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HIV Q

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jean robert
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05/13/08 - 11:57 PM

A 40 yr old HIV positive man with CD4 cell count of 25/mm3 complains of progressive memory loss, confusion, and incontinence. MRI reveals moderate brain atrophy. The patien t subsequently dies of disseminated aspergillosis. Autopsy confirms presence of moderate cerebral atrophy. Histologically, there are multifocal lymphohistiocytic infiltrates with numerous microglial nodules and scatterd multinucleated giant cells. Which of the following conditions was most likely responsible for this patient neurologic symptoms?

a) Aspergillosis

b) CMV encephalitis

c) HIV encephalitis

d) Mycobacterial infection

e) Vacuolar myelopathy

Edited by jean robert on 05/14/08 - 12:22 AM

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1.ammara
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05/14/08 - 12:23 AM

B

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Tiff
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05/14/08 - 05:15 AM

B - CMV

Aashi
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05/14/08 - 07:36 AM

The Clue for the answer to this q is in the topic heading itself----------------------->I would go for C---------->HIV encephalitis

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Tiff
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05/14/08 - 08:02 AM

Aashi wrote:
The Clue for the answer to this q is in the topic heading itself----------------------->I would go for C---------->HIV encephalitis

Agree

spinal shock
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05/14/08 - 02:10 PM

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basophilia
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05/14/08 - 02:14 PM

sigh
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05/14/08 - 03:25 PM

jean robert
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05/14/08 - 11:16 PM

Any other clue?

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1.ammara
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05/15/08 - 03:50 AM

#10

oh it states scattered multi nucleated gaint cells.... got it! its mycobacterial infection, if not C then, definitely D i guess raised eyebrow

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sigh
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05/15/08 - 10:20 AM

#11

I thought the same cells in HIV enc. sad

No? So this is really tricky question...

Aashi
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05/15/08 - 11:16 AM

#12

Wait a sec...did jean robert tell that answer C is wrong? or did he /she ask for another clue to the answer..well jean the answer is in the q itself ..all those histologic findings mentioned in the stem are of HIV encephalitis especially those scattered multinucleated giant cells....If HIV encephitis is not the answer please post the right answer with explanation.......thanks..

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new_n_lost
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05/15/08 - 12:42 PM

#13

Aashi wrote:
The Clue for the answer to this q is in the topic heading itself----------------------->I would go for C---------->HIV encephalitis

I seriously couldnt help laughing on this one.

jean robert wrote:
Any other clue?

1.moderate cerebral atrophy.
2.multifocal lymphohistiocytic infiltrates
3.numerous microglial nodules
4.scatterd multinucleated giant cells

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bbb
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05/15/08 - 02:10 PM

#14

b) CMV encephalitis - CD4 less than 50, multinuclear giant cells

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new_n_lost
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05/15/08 - 02:35 PM

#15

Me thinks CMV encephalitis leads to vertriculoatrophy and HIV leads to cerebral atrophy rest of the features almost the same.

Moi 2 cents.

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Tiff
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05/15/08 - 04:18 PM

#16

Is Choice C supposed to read HIV encephalitis or HSV encephalitis? I read it originally as HSV which is why I finally agreed to choice C. But if it's really HIV encephalitis, I'm not sure at all - because there are various forms of encephalitis in HIV patients.

Tiff
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05/15/08 - 04:32 PM

#17

Then again the question stem does say multinucleated giant cells and I think that might be pathognomic for HIV infection acting directly on the CNS. So basically I'm still lost on this one.

GoodGirl
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