kpmle2
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A 23-year-old man has the sudden onset of left-sided weakness. He has been HIV positive for 3 years and has a CD4+ lymphocyte count of 30/mm3 (Normal?500). His temperature is 38.5°C (101.3°F), blood pressure is 100/70 mm Hg, pulse is 100/min, and respirations are 14/min. There is weakness and diminished perception to light touch and pinprick on the left upper and lower extremities. A CT scan of the head with contrast enhancement is shown. Which of the following is the most likely explanation for the weakness?
O A) Cerebral toxoplasmosis
O B) Cryptococcal meningitis
O C) Herpes encephalitis
O D) Kaposi's sarcoma
O E) Progressive multifocal leukoencephalopathy
Pls explain u r answer. Thanks.
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| drdg
Forum Senior
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looks llike E since the CT scan is not here.
Cerebral Toxoplasmosis and PML can cause motor and sensory abnormalities and both can be seen in CT scan. PML typical occurs at CD 4 <100, and Toxoplasmosis CD4 will be 100-200.
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| titly
Forum Elite
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 between A and E
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| Nastya
Forum Newbie
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I think it`s E
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| tamerbashir
Forum Elite
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A FOCAL NEUR. SIGN
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| tamerbashir
Forum Elite
Topics: 20
Posts: 284
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STILL NEED THE TRUE ANSWE PLZ
WITH THE EXAPLAINATION
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| darkhorse
Forum Elite
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i havent seen the CT scan...it will be very useful i think....however...the case is a cute onset with focal neurology....presentation is of a mass rather than meningitis or encephalitis...that leaves us with A or E...PMLE is of insidious onset....takes weeks to months...usually afects parietooccipital area...presentiing with aphasia or blindness...all the symptoms come gradually rather tha in a day or 2 as given in this scenario...the lesions usually donot enhance with contrast...this is where looking at the CT will be useful.....that leaves us with AAAAAAAAAAAAAA....so i go for A
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