Clinical

When to initiate treatment in patients with HIV

Figure 1 Quiz of the Week A 60-year-old man who is HIV positive presents with fever, dyspnea, and inflammatory lesions on the skin. A biopsy reveals a diagnosis of histoplasmosis.  Image credit: @BiBiRamos. #AIDS15.   Answer: Any CD4 count The WHO now recommends ART should be started at any CD4 count. Early initiation of ART can...

How would you treat this tumor?

Figure 1 Quiz of the Week A 21-year-old female presents with a six-month history of irregular menses, decreased libido, impaired vision, and galactorrhea. An MRI is completed. Image credit: @suzical31.   Answer: Dopamine agonist This patient has clinical findings and imaging suggestive of macroprolactinoma, a benign adenoma of the pituitary gland that overproduces the hormone prolactin....

Do you recognize this blistering pruritic rash?

Figure 1 Quiz of the Week A 4-year-old boy with known G6PD deficiency is brought to the pediatrician by his mother with a blistering pruritic rash. On examination, numerous tense vesicles and bullae are seen on his neck, lower abdomen, and extremities. Ulcerative lesions on his buccal mucosa are also noted. Direct immunofluorescence of a...

A case of “broken-heart” syndrome

Figure 1 Quiz of the Week A 67-year-old woman presents to the emergency room with acute chest pain and dyspnea after the death of her husband. She is hypotensive, tachycardic, and diaphoretic. A diagnosis of takotsubo cardiomyopathy is suspected.   Image credit: @bioplasmik.   Answer: Normal coronary arteries The diagnosis of takotsubo, or stress-induced cardiomyopathy,...