Question

Cindy Chen, a 28-year-old Asian female complaining of the inability to sleep and nervousness, arrives at the office. She tested positive for HIV in 2005. Currently, she lives with her aunt and is going to school to become a phlebotomist. She has lost 20 pounds since her last visit to the clinic. She also has had a persistent cough and sore throat for the last 3 months. The physician orders a series of blood tests, including the helper T-cell test and a throat culture. Dr. Whalen asks you to send the throat culture to the reference lab for culture instead of doing a rapid strep test in the office.

Questions

1. Why are Cindy’s helper T cells being tested?

2. As Cindy’s HIV infection progresses, what symptoms might she exhibit?

3. What special precautions should you take when drawing Cindy’s blood?

4. Why do you think Dr. Whalen asked you to send the throat culture to the reference lab instead of doing a rapid strep test in the POL?

Please answer all 4 questions separately.

Answer 1

1. The reason is very clear. In the question it has been mentioned that Cindy has had a persistent cough and sore throat for the last 3 months which shows that her immune system isn’t functioning properly. T cells or lymphocytes are type white blood cells responsible for fighting off diseases and boost the immune function of the body. At the same time she also has a immunodeficiency disorder i.e. HIV. This is the reson doctor asked to get her helper T cells being tested.

2. As Cindy’s HIV infection progresses, she might exhibit the following symptoms -

• regular infections
• chronic diarrhoea
• swollen glands
• muscle and body pain
• skin rash and ulcer

3. While drawing Cindy’s blood, I will wear a protective eye wear, mask or face shields and new gloves. I will safely and carefully dump the used gloves and the needle along with the syringe after the procedure. (Gown is also recommended for a safer side) Before and after the procedure, I will wash my hands too.

4. Dr. Whalen asked to send the throat culture to the reference lab instead of doing a rapid strep test in the POL because a throat culture is considered to be more accurate as well as more in-depth than the rapid strep test. Cindy's condition is pretty complicated and serious she was tested positive of HIV and the cough she is having right now is persistent for the last 3 months. The doctors fears whether her condition has progressed to serious opportunistic infections or AIDS. That is why it is important to evaluate the germ that is causing the infection and why her body is not able to fight it.