A 37 year old man who is HIV 1 positive has had increasing memory - ProProfs
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A 37-year-old man who is HIV-1-positive has had increasing memory problems for the past year. He is depressed. During the past 3 months, he has had increasing problems with motor function and is now unable to stand or walk. For the past 3 days, he has had fever, cough, and dyspnea. A bronchoalveolar lavage shows cysts of Pneumocystis jiroveci. MRI of the brain shows diffuse cerebral atrophy; no focal lesions are identified. On microscopic examination of the brain, which of the following findings is most likely to be present?



A. Plaques of demyelination in periventricular white matter
B. Neocortical senile plaques and neurofibrillary tangles
C. Multiple lacunar infarcts in basal ganglia
D. Spongiform change involving cerebellum and neocortex
E. White matter microglial nodules with multinucleate cells

This question is part of

Pathology Review ch 28 CNS prt 3

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1 Answer

John Smith

John Smith

Answered on Sep 09, 2016

White matter microglial nodules with multinucleate cells-(e) this patient has aids dementia complex late in the course of hiv infection. hiv-1 produces an encephalitis that is characterized by a collection of reactive microglial cells (microglial nodules). hiv-1-infected mononuclear cells, particularly macrophages, can fuse to form multinucleate cells, which are seen in association with microglial nodules. plaques of demyelination are typical of multiple sclerosis. senile plaques and tangles are typical of alzheimer disease and are unlikely to manifest at this patients age. lacunar infarcts are small, cavitary infarcts that result from arteriolosclerosis of the deep penetrating arteries and arterioles. such arteriolar lesions occur in individuals with long-standing hypertension and are unlikely to be found in a 37-year-old man. spongiform change suggests creutzfeldt-jakob disease, a rapidly progressive dementia unrelated to hiv infection. bp7 829830bp8 877878pbd7 13751376pbd8 1305
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