A nurse is caring for a patient suffering from human immunodeficiency syndrome (HIV) and during the inspection of mouth notes whitish thickening (growths), unable to be scraped off. What is the term for this unexpected finding?

A) Glossitis: Glossitis refers to inflammation of the tongue, which can lead to redness, swelling, and sometimes a smooth appearance. It does not typically cause whitish thickening or growths in the mouth that cannot be scraped off. Glossitis is more related to the tongue's surface rather than abnormal growths or lesions.

B) Tonsillitis: Tonsillitis is an infection or inflammation of the tonsils, typically caused by viral or bacterial infections. It results in sore throat, swelling of the tonsils, and sometimes white patches. However, tonsillitis does not cause whitish thickening or growths on the oral mucosa that cannot be scraped off, making it an unlikely diagnosis here.

C) Herpes simplex: Herpes simplex virus (HSV) infections can cause oral lesions, such as cold sores or blisters. These lesions are usually painful, fluid-filled, and can be scraped off. They do not cause thick, white, non-scrapable growths like leukoplakia does.

D) Leukoplakia: Leukoplakia refers to the development of thick, white patches on the mucous membranes of the mouth, which cannot be scraped off. It is often associated with conditions like HIV, smoking, and chronic irritation. The presence of leukoplakia in an HIV-positive patient is concerning because it can be precancerous. This is the correct term for the finding described in the question.

A) Diabetic retinopathy: Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. It can lead to vision problems, including blurry vision, floaters, and in advanced stages, vision loss. However, the central vision loss specifically described in the question is more characteristic of macular degeneration, as diabetic retinopathy typically causes peripheral vision loss rather than affecting the center of the visual field.

B) Detached retina: A detached retina occurs when the retina pulls away from its normal position, which can lead to sudden vision changes such as the appearance of floaters, flashes of light, and a shadow or curtain over the vision. While it can result in significant visual impairment, it does not typically cause a black spot in the center of vision. The loss of vision in a detached retina tends to occur in peripheral vision first, not centrally.

C) Macular degeneration: Macular degeneration, specifically age-related macular degeneration (AMD), is the most likely cause of the central vision loss described. It affects the macula, the part of the retina responsible for central vision. As the disease progresses, patients may notice a dark or empty spot in the center of their visual field, which matches the complaint of a "black large spot" in the center of their vision.

D) Glaucoma: Glaucoma is a group of eye diseases that typically cause increased intraocular pressure, leading to damage to the optic nerve and peripheral vision loss. It is more commonly associated with peripheral vision loss, and the central vision is generally preserved until the disease progresses to advanced stages. Therefore, central vision loss is not typically a characteristic symptom of glaucoma.