Question

Answer and explain the choice of your answer.

James 28-year-old has a history of multiple unprotected sexual partners comes to clinic because of low-grade fever and rash. He also complained of recurrent fatigue, headache, malaise and sore throat for almost two years. Physical examination reveals 38.9 grade fever, mucosal ulceration, inflamed tonsils and mild lymphadenopathy. Rashes on his face, lower and upper trunk is also present.

            Laboratory results showed anemia (hematrocrit 37%) with marked decrease in total white blood cell count and absolute lymphocyte count.

Which of the following is most likely the diagnosis?
a) acute HIV
b) latent HIV
c) HIV infection
d) AIDS

If James is suspected of retroviral infection, which of the following is the most appropriate laboratory test to aid in the diagnosis?
a) Cell culture
b) Enzyme Immunoassay
c) Western Blot
d) Nucleic Acid Test

Marked decrease in total white blood cell count in this disease is a result of which of the following mechanisms?
a) defective cell-mediated immunity
b) leukopenia
c) helper T cell destruction
d) apoptosis

Answer 1

Q.N.1

Here the right option is HIV infection.

The acute stage of Hiv infection usually begins soon after the individual may came in contact with the HIV virus. It usually last for few weeks like 3 to 4 weeks. During that period the individual may show some flu like symptoms and no other manifestations will be present. Hence the first option can be excluded. In latent HIV period, the symptoms will go unnoticed and it will be usually a asymptomatic stage, also known as seroconversion period. During which the individual may look like healthy, but his immune sysytem is being destroyed by the HIV virus.AIDS is the final stage in the HIV disease, this stage usually characterized by leass CD4 cell counts and other associated oppertunistic infections like TB, candiasis etc. Hence that option can also excluded. In case of HIV infection period, the individual have been infected with the virus and started to show symptoms like persistent fever, lymphadenopathy, sore throat, oral ulcers, tonsil sore etc. All these are the active clinical manifestations of a active HIV infection.

Q.N.2

The right answer is Enzyme Immunoassay

Enzyme Immunoassay other wise known as ELISA, ia a test used to identify the antibodies against HIV virus in an individual. ELISA can provides 99.9% of accurate diagnosis regarding presence of HIV antibodies. Where as Western blot was used as the confirmatory test for HIV infection previously. Following ELISA results, doctors used to prescribe wester blot for the confirmatory diagnosis of HIV. But currently in most of the countries, western blot is not used . Cell culture and Nuclic acid tests are not widely used for HIV detection.Hence all remaining ptions can be excluded.

Q.N.3 The right answer is helper T-cell destruction.

Helper Tcells are also a type of white blood cells. In HIV, the virus is primarly attacking the helper T-Cells. This leading to the destruction of these cells and Marked decrease in total white blood cell. Helper T cells primary function is immune response.Leukopenia is the term used to describe reduced WBC count. Programmed cell death is known as apoptosis. Hence all other options can be excluded.