Short Case- Mono

Question 1

What virus causes mono?

Answer 1

EBV Epstein Barr Virus

Question 2

What age group is mc affected in mono?

Answer 2

Can infect people of any age, but highest incidence of symptomatic infection in the 15-24 age group

Question 3

What is the incubation period for mono?

Answer 3

Incubation period is 30-50 days

Question 4

How is mono spread?

Answer 4

-Saliva most common
“kissing disease”
-Can remain infectious for 6 months or longer
-Genital secretions
-Blood transfusion
-Bone marrow transplantation

Question 5

Classic mono triad?

Answer 5

Classic triad: fever, pharyngitis, lymphadenopathy

Question 6

Lymphadenopathy occurs in the __________ cervical chain

Answer 6

Posterior

Question 7

What is splenomegaly and why is it important?

Answer 7

Splenomegaly is a condition that occurs when your spleen becomes enlarged. It’s also commonly referred to as enlarged spleen or spleen enlargement. The spleen is a part of your lymphatic system. It helps the immune system by storing white blood cells and helping in the creation of antibodies.

Question 8

What medication can cause a rash if a patient has mono?

Answer 8

Amoxicillin (anything in PCN category)

Question 9

What lab thing is a defining feature of mono? and what does it mean?

Answer 9

Inverted differential (atypical lymphocytes and more lymphocytes than neutrophils)

Question 10

Which two antibodies are EBV-specific?

Answer 10

IgG and IgM

Question 11

What is a downey cell?

Answer 11

A cell that has a large nucleus taking up the entirety of the cell

Presence of these on a lab can confirm mono (they are atypical lymphocytes)

Question 12

What should you avoid when you have mono? (especially told to kids or younger active pts)

Answer 12

Avoid contact sports for 1 month

Question 13

What is the tx for mono?

Answer 13

• Generally supportive- self-limited illness
• Tylenol or NSAIDs

*antivirals not recommended

Question 14

What is a serious internal consequence of mono if a patient is not careful and is playing contact sports?

Answer 14

Splenic rupture

Question 15

What is the prognosis for mono? When does fever and sore throat go away? How long does fatigue last? When does splenomegaly and LAD go away?

Answer 15

• Good!
• Fever & sore throat usually resolve by 10 days
• Splenomegaly & lymphadenopathy usually resolved by 4 weeks
• The fatigue may last 2-3 months or longer