ChallengingCases by MedCases

Go back to:

Case #826
HIV

A 61-year-old African American woman with a diagnosis of HIV/AIDS

Release Date: January 13, 2010
Expiration Date: January 12, 2011

To Start Case:

Please scroll through this page to read all the disclosures and important information. Then sign-in or register at the bottom to start the case.

Chief Complaint

Severe flu for 2 weeks: diarrhea, fever, backache, nausea, vomiting, sore throat, headaches, and difficulty breathing

History of Present Illness

Dorothy reports developing muscle and joint aches over the last 2 weeks, confining her to bed. She has difficulty breathing and says that it “hurts to move.” Her fevers have spiked as high as 102° and she has experienced nausea, vomiting, and significant fatigue. She experiences intermittent headaches and has diarrhea that is frequent (4-5 times daily), with mostly watery stools. Her appetite has been poor, with subsequent weight loss (10 pounds in the last 2 weeks). She denies being around anyone who has been ill and has no significant travel history. She received a flu vaccine 5 months ago.


	Follow us on Twitter Author Cases For Us

Disclosures and Important Information

In cooperation with MedCases, LLC

Supported by an educational grant from Boehringer Ingelheim.

Release Date: January 13, 2010

Expiration Date: January 12, 2011

Estimated time to complete this activity: 2.0 hours

Accreditation Statement

The Association of Nurses in AIDS Care (ANAC) is approved as a provider of continuing education by the Virginia Nurses Association which is accredited as an approver of continuing education in nursing by the American Nurses Commission on Accreditation.

Credit Designation Statement

ANAC designates this educational activity for a maximum of 2.0 contact hours.

Statement of Responsibility

ANAC takes responsibility for the content, quality, and scientific integrity of this online activity.

Faculty

Adult Nurse Practitioner
VA Medical Center, Division of Infectious Disease
Baltimore, MD

Faculty Reviewer

Director, HIV Services
Tampa General Hospital
Clinical Assistant Professor
USF College of Medicine
Division of Infectious Disease and International Medicine
Nurse Practitioner, Specialty Care Center
Hillsborough County Health Department
Tampa, FL

Target Audience

This course is designed for members of ANAC, as well as other registered nurses and nurse practitioners.

Prerequisites

There are no prerequisites.

Statement of Need

Globally, there are an estimated 33.2 million people infected with Human Immunodeficiency Virus (HIV). There were 2.5 million new infections in 2007, while more than 2.1 million people died of AIDS-related illnesses. Since the beginning of the epidemic in the U.S. in 1981, approximately 565,000 people have died due to HIV/AIDS. In the U.S., there are approximately 1.2 million people living with HIV/AIDs, of whom nearly 25% are unaware of their disease state. There are more than 440,000 people with AIDS, with 40,000 new cases of HIV/AIDS added every year.

With the introduction of newer, more effective, and safer drugs, there has been a significant reduction in the number of deaths due to AIDS and more patients with HIV infection are living longer than before. Though there has been a decline in mortality due to HIV infection, there has been no proportionate decrease in the number of new infections. Further, because an increasing number of HIV patients on Highly Active Antiretroviral Therapy (HAART) are living longer, they are now more prone to acquire diseases of aging and long-term adverse effects of HAART. All these factors have contributed to transforming what once was an acute disease into a chronic disease with comorbidities such as diabetes, hypertension, coronary heart disease, and dyslipidemia.

An increasing number of these patients are seen by the nursing community in various settings such as community clinics, specialized HIV clinics, methadone clinics, psychiatric centers, and in hospitals where these patients are admitted with opportunistic infections. This imposes a need for the nurses to be intimately acquainted with HIV infection, as well as its long-term effects and comorbidities. There is a need for nurses to be informed about different aspects of HIV infections including the basic science, diagnosis, psychosocial issues, patient management and education strategies, adherence, and the changing face of HIV therapy, including the newer evidence and treatment guidelines.

