infect-10 - verypositive

[ArchivalUser]

A 26-year-old HIV-positive woman presents to the emergency department complaining of "a nosebleed that just won™t stop." Earlier today, she was playing a game of softball with some friends when she was hit in the face by a ball. The impact caused her nose to start bleeding profusely from the right nostril. She then pinched her nose shut and leaned forward for 15 minutes but the bleeding persisted, which prompted her to come to the emergency department. She does not recall any similar episodes occurring before, though her menstrual flow has become heavier lately. She was diagnosed with HIV two years ago after attempting to donate blood. Her medical history is also significant for gastroesophageal reflux disease and migraine headaches, and her medications include rizatriptan as needed and a multivitamin. Her temperature is 36.9C (98.4F), blood pressure is 116/78 mm Hg, pulse is 70/min, and respirations are 14/min. On examination, blood is dripping steadily from the right nostril. The nasal mucosa appears otherwise normal. The mouth and pharynx appear normal and without lesions. No blood is visible in the posterior throat. Cranial nerves are intact and the remainder of the neurologic exam is normal. Chest auscultation is unremarkable and heart sounds are normal. Her abdomen is nontender and nondistended. There is some splenomegaly. There is no evidence of purpura or petechiae. Laboratory evaluation reveals the following:
CBC
Hb 13.2 g/dL
Hct 41.1 %
MCV 90 fl
Platelet count 38,000/cmm
Leukocyte count 3,900/cmm
Segmented neutrophils 79%
Band neutrophils 2%
Lymphocytes 10%
Monocytes 5%
Eosinophils 3%
Basophils 1%
Coagulation Studies
Prothrombin time 13 sec
Partial thromboplastin time 24 sec
CD4 count 430/mm3
Viral load

[ArchivalUser]

sorry about this one

Viral load

[ArchivalUser]

viral load

[ArchivalUser]

sorry won't let me post the questions

[ArchivalUser]

try one more time

Appropriate action was taken. The patient decided to begin highly active antiretroviral therapy (HAART). Assuming she is able to adhere to the three-drug regimen, what is her expected HIV viral load after six months of treatment?
A) 0-50 copies/mL
B) 100-500 copies/mL
C) 1,000-5,000 copies/mL
D) 10,000-50,000 copies/mL
E) 100,000-500,000 copies/mL

[ArchivalUser]

the viral load

[ArchivalUser]

aaaaaa

[ArchivalUser]

what's the initial viral load before HAART?
my guess, the answer is D.
what, the answer?