IMN

Question 1

Cause of IMN?

Answer 1

EBV (DNA, oncogenic virus)

Question 2

EBV in oncogenic virus causing ?

Answer 2

1. Nasopharyngeal carcinoma

2. Burkitt’s lymphoma

Question 3

MOI of IMN?

Answer 3

Droplet infection mainly… RARELY blood

Question 4

IP of IMN?

Answer 4

1 to 2 MONTHS

Question 5

What does IMN attach?

Answer 5

Lymphocytes

Question 6

CP of IMN?

Answer 6

Prodromal and full blown picture

Question 7

Prodroma of IMN contain?

Answer 7

1. Fever (gradual up to 39 then decline over 1 week)
2. Sore throat
3. Fatigue
4. Skin rash (maculopapular in 15% of cases .. upto 90% if amphicillin is given

Question 8

Full blown picture of IMN?

Answer 8

1. Tonsillopharyngitis with thick white membrane over the tonsils
2. Generalized lymphadenopathy
3. Splenomegaly (rapidly occurring and tender)
4. Hepatitis

Question 9

Complications of IMN?

Answer 9

1. Spleen rupture even with minor trauma
2. Upper airway obstruction by englarged tonsils
3. Pneumonia
4. Myocarditis
5. Hematologic disorders
   a. Aplastic anemia
   b. AIHA
   c. Thrombocytopenia

Question 10

Investigations of IMN?

Answer 10

1. Absolute lymphocytosis with atypical lymphocytes
2. Detection of EBV IgM (specific)
3. Detection of heterophol antibodies by Paul benelle test (sheep rbcs) and monospot test (against Ox RBCs)

Question 11

Ttt of IMN?

Answer 11

IVIG decreases severity
Symptomatic
1.	Antipyretics avoid aspirin
2.	Bed rest 
3.	Avoid contact sports for 1 – 2 weeks 
Steroids
1.	Tonsillar enlargement with upper airway obst
2.	AIHA
3.	Thrombocytopenia
4.	Seizures and meningitis 
TTT of complications