Objectives

After completing this activity, you should be able to:

Describe the health complications that occur when an HIV-infected patient discontinues or interrupts antiretroviral therapy
Explain the differences between bacterial pneumonia, and Pneumocystis pneumonia in the HIV-infected patient
Differentiate between tuberculosis and other respiratory problems in the HIV-infected patient

Method of Participation

This Internet-based activity takes approximately 2 hours to complete. You should review the objectives and cases, answer the multiple-choice posttest, and complete an evaluation form online. Once completed, you will be able to save your certificate to your own computer and print it on your own printer.

Policy on Speaker and Provider Disclosure

All faculty members participating in continuing education programs accredited by the Association of Nurses in AIDS Care are expected to disclose any real or perceived conflict of interest related to the content of the program.

Faculty

Don Kurytka, PhD, NP has indicated that he as received grant/research support from: Gilead Sciences Inc, Merck Serono, and Tibotec Pharmaceuticals; and is on the speakers’ bureau for Bristol-Myers Squibb Company, Gilead Sciences Inc, GlaxoSmithKline, Tibotec Pharmaceuticals, and Virco Pharmaceuticals.

Gregory F. Parr, MSN, CRNP, ACRN, have no real or perceived conflict of interest that relates to this program.

Planning Committee

Kevin Blanchet, PhD, Lillie Chen, and Daryl Ehrentreu, RPh, MBA have no real or perceived conflict of interest that relates to this program.

Notice of Off-Label Use Presentations

In accordance with US Food and Drug Administration (FDA) requirements regarding the disclosure of off-label, investigational, or unapproved recommendations for the use of drugs or devices, you are advised that content in this activity does not contain reference(s) to uses of drugs or devices that are off-label, investigational, or unapproved in the United States. The following information is provided for educational purposes and not to endorse off-label use.

No faculty member has indicated that they have included information on off-label products.

Disclaimer

The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of MedCases’ name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

All information contained within this activity is intended for educational purposes only. Physicians and other health care professionals are encouraged to consult other sources and confirm the information contained in this site because no single reference or service can take the place of medical training, education and experience. Consumers are cautioned that this site is not intended to provide medical advice about any specific medical condition they may have or treatment they may need and they are encouraged to call or see their physician or other health care provider promptly with any health related questions they may have.

The MedCases Web site does not define a standard of care, nor is it intended to dictate an exclusive course of management. Cases are provided for informational and educational purposes only and are not intended as medical advice. This information should not substitute for a visit or consultation with a health care provider.

Privacy Statement

MedCases is committed to maintaining site visitors rights to privacy and confidentiality of personal information. Personal information about site visitors, specific visitor's access and navigation, and information volunteered by site visitors, such as survey information and site registration information, may be used by MedCases to improve the site but will not be shared with or sold to other organizations for commercial purposes without the site visitor's express permission.
Please click here to read MedCases’ detailed privacy policy and other terms of using this web site.

Copyright Information

For Further Information

MedCases
4365 US Highway 1, Suite 207
Princeton, NJ 08540
Phone (609) 454-0680
Fax (609) 951-0112
cme@medcases.com

Hardware/Software Requirements and Technical Assistance

This Web-based CME activity is best experienced using a current generation browser, such as Internet Explorer 5.5 or higher. This Web site requires that JavaScript and session cookies be enabled. In addition, you will require the Adobe Flash Player plugin to view the case simulation.

Detailed Requirements:

128 MB RAM
Windows 98 or newer
Adobe Flash Player 8 minimum needed
Audio playback with speakers for programs that have video content
Internet Explorer 5.5 or higher or Mozilla Firefox 1.0 or higher or Apple Safari
1024 x 768 resolution
Broadband connection highly recommended

More information about the software described above is available at the links below:

If you need assistance, please email us at info@medcases.com.

Confirmation

Enter your details in the box below and then click the Start Case button to begin. You may discontinue the case simulation at any time and then return later to resume where you left off. By clicking the Start Case button below, you are confirming that you have reviewed all the disclosures and important information.

Please enter your e-mail address: