Check out today’s Step 1 Qmax Question Challenge.
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A homeless 37-year-old woman with HIV infection comes to the clinic with a 4-week history of worsening hemiparesis, visual field deficits, and cognitive impairment. The patient’s CD4+ count is 22/mm³. A lumbar puncture shows a normal opening pressure, and cerebrospinal fluid analysis is largely normal. An MRI is performed and is shown in the image.
Which of the following entities is most likely responsible for this patient’s clinical picture?
A. Cortical tuberculoma
B. Cytomegalovirus encephalitis
C. JC virus
D. Primary central nervous system lymphoma
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