Order Carcinomatous meningitis discussion
A 49-year-old woman presents with sudden onset of left-sided facial
weakness, hearing loss, and ear pain for 2 days. On examination, she has
a vesicular rash on her left ear and sensorineural hearing loss on the left,
as well as left face weakness. What is the most likely diagnosis?
A. Carcinomatous meningitis
B. Ramsay Hunt syndrome
C. HHV-6
D. HTLV-1
E. None of the above
80. A 27-year-old man with a history of HIV presents with 3 weeks of
dysarthria and progressive left-sided weakness. He has been noncompli-
ant with his antiretroviral medications. His last CD4 count was 72. An
MRI brain scan demonstrated large confluent areas of T2 hyperintensities
in the subcortical white matter bilaterally consistent with severe demyeli-
nation. Diffusion-weighted images were negative. An LP was performed
and demonstrated normal opening pressure, normal cell count, glucose,
and protein. CSF polymerase chain reaction (PCR) for John Cunningham
(JC) virus was positive. What is the most likely location of this virus?
A. Astrocytes
B. Macrophages
C. Schwann cells
D. Oligodendrocytes
E. Basket cells
F. None of the above
81. A 60-year-old man with a history of untreated venereal disease complains
of sudden lancinating pain in both legs. On examination, the patient has
unequal pupils. The involved pupil does not react to light but constricts
during accommodation. Sensory examination reveals decreased vibration
and joint position sense. The patient exhibited a mild decrease in sensation
to pinprick and temperature. Absent reflexes and a wide-based gait were
demonstrated. Laboratory findings showed that his rapid plasma regain
was positive and FTA-ABS was also positive. An LP demonstrated increased
lymphocytes, elevated protein, and positive Venereal Disease Research Lab-
oratory results (VDRL) in the CSF. The patient’s eye findings are known as:
A. Marcus-Gunn pupil
B. Adie’s pupil
C. Argyll-Robertson pupil
D. tonic pupil
E. There is no known name for his eye findings
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