Page | 1
Pharyngitis: Complete Clinical
Guide to Causes, Symptoms,
Diagnosis & Evidence-Based
Treatment (2026 Update)
A 17-year-old presents with tonsillar hypertrophy, bilateral
cervical lymphadenopathy, low-grade fever, and general malaise.
Which of the following is the gold standard test for diagnosing
this condition?
A.
Abdominal CT
B.
Heterophil antibody test
C.
Hepatobiliary iminodiacetic acid scan
D.
Blood cultures and complete blood count
Submit - ............ SOLUTION✔✔✔..........B.
Heterophil antibody test
The patient most likely had infectious mononucleosis. The
Epstein-Barr virus causes the illness, and symptoms often persist
for 1 to 2 months. A mononuclear spot (also called heterophile
, Page | 2
antibody test) test can help confirm the diagnosis. However, many
are comfortable making the diagnosis based on clinical
presentation alone.
The virus can lay dormant in B cells long after symptoms have
resolved. Symptoms recur in about 6% of patients.
Some people who have no symptoms are still contagious. This is
most common in children as they can have a very mild,
undiagnosed illness.
Imaging is not always required, but splenomegaly is common and
can result in a ruptured spleen even without trauma. A CT or
ultrasound of the abdomen may be needed to evaluate for splenic
rupture if symptoms are suggestive.
A 17-year-old girl presents with a severe sore throat and fever for
4 days. The patient's voice is muffled, and she prefers not to speak
secondary to pain. She has not been able to eat solids for 2 days
and has refused to drink for 1 day. Vital signs are temperature
39.8 C (103.6 F), heart rate 140 bpm, respiratory rate 20
breaths/min, and blood pressure 110/70 mmHg. The physical
examination shows the tonsils to be 4+ enlarged with partial
airway obstruction and grey-white exudates, cervical
lymphadenopathy, and splenomegaly. A rapid strep screen is
negative. A CBC shows atypical lymphocytes. What is the most
appropriate management?
A.
Admission for IV antibiotics
B.
Admission for IV corticosteroids
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C.
Admission for hydration and IV antibiotics
D.
Admission for hydration and corticosteroids
Submit - ............ SOLUTION✔✔✔..........D.
Admission for hydration and corticosteroids
This patient likely has infectious mononucleosis. The clinical
presentation can vary, but patients typically have a fever,
pharyngitis, and lymphadenopathy.
The patient is febrile, tachypneic, tachycardic, refusing to eat or
drink secondary to throat pain, and is at risk of airway
obstruction. She needs IV fluids and corticosteroids.
Treatment typically is supportive only, including rest, analgesics,
and antipyretics.
Amoxicillin is not effective against the Epstein-Barr virus and
often causes a rash.
A 3-year-old boy presents with a 3-day history of mild headache
and decreased activity, a fever of 39.4 C (102.9 F), and a mild
cough and sore throat. On physical examination, he has anterior
and posterior cervical lymphadenopathy with mild splenomegaly.
The white blood cell count is 5000/mm3 with an average
differential count. The alanine aminotransferase level is increased
to 280 U/L. What is the most appropriate diagnostic study?
A.
IgM for hepatitis A in serum.
Pharyngitis: Complete Clinical
Guide to Causes, Symptoms,
Diagnosis & Evidence-Based
Treatment (2026 Update)
A 17-year-old presents with tonsillar hypertrophy, bilateral
cervical lymphadenopathy, low-grade fever, and general malaise.
Which of the following is the gold standard test for diagnosing
this condition?
A.
Abdominal CT
B.
Heterophil antibody test
C.
Hepatobiliary iminodiacetic acid scan
D.
Blood cultures and complete blood count
Submit - ............ SOLUTION✔✔✔..........B.
Heterophil antibody test
The patient most likely had infectious mononucleosis. The
Epstein-Barr virus causes the illness, and symptoms often persist
for 1 to 2 months. A mononuclear spot (also called heterophile
, Page | 2
antibody test) test can help confirm the diagnosis. However, many
are comfortable making the diagnosis based on clinical
presentation alone.
The virus can lay dormant in B cells long after symptoms have
resolved. Symptoms recur in about 6% of patients.
Some people who have no symptoms are still contagious. This is
most common in children as they can have a very mild,
undiagnosed illness.
Imaging is not always required, but splenomegaly is common and
can result in a ruptured spleen even without trauma. A CT or
ultrasound of the abdomen may be needed to evaluate for splenic
rupture if symptoms are suggestive.
A 17-year-old girl presents with a severe sore throat and fever for
4 days. The patient's voice is muffled, and she prefers not to speak
secondary to pain. She has not been able to eat solids for 2 days
and has refused to drink for 1 day. Vital signs are temperature
39.8 C (103.6 F), heart rate 140 bpm, respiratory rate 20
breaths/min, and blood pressure 110/70 mmHg. The physical
examination shows the tonsils to be 4+ enlarged with partial
airway obstruction and grey-white exudates, cervical
lymphadenopathy, and splenomegaly. A rapid strep screen is
negative. A CBC shows atypical lymphocytes. What is the most
appropriate management?
A.
Admission for IV antibiotics
B.
Admission for IV corticosteroids
, Page | 3
C.
Admission for hydration and IV antibiotics
D.
Admission for hydration and corticosteroids
Submit - ............ SOLUTION✔✔✔..........D.
Admission for hydration and corticosteroids
This patient likely has infectious mononucleosis. The clinical
presentation can vary, but patients typically have a fever,
pharyngitis, and lymphadenopathy.
The patient is febrile, tachypneic, tachycardic, refusing to eat or
drink secondary to throat pain, and is at risk of airway
obstruction. She needs IV fluids and corticosteroids.
Treatment typically is supportive only, including rest, analgesics,
and antipyretics.
Amoxicillin is not effective against the Epstein-Barr virus and
often causes a rash.
A 3-year-old boy presents with a 3-day history of mild headache
and decreased activity, a fever of 39.4 C (102.9 F), and a mild
cough and sore throat. On physical examination, he has anterior
and posterior cervical lymphadenopathy with mild splenomegaly.
The white blood cell count is 5000/mm3 with an average
differential count. The alanine aminotransferase level is increased
to 280 U/L. What is the most appropriate diagnostic study?
A.
IgM for hepatitis A in serum.
