Exam 1 - Infectious mononucleosis

Question 1

What causes mono? How is it transmitted?

Answer 1

EBV - transmitted via saliva

Question 2

What is the incubation period of mono?

Answer 2

30-50 days

Question 3

What is the classic triad for mono presentation?

Answer 3

• Fever
• Sore throat
• Lymphadenopathy (posterior cervical)

Question 4

Mono differential diagnosis

Answer 4

• CMV
• Acute HIV
• Group a beta hemolytic strep

Question 5

Mono physical exam findings

Answer 5

• Tonsillar inflammation and exudates
• Petechiae soft palate
• Lymphadenopathy
• Splenomegaly
• Hepatomegaly

Question 6

What tests could the provider order to determine mono diagnosis?

Answer 6

• Mono spot (can take 2 weeks to turn positive)
• CBC w/ diff
• EBV testing (if mono spot is neg and still concerned)
• Liver function tests

Question 7

Lab results that indicate mono

Answer 7

• CBC w/ diff
  
  • Elevated or atypical lymphocytes
• EBV testing
  
  • Viral capsid antigen (VCA) immunoglobulin M (IgM)
• Liver function test
  
  • Elevated AST/ALT

Question 8

When do acute symptoms of mono resolve?

Answer 8

Acute symptoms resolve in 1-2 weeks but can have persistent fatigue for 1+ months

Question 9

Mono management and patient education

Answer 9

• Hydration
• OTC pain relievers to manage fever and sore throat
• Avoid alcohol due to hepatomegaly
• Avoid strenous exercise (splenomegaly)