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NELSONS > EPSTEIN BARR VIRUS > Flashcards

EPSTEIN BARR VIRUS Flashcards

1
Q

What s Infectious mononucleosis?

A

characterized by systemic somatic
complaints consisting primarily of
fatigue, malaise, fever, sore throat,
and generalized lymphadenopathy

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2
Q

EBV is primarily transmitted how?

A

oral secretions

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3
Q

How long does EBV shed in oral secretions?

A

6 mos and intermittently for life

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4
Q

What is the other way of EBV transmission?

A

male and female genital secretions

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5
Q

What is the triad of EBV?

A

fatigue, pharyngitis, and generalized lymphadenopathy

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6
Q

What cells are the target of EBV?

A

oral epithelial cells and tonsillar B lymphocytes

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7
Q

How long is the incubation period of EBV?

A

6 WEEKS

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8
Q

What lymphocytes that are frequently detected in patients with infectious mononucleosis?

A

CD8 T lymphocytes

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9
Q

How long is the prodromal syndrome?

A

1-2 wk

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10
Q

What is the reason for the left upper quadrant abdominal discomfort and tenderness?

A

Splenic enlargement

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11
Q

What is the classic physical examination finding?

A

generalized lymphadenopathy
splenomegaly (2-3 cm below the costal margin)
hepatomegaly

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12
Q

Where is the most common location of lymphadenopathy?

A

Epitrochlear lymphadenopathy

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13
Q

Patients with infectious mononucleosis who are
treated with ampicillin or amoxicillin may experience what?

A

ampicillin rash,

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14
Q

What is Ampicillin Rash?

A

morbilliform, vasculitic rash that is probably immune mediated and resolves without specific treatment

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15
Q

What is Gianotti-Crosti syndrome?

A

symmetric rash on the cheeks with multiple
erythematous papules that may coalesce into plaques and persist for 15-50 days.

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16
Q

What is the laboratory finding in patient with Infectious Mononucleosis?

A

atypical lymphocytes

17
Q

What EBV test that is sensitive, that remain positive for up to 12 mos?

A

monospot test that detects Heterophile antibodies

18
Q

The acute phase of infectious mononucleosis
is characterized by what increase in antibodies?

A

IgG and IgM antibody responses to viral capsid antigen (VCA) and IgG response to Early Antigen (EA)

19
Q

IgM response to VCA can be detected how long?

A

4 wk and occasionally up to 3 mo

20
Q

What antibodies that the last to develop in infectious mononucleosis and gradually appear 3-4 mo after the onset of illness
and remain at low levels for life?

A

Anti-EBNA IgG antibodies

21
Q

If anti EBNA is is negative and all other antibodies are present, what does it imply?

A

theres a recent infection

22
Q

What is the most valuable and specific serologic test for the diagnosis of acute EBV infection and is generally sufficient to confirm the diagnosis?

A

IgM antibody to viral capsid antigen (VCA)

23
Q

Is detection of EBV DNA necessary to diagnose infectious mononucleosis in immunocompetent patients with typical manifestations of disease?

A

nO

24
Q

What are the antibodies that are present during acute infection?

A

VCA IgM
VCA IgG
EA IgG

25
Q

What are the antibodies that are present when you have Past infection?

A

VCA IgG (primarily)
EA IgG

26
Q

What are the antibodies that are present when you have recent primary infection?

A

VCA IgG (primarily)
VCA IgM
EA IgG
EBNA Ig

27
Q

What complication that manifest Perceptual distortions of sizes, shapes, and spatial relationships?

A

Alice in Wonderland syndrome (metamorphopsia)

28
Q

What hematologic abnormality is common?

A

mild hemolytic anemia
thrombocytopenia
neutropenia

29
Q

EBV is associated with what lymphoid
malignancies?

A

Burkitt lymphoma
Hodgkin lymphoma
aggressive NK cell leukemia
T- and NK cell lymphoproliferative disorder
epithelial cell malignancies

30
Q

What are the The mainstays of management?

A

rest, adequate fluid and nutrition intake, and
symptomatic treatment

31
Q

What should be advised regarding contact sports?

A

advise against participation in contact sports and strenuous athletic activities during the first 2-3 wk of illness or while splenomegaly is present.

32
Q

Is antiviral therapy effective?

A

NO

33
Q

Discuss the prognosis

A

The prognosis for complete recovery is excellent.

The major symptoms typically last 2-4 wk, followed by gradual recovery within 2 mo of
symptom onset.

Cervical lymphadenopathy and fatigue may resolve more slowly.

Prolonged and debilitating fatigue and malaise may wax and wane for several weeks to 6 mo and are common complaints even in otherwise unremarkable cases.

Occasional persistence of fatigue for
a few years after infectious mononucleosis is well recognized.

NELSONS (5 decks)

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