where is team..enjoyin sunday?12 - showman

[ArchivalUser]

hi evryone

[ArchivalUser]

1a
The correct answer is A. Cutaneous cryptococcosis is primarily an opportunistic infection with Cryptococcus neoformans which affects the central nervous system. The disease is subacute and mild headaches, fever, and malaise are the predominant features. Cutaneous cryptococcosis in HIV infection usually presents as small papules with central umbilication covered with hemorrhagic crust. Tumors and ulcerative lesions of skin or mucous membranes are also seen. Often, the lesions resemble Molluscum contagiosum, herpes infection, and Kaposi sarcoma. Whenever presented with an immunosuppressed patient with lesions resembling molluscum, always bear in mind other deep fungal infections. If there is enough doubt, biopsy the lesions for culture and warn the laboratory that cryptococcus is suspected, since the culture form is highly contagious.
Acyclovir (choice B) is incorrect because herpes may be in the differential of cutaneous cryptococcus. One should rule out more dangerous infection first before treating blindly.
No treatment (choice C) is incorrect because, as mentioned above, immunosuppressed patients are at a much higher risk for deep fungal infection and this patient's CD4 count is well under 200.
Tinea faciei (choice D) is incorrect because this is a superficial fungal infection that usually does not result in papules and is not associated with systemic symptoms such as fever and malaise as in this patient.
Treating the lesions with liquid nitrogen (choice E) as if these are typical Molluscum contagiosum lesions is incorrect as described above.

[ArchivalUser]

2d
The correct answer is D. Patients with recurrent episodes of candidiasis should be evaluated for predisposing factors such as diabetes mellitus and immunosuppression. Since she has no other obvious risk factors for HIV or any other immune defects, it is best to first rule out diabetes before testing for immunodeficiency (choice B). Other risk factors for recurrences were ruled out in the history (habitual use of panty liners, wearing warm moist clothing for prolonged periods of time, antibiotic usage, and reinfection from an infected sexual partner).
Advising her to stop exercising for a month and then return for reexamination (choice A) is inappropriate. While wearing warm, moist clothing for prolonged periods of time can increase the risk of Candida infection, as long as she changes after exercising, she should be fine. She should be tested for diabetes at this time.
Since she has not been sexually active in months, it is inappropriate to have her contact past sexual partners for an evaluation (choice C). She has recurrences despite sexual activity.
It is incorrect to prescribe one 500 mg vaginal tablet of clotrimazole for prophylaxis, and ask her to return for reexamination in 1 month (choice E), because she has a current infection and requires evaluation and treatment, not prophylaxis.

[ArchivalUser]

stefan are you tensed?chill down.....

[ArchivalUser]

stefan is not tensed...no worry.