Infectious mononucleosis Flashcards
define infectious mononucleosis?
Clinical syndrome caused by primary EBV infection.
Also known as glandular fever.
what are the causes of infectious mononucleosis?
- Affects 90-95% of people at some point in their lives
- EBVspread by saliva/ respiratory droplets
- Infects B lymphocytes, incorporation of viral DNA into host DNA
outline the presentation of infectious mononucleosis?
- Fever
- Hepatosplenomegaly (jaundice)
- Pharyngitis (Tonsillar Exudates)
Lymphadenopathy (Posterior Cervical Nodes
what is the triad of atypical lymphocytosis?
fever
lymphadenopathy
pharyngitis
what are the investigations for infectious mononucleosis?
- FBC - Lymphocytosis (highest in week 2-3)
- Blood film - Atypical lymphocytosis
- Heterophile antibodies - Monospottest
- EBV specific antibodies
- Real time PCR - EBV DNA detection
outline the management of infectious mononicleosi?
- Supportive care- Paracetamol or Ibuprofen (anti inflammatory + analgesics)
- Corticosteroids may be indicated for severe cases (e.g. haemolytic anaemia, severe tonsillar swelling, obstructive pharyngitis).
•Amoxicillin or ampicillin is CONTRAINDICATED due to widespread maculopapular rash
outline the prognosis of infectious mononucleosis?
Most make an uncomplicated recovery in 3–21 days.
what do the different types of specific antibodies to EBV show?
A 32 year old dentist presents to GP with a history of sharp tingling around his lips followed by a painful ulceron the side of his mouth. O/E he has cervical lymphadenopathy and a blister on his finger. What is the pathogen?
A.Varicella Zoster Virus
B.Epstein-Barr Virus
C.Herpes Simplex Virus 1
D.Herpes Simplex Virus 2
E.Cytomegalovirus
Herpes Simplex Virus 1
A 6-year oldgirl presents with a feverof 38.5, fatigue and aitchy,maculopapular rash on her faceand trunk. Other children at school present with similar symptoms. How should this patient be managed?
A.Hydration and NSAIDs.
B.Give oral acyclovir
C.Consider oral valaciclovir if within 24 h of rash onset
D.Paracetamol and Calamine lotion
E.Vaccinate with Varicella Immunoglobulin
Paracetamol and Calamine lotion
(Give oral acyclovir - Adults)
( Consider oral valaciclovir if within 24 h of rash onset – shingles)
50-year-oldman presents with a painful, vesicular rash on his trunk. Which of the following is true?
A.Infection was due to recent contact with other people with similar symptoms
B.This rash can only present unilaterally
C.Tingling in his extremities is present
D.Treatment is supportive
E. The virus causing this is an RNA virus
A.Infection was due to recent contact with other people with similar symptoms – reactivation of VZV
B.This rash can only present unilaterally
C.Tingling in his extremities is present – tingling in dermatomal distribution
D.Treatment is supportive – Valaciclovir
E. The virus causing this is an RNA virus – DNA virus
A medical student presents with sore throat and tonsillar exudates, posterior cervical lymphadenopathy and his basic observations are 38.9oC, HR is 90bpm and oxygen saturation on air is 99%. On examination there is splenomegaly. His condition is most likely due to which of the following?
A.EBV
B.Streptococcus pyogenes
C.Adenovirus
D.Covid-19
E.Candida
A.EBV
B.Streptococcus pyogenes (Anterior cervical lymphadenopathy, no splenomegaly)
C.Adenovirus
D.Covid-19
E.Candida
A 42-year-old man, previously treated for pneumocysticpneumonia and oral ulcers, presents with a purple, purpurallesion on his nose. Which is the causative organism for this skin lesion?
A.Staphylococcus Aureus
B.Malignant Melanoma
C.Human Immunodeficiency Virus
D.Human herpesvirus 6
E.Human Herpesvirus 8
A.Staphylococcus Aureus
B.Malignant Melanoma
C.Human Immunodeficiency Virus – causes immunosuppression and predisposes to Kaposi’s
D.Human herpesvirus 6
E.Human Herpesvirus 8
