Keshitha konda

  1.Which clinical history and physical findings are characteristic of Tracheo oesophagal fistula? A. Dysphagia is the common presentation of tracheo oesophagal fistula(TOF)      This patient has clinical symptoms suggestive of Tuberculosis which could be one of the reason for    TOF .      Laryngeal crepitus is positive in this patient which can be seen in TOF 2.What are the chances of this patient developing immune reconstitution inflammatory syndrome?Can we prevent this? A.IRIS can be prevented by initiating the ART before the development of advanced Immunosuppression i.e;starting the therapy before CD4 cell count decreases more This patient has   CD4 count of 420 when ART is initiated .So this patient has very less chances of developin IRIS. Risk factors for IRIS : Low baseline CD4 count                                      High viral load                                      Short time interval between starting ATT & HRTT 1.What is the evolution of symptom