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NBME 20 Answers

nbme20/Block 4/Question#7 (39.3 difficulty score)
A 33-year-old woman with HIV infection is ...
Non-Hodgkin lymphomaπŸ”

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submitted by hayayah(1056),
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Tsih si a rypiram claertn noesvur mtssye molhy.pam toMs lomncmoy adaicetsso wtih S/AV;HIDI ioseshgenpta osenlvvi BVE neion.cift

nedisoedCr na geAIinnifDd-S lsl.iesn ablaeVir ttesnpo:irean finou,oscn ryeomm o,ssl srzui.ese Mass nosil)se( mya( be nrenicina-hggn ni mspdmmmroucoenoii petait)n no IR,M eensd to be eugdsthinsidi fomr salxpsotsoomi iva CSF aynaisls or oterh bla .tsset xToo lyulusa has uiplltem ignr hncnneiag nlseis.o

peridot  For those who are curious, this is on p.422 of FA2019 +  

submitted by radion(16),
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liSgne cninhegna linseo tsipno orem owstdra hmpaomly htan xt.oo xooT si lauylus urmil-gtni ehingnacn .nsiolse

submitted by yotsubato(968),
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tI tnac eb aaicrtBel bssseca )cadai(Nro esbauce essh igantk MPT .MSX

tI tcna be xo,to uaseebc hse sah noe leonis dan is lsao ignkat MPT MXS whihc ohdusl mpervio her ps.stoymm

aatiloolbsGm si a edaesis fo erlod diuidlvsina

ctiaetsatM essiade ttah esmt ot teh airbn si iknlleyu ta iths ae.g

NCS pahoymlm is oocmmn in VHI IASD tt,paiesn os htta is het tosm likely h.oicec

mrglass  She's not taking TMP/SMX though. I would pick lymphoma over abscess mainly because .5cm growth in 2 weeks is incredibly rapid, which is classic for diffuse B-cell lymphoma, which is what tends to be in the CNS. Also there was no evidence of a classic source of brain abscess like mastoiditis. +19