AIDS defining dz

[MudPhud20XX]

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Here is one of the Kaplan questions:

Which of the following would be consistent with a diagnosis of full-blown AIDS?
A. Bacillary angiomatosis
B. CD4 cell count above 200/mm3
C. Hairy leukoplakia
D. Persistent vulvovaginal candidiasis
E. Pneumocystis pneumonia

The answer is E. But why not C? I thought hairy leukoplakia was one of the AIDS defining dz? So AIDS defining dz doesn't necessary mean it's full-blown AIDS?

Many thanks in advance.

 

[Missorleans]

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[Missorleans]

I think this is a bad question, except that it tests your test-taking skills. Hairy leukoplakia is more common in AIDS patients, but you know PCP pneumonia is an aids defining illness, so don't be lured by another answer that might be correct. Also, wtf Kaplan, "full blown AIDS" is not a diagnosis, nor an appropriate description.

 

[Missorleans]

CDC revised classification system for HIV.
It's from 1993, but is the most recent classification revision that I could find. Doesn't include oral hairy leukoplakia, nor persistent vulvovaginal candidiasis (but oral candidiasis is).

www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm

Scroll down to the conclusion.

 

[igcgnerd]

C can be seen in AIDS patients, however it can also be seen in other patients without aids. PCP is textbook for AIDS defining illness. AIDS defining illnesses are a set of clinical criteria for diagnosis outside of a true CD4 count.

 

[Selector]

C can be seen in AIDS patients, however it can also be seen in other patients without aids. PCP is textbook for AIDS defining illness. AIDS defining illnesses are a set of clinical criteria for diagnosis outside of a true CD4 count.

Or outside of a CD4 percentage.


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[Selector]

Not to harp on the subject (I'm only bringing this up since in my review I thought it to be a relevant distinction that could possibly be tested) and maybe this is a small point that most already have thought of: I think the key is that in a person who is HIV positive, PCP is AIDS defining, but that doesn't mean that it, or any other AIDS defining illnesses cannot be seen in other populations (immunocompromised, pts undergoing immunosuppressive therapy, etc...)

So if you were to be asked: A pt comes in, you suspect AIDS. Which of the following would be most consistent with a diagnosis of AIDS:
A. CD4 < 200
B. CD4 < 14%
C. PCP

The 'best' answer is CD4 %. Followed by CD4 count.
Point being, if it isn't established that the patient is first HIV positive (an assumption that I could see making on test day) then AIDS defining illnesses are not really AIDS defining.

 

[Instatewaiter]

C can be seen in AIDS patients, however it can also be seen in other patients without aids. PCP is textbook for AIDS defining illness. AIDS defining illnesses are a set of clinical criteria for diagnosis outside of a true CD4 count.

And PCP can be seen outside of AIDS as well...