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Retired NBME 13 Answers

nbme13/Block 2/Question#21 (reveal difficulty score)
A 36-year-old man who is seropositive for HIV ...
Pneumocystis jiroveci (formerly P. carinii) ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by cv020496(1)
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P. jiroveci: Causes Pneumocystis pneumonia (PCP), a diffuse interstitial pneumonia. Yeast-like fungus (originally classified as protozoan). Inhaled. Most infections are asymptomatic. Immunosuppression (eg, AIDS) predisposes to disease. Diffuse, bilateral ground-glass opacities on CXR/CT. Diagnosed by lung biopsy or lavage. Disc-shaped yeast seen on methenamine silver stain of lung tissue

Treatment/prophylaxis: TMP-SMX, pentamidine, dapsone (prophylaxis only), atovaquone. Start prophylaxis when CD4+ count drops to < 200 cells/mm3 in HIV patients.

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