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NU 545 Unit 4 Questions and Correct
Answers/ Latest Update / Already Graded
Infectious Mononucleosis (IM) p. 945
Ans: A benign, acute, self-limiting lymphoproliferative clinical
syndrome characterized by acute viral infection of B
lymphocytes (B cells). Associated with several tumors, such as B
cell and T cell, Hodgkin lymphoma (HL) and nasopharyngeal
carcinoma. Linked to post-transplant lymphoproliferative
diseases (PTLD) and gastric carcinoma. Most common cause -
EBV (herpes virus). 90% of people have antibodies, early
infections rarely develop into IM. During adolescence or later
35-50% get IM (p945). Transmission of EBV: Saliva (Kissing
Disease), secretions of genital, rectal, resp tract & blood,
cervical and seminal fluid.. No aerosol transmission. Disease
begins with widespread infection of B lymphocytes which have
receptors for EBV. Virus initially infects oropharynx,
nasopharynx, and salivary epithelial cells then spreads to
lymphoid tissue and B cells. Infection of B cells allows the virus
to enter the bloodstream, then the virus spreads systemically
(p946)
Patho of Infectious Mononucleosis p. 946
Ans: Immunodeficiency, infected B cells may be uncontrolled
and lead to B-cell lymphoma. In the immunocompetent patient,
unaffected B cells produce antibodies (IgG, IgM, IgA) against
All rights reserved © 2025/ 2026 |
, Page |2
the virus. There is a massive activation of proliferation of
cytotoxic T cells (CD8) directed against EBV infected cells.
Immune response against EBV is largely responsible for cellular
proliferation in the lymphoid tissue (lymph nodes, spleen,
tonsils, liver). Sore throat and fever are the earliest
manifestations d/t inflammation at the site of viral entry and
initial infection, usually the mouth and throat.
Clinical manifestations of infectious mononucleosis p. 946
Ans: Pharyngitis (sore throat), lymphadenopathy, and fever
(p945). Incubation period: 30-50 days (4-8 weeks), then a 3-5
day prodrome of HA, fever, malaise, arthralgias (joint pain).
cervical lymph nodes. Pharyngitis: whitish, greyish green thick
exudate. Severe complications: meningitis, encephalitis,
guillain barre syndrome, bells palsy, optic neuritis, mental
impairment, transverse myelitis, cerebellar ataxia,
demyelinating disease.
Ocular manifestations: eyelid/periorbital edema, dry eyes,
keratitis, uveitis, conjunctivitis, retinitis, oculoglandular
syndrome, choroiditis, papillitis, ophthalmoplegia.
In child: Reye syndrome.
Pulmonary involvement: RARE- hilar and mediastinal
lymphadenopathy, interstitial pneumonitis, pleural effusions,
pneumonia and resp fail in immunocompromised patient. Older
patient with 2 weeks of temp that can't be explained EBV
should be suspected, Most common cause of death is splenic
All rights reserved © 2025/ 2026 |
, Page |3
rupture (rare, 0.1-0.5%) r/t mild trauma in men <25 between 4
and 21 days after symptoms. Other deaths: hepatic failure,
bacterial infection, viral myocarditis.
Eval and Tx of infectious mononucleosis p. 947
Ans: Children present w/: fever, pharyngitis (sore throat),
lymphadenitis.
Young adults present w/: malaise, fatigue, lymphadenopathy
and fever of unknown origin.
Palatal petechiae (redish-brown spots on roof of mouth),
splenomegaly, and posterior cervical adenopathy
(lymphnodes).
Blood contains increased WBC (lymphocytes).
Dx based on Hoagland's criteria: 50% lymphocytes, 10%
atypical lymphocytes in the blood with positive heterophile
antibody (IgM) with Monospot test. presence of fever,
pharyngitis, adenopathy confirmed by a + serologic test.
Serological test: heterophile antibodies,
Monospot test (limited b/c CMV, adenovirus, toxoplasmosis
also produce heterophilic antibodies causing false +).
All rights reserved © 2025/ 2026 |
, Page |4
Tx: IM is usually self limiting and intervention is rarely required.
Rest & alleviation of symptoms. No ASA used with child or
adolescent d/t reye syndrome. Streptococcal pharyngitis (20 -
30% cases) tx w/ PCN or erythromycin. NO ampicillin (causes
rash in patients with IM). Avoid strenuous activities. Steroids
only with severe complications (airway obstruction). Acyclovir
with immunocompromised pts.
Complications of Infectious Mononucleosis
Ans: B-cell and T-cell lymphomas, Hodgkin Lymphoma (HL),
and nasopharyngeal carcinoma.
