Infectious Mononucleosis

Question 1

How does Mono present?

Answer 1

Fatigue - Malaise - Fever/Chills - Aches
Headache
Fine red skin rash
Loss of apetite
Cough
Nausea

Lymphadenopathy - Swollen red/white tonsils - Splenomegaly - Periorbital & Pharyngeal Oedema

Question 2

What causes mono?

Answer 2

Epstein Barr Virus (EBV)

Question 3

How do we investigate Glandular fever?

Answer 3

Serology for antibodies (IgM current and IgG past)
Blood Film: Atypical mononuclear lymphocytes (<20% of them)
Monospot Test: Heteophile Antibody Test

Question 4

Why isnt the monospot test reliable?

Answer 4

Its only 70-90% sensitive
Also shows false positives for many conditions e.g:
SLE, lymphoma, pancreatic cancer, leukeamia, secondary syphilis, rubella, malaria & hepatitis

Question 5

How is Mono treated?

Answer 5

Rest!!!

Corticosteroids if pharyngeal oedema constricts airway

Avoid penicillin esters just like tonsilitis. e.g. amoxicillin, co-amoxiclav & ampicillin as they react with EBV -> Rash

Question 6

How does Mono spread?

Answer 6

By kissing (sharing pharyngeal secretions)