Short of breath
  Too tired
  The dwindles
  Weight loss
  Mom to be
  Very sociable
   Thanks To
 Mark W. Braun, MD

   Nutrition and Diagnosis-Related Care



Mr. John Abrahms is a 38 year-old man who presents with weight loss, lethargy, shortness of breath and a "sore mouth". He is known to be HIV positive for the past two and half years.
  • Mr. Abrahms is a single, sexually active man who denies same-sex intercourse.
  • Four years ago he was employed as a lab technician and sustained a needle stick injury on the job.
  • Although initially negative for HIV following the accident, he subsequently developed a positive test by both ELISA and Western Blot.
  • Since the conversion of his HIV serology, he claims to have been very cautious with respect to his sexual contacts.
  • He is on no medication although he takes a multivitamin, ginseng and echinacea.

Physical exam

  • Mr. Abrahms is 5' 10" tall and weighs 140 pounds, down from 160 six months ago.
  • Vitals: Temp 100.2oF, BP 126/60, P 78/min and regular, R 24 with mild labor.
  • Chest auscultation reveals some end-inspiratory rales.
  • There are no abdominal masses and no adenopathy.
  • There is generalized muscle atrophy and fat wasting.
  • Oral exam reveals a red and injected mucosa with a milky, white membrane.
  • His neurological exam is unremarkable.

How about a chest X-Ray, some lab studies and his nutritional SGA form?

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