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Nutrition and Diagnosis-Related
Care
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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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