EPSTEIN BARR VIRUS

Question 1

What s Infectious mononucleosis?

Answer 1

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

Question 2

EBV is primarily transmitted how?

Answer 2

oral secretions

Question 3

How long does EBV shed in oral secretions?

Answer 3

6 mos and intermittently for life

Question 4

What is the other way of EBV transmission?

Answer 4

male and female genital secretions

Question 5

What is the triad of EBV?

Answer 5

fatigue, pharyngitis, and generalized lymphadenopathy

Question 6

What cells are the target of EBV?

Answer 6

oral epithelial cells and tonsillar B lymphocytes

Question 7

How long is the incubation period of EBV?

Answer 7

6 WEEKS

Question 8

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

Answer 8

CD8 T lymphocytes

Question 9

How long is the prodromal syndrome?

Answer 9

1-2 wk

Question 10

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

Answer 10

Splenic enlargement

Question 11

What is the classic physical examination finding?

Answer 11

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

Question 12

Where is the most common location of lymphadenopathy?

Answer 12

Epitrochlear lymphadenopathy

Question 13

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

Answer 13

ampicillin rash,

Question 14

What is Ampicillin Rash?

Answer 14

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

Question 15

What is Gianotti-Crosti syndrome?

Answer 15

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

Question 16

What is the laboratory finding in patient with Infectious Mononucleosis?

Answer 16

atypical lymphocytes

Question 17

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

Answer 17

monospot test that detects Heterophile antibodies

Question 18

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

Answer 18

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

Question 19

IgM response to VCA can be detected how long?

Answer 19

4 wk and occasionally up to 3 mo

Question 20

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?

Answer 20

Anti-EBNA IgG antibodies

Question 21

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

Answer 21

theres a recent infection

Question 22

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

Answer 22

IgM antibody to viral capsid antigen (VCA)

Question 23

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

Answer 23

nO

Question 24

What are the antibodies that are present during acute infection?

Answer 24

VCA IgM
VCA IgG
EA IgG

Question 25

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

Answer 25

VCA IgG (primarily) EA IgG

Question 26

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

Answer 26

VCA IgG (primarily) VCA IgM EA IgG EBNA Ig

Question 27

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

Answer 27

Alice in Wonderland syndrome (metamorphopsia)

Question 28

What hematologic abnormality is common?

Answer 28

mild hemolytic anemia thrombocytopenia neutropenia

Question 29

EBV is associated with what lymphoid malignancies?

Answer 29

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

Question 30

What are the The mainstays of management?

Answer 30

rest, adequate fluid and nutrition intake, and symptomatic treatment

Question 31

What should be advised regarding contact sports?

Answer 31

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

Question 32

Is antiviral therapy effective?

Answer 32

NO

Question 33

Discuss the prognosis

Answer 33

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.