QuestionSBA
QuestionChoice
The most likely diagnosis is glandular fever; an infection caused by the Epstein-Barr Virus. This is a common infection in people aged 15-24 and can be transmitted through contact with saliva. Splenomegaly is extremely common, and patients should be advised to avoid contact sports for a month to reduce the risk of splenic rupture.
10035457
a
Splenomegaly
QuestionChoice
The most likely diagnosis given the clinical history and sore throat is glandular fever, an infection caused by the Epstein-Barr virus. Drenching night sweats would suggest a diagnosis of lymphoma, which is also possible given the lymphadenopathy but is less likely with the infectious symptoms. EBV infections may cause sweats but they would typically not be drenching.
10035458
b
Drenching night sweats
QuestionChoice
The most likely diagnosis given the clinical history and sore throat is glandular fever, an infection caused by the Epstein-Barr virus. Significant weight loss would suggest a diagnosis of lymphoma, which is also possible given the lymphadenopathy but is less likely with the infectious symptoms.
10035459
c
More than 10% weight loss in 1 month
QuestionChoice
The most likely diagnosis given the clinical history and sore throat is glandular fever, an infection caused by the Epstein-Barr virus. A lymph node biopsy would not routinely be performed unless there is a high suspicion of lymphoma. 'Mirror image nuclei', also known as Reed-Sternberg cells, are seen in Hodgkin lymphoma.
10035461
e
'Mirror-image nuclei' on lymph node biopsy
QuestionChoice
The most likely diagnosis given the clinical history and sore throat is glandular fever, an infection caused by the Epstein-Barr virus. A lymph node biopsy would not routinely be performed unless there is a high suspicion of lymphoma. 'Owl's eye' inclusions are seen in cytomegalovirus infection, rather than EBV infection.
10035460
d
'Owl's eye' inclusions seen on lymph node biopsy
Concept
Chapter
2693
4335
Epstein-Barr Virus (EBV)
Topic
194
Infectious Diseases
19495
Glandular fever, caused by Epstein-Barr Virus, commonly presents with splenomegaly and requires avoidance of contact sports to prevent splenic rupture.
An 18-year-old university student visits his GP feeling tired all the time. He describes a 2-week period of lethargy, myalgia, headache, and a sore throat.

He has bilateral posterior cervical lymphadenopathy and a red pharynx with some palatal petechiae. He is slightly tachycardic, but observations are otherwise normal.

Which feature would be most consistent with the most likely diagnosis?
a