NBME Answers : ashishsuthar's page

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Young patient with high-risk sexual behaviors presents with acute fever, sore throat, fatigue, tender/enlarged cervical lymph nodes, increased lymphocytes, and mildly increased LFTs with a negative rapid strep test, most consistent with infectious mononucleosis, which is caused by EBV > CMV

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tinylilron Why is high-risk sexual activity a risk factor? +

stinkysulfaeggs Also they use condoms and she takes an OCP. That's not high risk sexual behavior. +1

jmorga75 She's probably kissing her sex partners before getting freaky... → EBV (plus the characteristic LAD and labs that point toward EBV). Also, HSV2 is the sexually transmitted one, and that tends to cause inguinal LAD, not cervical. +1

ashishsuthar is 44% lymphocyte elevated?? also bilateral posterior cervical lymphadenopathy is more specific for EBV infectious mononucleosis. moreover, she does not have splenomegaly. Maybe all patients do not have splenomegaly at presentation but still this is confusing. +