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24 Cards in this Set
- Front
- Back
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1. Best tool to diagnose Mono?
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a. Assay for Heterophile antibodies.
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2. Best management of mono?
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a. Symptomatic care
b. Avoidance of contact sports while spleen is enlarged (1-3 months_ |
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3. Expected course of Mono?
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a. Acute illness lasts 2-4 weeks, w/gradual recovery
b. Splenic rupture is a rare but potentially fatal complication. c. Rarely, some pts have persistent fatigue. |
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4. Eye complication w/EBV?
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a. Supraorbital oedema in 10-20% of pts.
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5. Incubation for EBV?
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a. 30-50 days.
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6. Rash with EBV in response to ampicillin, amoxacillin, or penicillin?
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a. Morbilliform rash.
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7. Epstein-Barr Virus characteristics?
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a. A double-stranded DNA herpes virus
b. Infects human oropharyngeal and salivary tissue and B lymphocytes. c. It can cause persistent viral shedding d. EBV is ubiquitous in humans. |
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8. With what condition is EBV associated w/HIV pts?
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a. Oral hairy leukoplakia.
b. Causes several malignancies. |
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9. Typical infectious mono presentation in children and adolescents (seen in >80% of cases)?
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a. Fever
b. Posterior cervical adenopathy c. Sore throat |
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10. For how long after acute infection does EBV shedding in the saliva continue?
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a. For >6 months and then intermittently thereafter for life.
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11. Where does EBV replicate after infection occurs?
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a. In the oropharyngeal epithelium.
b. Later in B lymphocytes. |
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12. Prodromal mono period?
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a. May last 1-2 weeks w/vague findings of fever, nausea, malaise, HA, sore throat, and abdominal pain.
b. The sore throat and fever gradually worsen and frequently cause a pt to seek medical help. |
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13. Physical findings during acute infection w/mono?
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a. Generalized lymphadenopathy
b. Splenomegaly c. Tonsillar enlargement w/exudate. d. Less common findings include a rash and hepatomegaly. |
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14. Mono presentation in small children?
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a. Many infections are asymptomatic
b. In others, fever may be the only presenting sign. c. Additional acute findings in small children include: 1. Otitis media 2. Abdominal pain 3. Diarrhea. d. Hepatosplenomegaly and rash are more often seen in small children than in older individuals. |
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15. Monospot test?
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a. A useful diagnostic test in children older than ~5 yrs of age!
b. Early in illness, it may be falsely negative. |
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16. More definitive testing for EBV?
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1. EBV viral capsid antigen (EBV-VCA)
2. Early Antigen (EA) 3. Epstein-Barr nuclear antigen (EBNA) b. Typically, IgG and IgM antibodies to EBC-VCA appear first. c. Anti-EBNA antibodies appear 1-2 months following infection and persist for years. d. Anti-EA antibodies are seen in most children during acute infection and persist for years in ~ 1/3 of pts. |
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17. Which 2 antibodies indicate past infection w/EBV?
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a. VCA-IgG and EBNA-IgG.
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18. Other lab findings w/EBV infection?
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a. Lymphocytic leukocytosis w/~20-40% atypical lymphocytes.
b. Mild thrombocytopenia is common, rarely precipitating bleeding or purpura. c. >50% develop mildly elevated LFTs d. Jaundice is uncommon. |
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19. EBV infection complications (rare but can be life-threatening)?
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a. Bell palsy
b. Seizures c. Aseptic meningitis or encephalitis d. Guillain-Barre syndrome e. Optic neuritis f. Transverse myelitis g. Parotitis, orchitis, or pancreatitis may develop. h. Airway compromise may result from tonsillar hypertrophy. |
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20. Tx of tonsillar hypertrophy?
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a. Steroids.
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21. How common is splenomegaly in Mono?
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a. Seen in ~50% of pts.
b. Rupture is rare, but the blood loss is life-threatening. |
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22. With what malignancies is EBV associated?
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a. Burkitt lymphoma.
b. Hodgkin disease c. Nasopharyngeal carcinoma d. Lymphoproliferative disorders. e. EBV can stimulate Hemophagocytic syndrome. |
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23. Additional EBV complications in HIV pts?
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a. Oral hairy leukoplakia
b. Smooth muscle tumours c. Lymphoid interstitial pneumonitis w/EBV. |
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24. Is monospot heterophil antibody test useful in younger children?
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a. No.
b. Antibodies against specific EBV antigens are more helpful in younger children. |
