Question: Question 4: Case Study Joan Silva, Age 35, Comes To Her Primary Care Provider With A History Of Recurrent Vaginal Infections. She Also Mentions Weight Loss And Generalized Fatigue That Has Been Worsening Over The Past 4 Months. She Has Been Previously Healthy, Takes No Medications Other Than Oral Contraceptives And Calcium Supplements, And Has No Other …

Question 4: Case study Joan Silva, age 35, comes to her primary care provider with a history of recurrent vaginal infections. She also mentions weight loss and generalized fatigue that has been worsening over the past 4 months. She has been previously healthy, takes no medications other than oral contraceptives and calcium supplements, and has no other significant medical history. Joan states that she became sexually active at the age of 19 and that she has had four sexual partners in her lifetime. She has never used any form of barrier protection during intercourse. She is currently in a 4-year monogamous relationship with a 37-year-old man who is in good health. Physical Examination Thin, anxious woman in no distress Temperature 38°C (100.4°F) orally; pulse 96 and regular; blood pressure 138/76 sitting; respiratory rate 15 Head/Eyes/Ears/Throar: No alopecia; pupils equil and reactive; fundi without lesions; tympanic membranes clear, cheesy white exudate on tongue and pharynx Neck: Mild anterior cervical adenopathy; no thyromegaly Lungs: Clear to auscultation and percussion Cardiac: Regular rate and rhythm without murmurs or gallops Abdomen: Nontender, without masses Pelvic: Thick, white vaginal discharge; venereal warts present Extremities: Without edema, pulses full throughout Neurologic: Cranial nerves, strength, sensation, reflexes, and gait all intact Laboratory Results HIV antibody test: Positive, confirmed by Western blot Complete blood count: Decreased lymphocytes, CD4+ = 170 cells/ul Potassium hydroxide preparation of oral and vaginal exudate: yeast Answer four questions about Joan Silva and her condition. 1) Does Joan meet the diagnostic criteria for AIDS? Explain your answer. 2) The organism is the most likely cause of the whitish areas in her mouth and the vaginal discharge is Candida albicans, a type of fungus (yeast), Why does Joan have oral and vaginal candidiasis? 3) What does the term opportunistic infection mean? 4) Why does her low CD4+ cell count put Joan at high risk for opportunistic infections?