Instructions: Read the following case study and answer the reflective questions. 
Requirements:
– Formatted and cited in current APA 7 
– The discussion must address the topic
– Rationale must be provided
– Use at least 600 words (no included 1st page or references in the 600 words)
– Use 3 academic sources. Not older than 5 years
– Not Websites are allowed.
– Plagiarism is NOT allowed
AIDS (Acquired Immunodeficiency Syndrome)
The patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic diarrhea, and respiratory congestion during the past 6 months. Physical examination revealed right-sided pneumonitis. The following studies were performed:
  
Studies
Results
 
Complete blood cell   count (CBC), p. 174
 
Hemoglobin (Hgb), p.   259
12 g/dL (normal:   14-18 g/dL)
 
Hematocrit (Hct), p.   256
36% (normal:   42%-52%)
 
Chest X-ray, p. 1014
Right-sided   consolidation affecting the posterior lower lung
 
Bronchoscopy, p. 587
No tumor seen
 
Lung biopsy, p. 738
Pneumocystis   jiroveci pneumonia   (PCP)
 
Stool culture, p.   855
Cryptosporidium   muris
 
Acquired   immunodeficiency syndrome (AIDS) serology, p. 297
 
p24 antigen
Positive
 
Enzyme-linked   immunosorbent assay (ELISA)
Positive
 
Western blot
Positive
 
Lymphocyte   immunophenotyping, p. 306
 
Total CD4
280 (normal:   600-1500 cells/mL)
 
CD4%
18% (normal:   60%-75%)
 
CD4/CD8 ratio
0.58 (normal:   >1.0)
 
Human immune   deficiency virus (HIV) viral load, p. 297
75,000 copies/mL
1. Diagnostic Analysis: establish a diagnostic analysis of this case supported by a clinical guideline : 
-summary of signficiant clinical data
– create a diagnostic rationale of the case including diagnosis and clinical data that support it  
Critical Thinking Questions
1.      What is the relationship between levels of CD4 lymphocytes and the likelihood of clinical complications from AIDS?
2.      Why does the United States Public Health Service recommend monitoring CD4 counts every 3 to 6 months in patients infected with HIV?