HIV-Positive Patient — CD4 82, Oral White Plaques That Cannot Be Wiped Off

About This Case

This clinical reasoning case presents a patient with hiv-positive patient / cd4 82 / oral white plaques that cannot be wiped off in a infectious disease context. Learners work through a structured 10-phase simulation covering initial differential, history-taking, physical examination, labs and imaging, and management planning.

"An HIV-positive patient with CD4 of 82 presents to your dental clinic. You find white plaques on the lateral tongue and buccal mucosa that cannot be wiped off. He mentions his physician recently started him on fluconazole for 'a fungal infection.' What do you think these plaques represent — and does the ongoing fluconazole treatment change your assessment?"

How the Simulation Works

1. Read the patient presentation and form your initial differential diagnosis
2. Interview the AI patient to gather history and explore your hypotheses
3. Perform a focused physical examination based on your differential
4. Order appropriate labs and imaging, then interpret the results
5. Revise your diagnosis and develop a management plan
6. Receive personalized teaching feedback from your AI attending, Dr. Patel

What You'll Learn

This case builds skills in systematic clinical reasoning, hypothesis-driven history-taking, appropriate test ordering, and evidence-based management. It is designed for Dentistry students and practicing clinicians seeking to sharpen diagnostic thinking in infectious disease.

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About ReasonDx

ReasonDx is an AI-powered clinical reasoning education platform developed by Dr. Lauren Fine, MD, FAAAAI, Associate Professor and Assistant Dean of Clinical Skills Education at NSU Dr. Kiran C. Patel College of Allopathic Medicine. The platform features 394 simulation cases across 10 health professions, designed to train the cognitive processes underlying accurate diagnosis.