Post transplant lymphoproliferative diseases (PTLDs), gastric
carcinoma
Pharyngitis (sore throat)
Lymphadenopathy
Fever
Burkitt lymphoma (BL)
HA
Malaise
Joint pain
Fatigue
Cervical Lymph node enlargement
Progression:
Lymphadenopathy
All rights reserved © 2025/ 2026 |
NU 545 Unit 4 Questions and Correct
Answers/ Latest Update / Already Graded
Infectious Mononucleosis (IM) p. 945
Ans: A benign, acute, self-limiting lymphoproliferative clinical
syndrome characterized by acute viral infection of B
lymphocytes (B cells). Associated with several tumors, such as B
cell and T cell, Hodgkin lymphoma (HL) and nasopharyngeal
carcinoma. Linked to post-transplant lymphoproliferative
diseases (PTLD) and gastric carcinoma. Most common cause -
EBV (herpes virus). 90% of people have antibodies, early
infections rarely develop into IM. During adolescence or later
35-50% get IM (p945). Transmission of EBV: Saliva (Kissing
Disease), secretions of genital, rectal, resp tract & blood,
cervical and seminal fluid.. No aerosol transmission. Disease
begins with widespread infection of B lymphocytes which have
receptors for EBV. Virus initially infects oropharynx,
nasopharynx, and salivary epithelial cells then spreads to
lymphoid tissue and B cells. Infection of B cells allows the virus
to enter the bloodstream, then the virus spreads systemically
(p946)
Patho of Infectious Mononucleosis p. 946
Ans: Immunodeficiency, infected B cells may be uncontrolled
and lead to B-cell lymphoma. In the immunocompetent patient,
unaffected B cells produce antibodies (IgG, IgM, IgA) against
All rights reserved © 2025/ 2026 |
, Page |2
the virus. There is a massive activation of proliferation of
cytotoxic T cells (CD8) directed against EBV infected cells.
Immune response against EBV is largely responsible for cellular
proliferation in the lymphoid tissue (lymph nodes, spleen,
tonsils, liver). Sore throat and fever are the earliest
manifestations d/t inflammation at the site of viral entry and
initial infection, usually the mouth and throat.
Clinical manifestations of infectious mononucleosis p. 946
Ans: Pharyngitis (sore throat), lymphadenopathy, and fever
(p945). Incubation period: 30-50 days (4-8 weeks), then a 3-5
day prodrome of HA, fever, malaise, arthralgias (joint pain).
cervical lymph nodes. Pharyngitis: whitish, greyish green thick
exudate. Severe complications: meningitis, encephalitis,
guillain barre syndrome, bells palsy, optic neuritis, mental
impairment, transverse myelitis, cerebellar ataxia,
demyelinating disease.
Ocular manifestations: eyelid/periorbital edema, dry eyes,
keratitis, uveitis, conjunctivitis, retinitis, oculoglandular
syndrome, choroiditis, papillitis, ophthalmoplegia.
In child: Reye syndrome.
Pulmonary involvement: RARE- hilar and mediastinal
lymphadenopathy, interstitial pneumonitis, pleural effusions,
pneumonia and resp fail in immunocompromised patient. Older
patient with 2 weeks of temp that can't be explained EBV
should be suspected, Most common cause of death is splenic
All rights reserved © 2025/ 2026 |
, Page |3
rupture (rare, 0.1-0.5%) r/t mild trauma in men <25 between 4
and 21 days after symptoms. Other deaths: hepatic failure,
bacterial infection, viral myocarditis.
Eval and Tx of infectious mononucleosis p. 947
Ans: Children present w/: fever, pharyngitis (sore throat),
lymphadenitis.
Young adults present w/: malaise, fatigue, lymphadenopathy
and fever of unknown origin.
Palatal petechiae (redish-brown spots on roof of mouth),
splenomegaly, and posterior cervical adenopathy
(lymphnodes).
Blood contains increased WBC (lymphocytes).
Dx based on Hoagland's criteria: 50% lymphocytes, 10%
atypical lymphocytes in the blood with positive heterophile
antibody (IgM) with Monospot test. presence of fever,
pharyngitis, adenopathy confirmed by a + serologic test.
Serological test: heterophile antibodies,
Monospot test (limited b/c CMV, adenovirus, toxoplasmosis
also produce heterophilic antibodies causing false +).
All rights reserved © 2025/ 2026 |
, Page |4
Tx: IM is usually self limiting and intervention is rarely required.
Rest & alleviation of symptoms. No ASA used with child or
adolescent d/t reye syndrome. Streptococcal pharyngitis (20 -
30% cases) tx w/ PCN or erythromycin. NO ampicillin (causes
rash in patients with IM). Avoid strenuous activities. Steroids
only with severe complications (airway obstruction). Acyclovir
with immunocompromised pts.
Complications of Infectious Mononucleosis
Ans: B-cell and T-cell lymphomas, Hodgkin Lymphoma (HL),
and nasopharyngeal carcinoma.
Post transplant lymphoproliferative diseases (PTLDs), gastric
carcinoma
Pharyngitis (sore throat)
Lymphadenopathy
Fever
Burkitt lymphoma (BL)
HA
Malaise
Joint pain
Fatigue
Cervical Lymph node enlargement
Progression:
Lymphadenopathy
All rights reserved © 2025/ 2026 |
