis, such as a lymph node biopsy. What information from the biopsy would support a diagnosis of Hodgkin's disease? If it were Hodgkin's disease, what would be the treatment and what would be the prognosis? What were the specific symptoms that made Zach suspect he had HIV? Were there signs and symptoms that could have supported lymphoma?

Zach is a 28-year-old graduate student working in a laboratory that studies the genetics of the human immunodeficiency virus (HIV). He has recently noticed that he is losing weight, his lymph nodes are swollen, and that he has been experiencing night sweats. He also seems to be scratching more often than normal. Zach is concerned that he may have contracted HIV through his research project. Zach is married, monogamous, and has never received a blood transfusion or used IV drugs. His physical check reveals pallor, lymphadenopathy, splenomegaly, and an abnormal mass in his abdomen. Zach's heart and respiratory sounds are normal, but his body temperature is slightly elevated at 99°F. Blood analysis is done with the following results:

Hematocrit (HCT) = 35%
Hemoglobin (Hb) = 9.5 g/dL
RBC count = 3.5x10^6/uL
WBC count = 22,000/uL
Platelet count = 450,000/uL
Alkaline Phosphatase = 120 IU/L
HIV antibodies = Negative
IgA = 300 mg/dL
IgG = 1,500 mg/dL
IgM = 65 mg/dL
Erythrocyte sedimentation rate = 22 mm/hr
Differential WBC count:
Neutrophils = 65%
Eosinophils = <1%
Basophils = 15%
Lymphocytes = 30%
Monocytes = 3%

As you begin to write your response for this case study, think about any additional tests you might want to order that would help with the diagnosis, such as a lymph node biopsy. What information from the biopsy would support a diagnosis of Hodgkin's disease? If it were Hodgkin's disease, what would be the treatment and what would be the prognosis? What were the specific symptoms that made Zach suspect he had HIV? Were there signs and symptoms that could have supported lymphoma?

zach is a 28 year old graduate student working in a laboratory that studies genetics the of the human immunodeficiency virus hiv he has recently noticed that he is losing weight his lymph no 33304

Added by Sandra Y.

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