USMLE Step 1

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


check back tomorrow for your answer.

Yesterday's Answer:
B) Kayser-Fleischer rings. This man most likely has Wilson’s disease, an autosomal recessive disorder of copper metabolism. There is an accumulation of copper (but a decrease in serum ceruloplasmin) which deposits in the liver, basal ganglia, kidney, and cornea (kayser-fleischer rings). Bronze diabetes is seen in hemochromatosis; Nutmeg liver usually manifests in congestive heart failure (most often right sided); emphysema is noted in alpha-1 Antitrypsin deficiency.