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  • Medical Setting: A thirty-five year-old gay male patient with a history of high-risk sexual activity and recreational drug use (IV) is seen in an internal medicine clinic.
  •  Chief Complaint/History:
    •  sore throat
    •  intermittent fevers and occasional night sweats
  • Physical Exam:
    •  Thin male, no acute distress
    •  Temperature: 37
    •  BP: 90/60 mm Hg
    •  Pulse: 85
    •  Pharynx-white exudate consistent with candidiasis
    •  Lungs-clear
  • Laboratory values:
    •  HIV antibody: positive
    •  CD4: 350 cells/ul
    •  Viral load-10,000 copies/ml
    •  Amylase-normal
    •  Creatinine-1.1 mg/dL
    •  HCT: 27%
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case material courtesy of Dr. Susan Masters, Department. of Pharmacology University of California San Francisco (used with permission)