Station - Instructions for candidate
You are a doctor in general practice.
Sophie Larkin, a 26-year-old pharmacy assistant, presents today to receive her HIV test results.
HIV antibody/antigen test (4th generation)
| Item | Value | Reference range |
|---|---|---|
| HIV antibody/antigen | Positive | Negative |
CD4 count and lymphocyte subset
| Item | Value | Reference range |
|---|---|---|
| CD4 count | 480 cells/μL | >500 cells/μL |
| CD4 percentage | 22% | >20% |
HIV RNA viral load
| Item | Value | Reference range |
|---|---|---|
| HIV viral load | 62,000 copies/mL | <50 copies/mL |
Full blood count
| Item | Value | Reference range |
|---|---|---|
| Haemoglobin | 134 g/L | 120-160 g/L |
| White cell count | 6.2 x10^9/L | 4.0-11.0 x10^9/L |
| Platelet count | 210 x10^9/L | 150-400 x10^9/L |
Liver function tests
| Item | Value | Reference range |
|---|---|---|
| AST | 28 U/L | 10-40 U/L |
| ALT | 26 U/L | 7-56 U/L |
| Alkaline phosphatase | 72 U/L | 30-120 U/L |
| Bilirubin | 12 umol/L | 3-20 umol/L |
Renal function
| Item | Value | Reference range |
|---|---|---|
| Creatinine | 78 umol/L | 50-100 umol/L |
| eGFR | >60 mL/min/1.73m2 | >60 mL/min/1.73m2 |
| Potassium | 4.2 mmol/L | 3.5-5.0 mmol/L |
Your tasks are to:
- Explain the test result to her.
- Take the focused history the diagnosis now needs.
- Outline your immediate management plan to her.
- You do NOT need to perform a physical examination.
This is a 15-minute station, with 2 minutes of reading time.