A 40-Year-Old Male Is Brought to the Emergency Room with Confusion, Lethargy, and Decreased

question 1097

Multiple Choice

A 40-year-old male is brought to the emergency room with confusion, lethargy, and decreased strength in his left arm.  He is HIV-positive.  He was diagnosed several months ago, but he refused any kind of therapy.  His most recent CD4 cell count was 40/μL.  A lumbar puncture is performed, but cerebral spinal fluid findings and cytology are inconclusive.  A CT scan reveals a well-defined small focal lesion in the right cerebral hemisphere.  Biopsy findings are consistent with primary CNS lymphoma.  You decide to proceed with radiation therapy and corticosteroids, and to institute HAART.  Which of the following is the best prognostic sign for this patient's condition?

• A)The stage of the lymphoma
• B)Decrease in EBV DNA in CSF
• C)Increase in soluble B-cell marker in CSF
• D)Increase in CD4 count
• E)Rapid response to radiation therapy

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Definitions:

Insight Learning

Insight Learning is a cognitive process in which learning occurs suddenly through understanding the relationships between various parts of a problem rather than by trial and error.

Latent Learning

A form of learning that occurs without any obvious reinforcement of the behavior or associations that are learned.

Aha! Experience

A moment of sudden insight or discovery when a solution to a problem becomes clear, often after a period of contemplation or confusion.

Learned Helplessness

A scenario in which someone is afflicted by a profound sense of ineffectiveness, triggered by a harrowing event or consistent failures.