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USMLE Step 1 QUESTION of the DAY!

A 43 year-old woman has been HIV positive for 18 years. Recently her sister has noticed that she has been slow responding to questions and also somewhat uncoordinated in her movements. A full workup is done including a CT of her brain. The CT demonstrates ring enhancing lesions. Which of the following would be her best treatment choice?

A) Pyrimethamine-sulfadiazine
B) Metronidazole
C) Chloroquine
D) Trimethoprim-sulfamethoxazole
E) Clarithromycin and ethambutol

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Answer: A) Pyrimethamine-sulfadiazine. This patient is experiencing Toxoplasma encephalitis caused by toxoplasma gondii. It is a common dementia in full blown AIDS. Drug of choice for toxoplasma is Pyrimethamine-sulfadiazine. Answer D is the D.O.C. for Pneumocystis carinii. Answer E is the D.O.C. for M. avium complex.



USMLE Step 1 D.O.C. of the DAY!

Drug of choice for

Neisseria Meningitis causing meningitis

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Penicillin G


FACT of the DAY!

Congenital Heart Defects:
Cyanotic (represents R to L shunt)
-Tetralogy of Fallot
-Transposition of great vessels
-Persistent truncus arteriosus
-Eisenmenger’s complex (board favorite)

Acyanotic (represents L to R shunt)
-Ventricular septal defects
-atrial septal defects
-patent ductus arteriosus

Obstructive
-coarctation of aorta (infants-preductal; adults-postductal)
-pulmonary stenosis or atresia
-aortic stenosis or atresia