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Z Year3 Gastro Conditions > Infectious Mononucleosis > Flashcards

Infectious Mononucleosis Flashcards

1
Q

What is infectious mononucleosis (IM) also known as?

A

glandular fever

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2
Q

What is IM mostly caused by?

A

Epstein-Barr virus (EBV) infection in 80% to 90% of cases

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3
Q

What are the risk factors for IM?

A
  1. Sexual activity

2. Kissing

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4
Q

What is the typical epid for IM?

A

aged 15 to 24 years are the most affected age group

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5
Q

What are symptoms of IM?

A
  1. Fever
  2. Pharyngitis
  3. Cervical or generalised lymphadenopathy
  4. Malaise
  5. Splenomegaly
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6
Q

What are potential differential diagnosis of IM?

A
  1. Group A streptococcal pharyngitis
  2. Hepatitis A
  3. Acute HIV infection
  4. Adenovirus
  5. Human herpes virus-6
  6. Cytomegalovirus (CMV) infection
  7. Herpes simplex virus-1
  8. Influenza infection
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7
Q

What are 1st line investigations for IM?

A
  1. FBC
  2. Heterophile antibodies
  3. EBV-specific antibodies
  4. LFTs
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8
Q

What might the FBC show in IM?

A

lymphocytosis, atypical lymphocytosis

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9
Q

What would the heterophile antibodies show in IM?

A

positive heterophile antibodies

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10
Q

What would EBV-specific antibodies show in IM?

A

positive for EBV-specific antibodies: VCA-IgM, VCA-IgG, EA, EBV EBNA

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11
Q

What would LFTs be like in IM?

A

elevated

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12
Q

What other investigations would you consider for IM and why?

A
  1. PCR: EBV DNA detection
  2. Us of abdomen: splenomegaly
  3. Ct of abdomen: if splenic rupture suspected
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13
Q

What is the 1st line treatment for IM?

A

supportive care: analgesia, hydration

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14
Q

What is the 1st line treatment for IM with upper airway obstruction or haemolytic anaemia?

A

supportive care + corticosteroid

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15
Q

What is the 1st line treatment for IM with thrombocytopaenia?

A

supportive care + corticosteroids or intravenous immunoglobulin

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16
Q

What are the possible complications of IM?

A
  1. antibiotic-induced rash
  2. splenic rupture
  3. neurological complications
  4. chronic active Epstein-Barr virus (EBV) infection
  5. autoimmune diseases, non-haematological
  6. malignancy
  7. chronic fatigue
  8. acute acalculous cholecystitis (AAC)
  9. renal complications
  10. haemophagocytic lymphohistiocytosis (HLH)
17
Q

What is the prognosis for IM?

A
  • healthy people with IM is very good
  • Death occurs rarely, and is usually caused by airway obstruction, splenic rupture, neurological complications, haemorrhage, or secondary infection

Z Year3 Gastro Conditions (48 decks)

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