Pharyngitis

Question 1

Fever, tonsillitis/pharyngitis +/- EXUDATES

POSTERIOR CERVICAL lymphadenopathy (but lymphadenopathy CAN be generalized!!)

Answer 1

EBV

Also significant fatigue, +/- hepatosplenomegaly
+/- Rash after amoxicillin

Note: acute HIV can look similar, but should have diarrhea instead of pharyngitis/exudates

Question 2

Diagnostic findings of infectious mononucleosis

Answer 2

Positive Heterophile antibody (Monospot), although 25% false-neg during 1st week of illness

Atypical lymphocytosis
Transient hepatitis

Question 3

Can heterophile antibody test (Monospot) by negative during first week of illness?

Answer 3

Yes (25% chance)

Question 4

Leukocytosis and variant lymphocytes with a large, vacuolated cytoplasm

Answer 4

Infectious mononucleosis (atypical lymphocytes)

Note that leukemias don’t have these… blasts instead.

Question 5

EBV vs CMV

Answer 5

Both can give fever, malaise, fatigue, absolute lymphocytosis

EBV more likely to give pharyngitis, lymphadenopathy, and splenomegaly

CMV can have rash. EBV only has rash after amoxicillin.