1. CASE 5 54 yo man HIV positive in 2001 Immune Thrombocytopenia Chronic G1a Hepatitis C Crack use daily Normotensive

2. CASE 5 April 2013 TDF/FTC/EFAVIRENZ CD4 520 HIV Viral load<50 Platelets 222 Creatinine 81 K 4.2 a/c ratio<2…u/a negative for all

3. CASE 5 September 2014 Off meds x 1 year Severe Headaches over the last few months in the absence of fevers/constitutional signs/symptoms Crack use daily

4. CASE 5 September 2014 O/E : BP 250/130 x 2 Fundi…blurring of disc margins SOAs to mid calves..no bruits Chest clear Jvp 2 cm

5. CASE 5 September 2014 Sent to ER as a hypertensive emergency Sent back out same day on Hydralazine 25mg qid BP in my office the next day was still 215/120…No overt CHF

6. CASE 5 September 2014 Refused to go back to ER Stopped crack

7. CASE 5 September 2014 Trandolapril 2mg/day added to hydralazine 25mg tid Bloods done Agreed to be seen 3x weekly

8. CASE 5 September 2014 Bp down to 200/110 Labs Creatinine 197 random urine protein 11.586g/l.. Urine albumin 6.656 g/l U/A 2+ blood/>3g/l protein K 4.7 Albumin 31 CBC …normal platelets CD4 380

9. CASE 5 September 2014 Furosemide 80mg added\restarted RTV/DRV/RGV BP 175/80 No soas Awaiting nephrology consult re biopsy of kidney