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Old 11-06-2012
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Question Diagnosis of Infectious Mononucleosis

the most common lab finding for diagnosing infectious monoucleosis is:
a) monospot test to detect EBV specific antibody.
b) assay for EBV nuclear antibody
c) prescence of atypical lymphocytes in the blood
d) test for heterophile antibody test which cross reacts with antigen found on variety of animal RBC
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DD...heterophile antibodies
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haha......again similar looking options

will also go with D) heterophile antibodies...

thanks
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Old 11-06-2012
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Default my answer :)

c)prescence of atypical lymphocytes in the blood

quick question guys, how is A) different from D)? isn't monospot test a test for heterophile antibodies?

btw I came across nice concept lately (I think it was in Uworld):

we use monotest in adults (in kids it's usually falsely negative)

IgM/IgG for EBV in kids - most sensitive.
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Quote:
Originally Posted by Casandra View Post
c)prescence of atypical lymphocytes in the blood

quick question guys, how is A) different from D)? isn't monospot test a test for heterophile antibodies?

btw I came across nice concept lately (I think it was in Uworld):

we use monotest in adults (in kids it's usually falsely negative)

IgM/IgG for EBV in kids - most sensitive.
haha....ya both A and D are same............but as A specifically says abt EBV ,went with D(other causes like CMV,toxo)..........
but i didnt know abt your concept of doing it only in adults...thanks
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Quote:
Originally Posted by Casandra View Post
c)prescence of atypical lymphocytes in the blood

quick question guys, how is A) different from D)? isn't monospot test a test for heterophile antibodies?

btw I came across nice concept lately (I think it was in Uworld):

we use monotest in adults (in kids it's usually falsely negative)

IgM/IgG for EBV in kids - most sensitive.
-heterophile antibodies test is diagnostic of IM but
just as vencky said,it can be negative in other causes of inf.mono like CMV and HSV
-Definitive test is testing for EBV antigen which is the most common cause of IM but that option is not given.
-atypical lymphocytosis is not diagnostic.its seen in many viral infections
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Correct Answer d

i also thought monospot test and heterophile antibody test is the one and same but according to kaplan q 22 from virology monospot test detects mononucleosis caused by EBV however it does not detect EBV specific antibody......which is detected by Heterophile antibody test.......t his text is other explanation is somewhat confusing for me.......
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Quote:
Originally Posted by rupesh View Post
i also thought monospot test and heterophile antibody test is the one and same but according to kaplan q 22 from virology monospot test detects mononucleosis caused by EBV however it does not detect EBV specific antibody......which is detected by Heterophile antibody test.......t his text is other explanation is somewhat confusing for me.......
I assume that EBV specific atbs are heterophile. everything is clear now. thanks for the question
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Default IM

answer is C: atypical lymphocytes in blood
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the answer is D....monospot test or heterophile antibody test is sensitive and specific for diagnosing IM.

EBV specific antibody test is used in patients with suspected IM and negative heterophile antibody test.

atypical lymphocytes on smear are non specific...caused by many conditions.
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Please check again kaplan for the correct answer.. Heterophile antibodies is the monospot test, so A&D is exactly the same. The question asks which is the -most common- lab finding which is atypical lymphocytes. Here is a quick seatch from wikipedia :
The most commonly used diagnostic criterion is the presence of 50% lymphocytes with at least 10% atypical lymphocytes (large, irregular nuclei),[10] while the person also has fever, pharyngitis and adenopathy. Furthermore, it should be confirmed by a serological test.[11] The atypical lymphocytes resembled monocytes when they were first discovered, thus the term "mononucleosis" was coined. Diagnostic tests are used to confirm infectious mononucleosis, but the disease should be suspected from symptoms prior to the results from hematology.[22] These criteria are specific; however, they are not particularly sensitive and are more useful for research than for clinical use. Only half the patients presenting with the symptoms held by mononucleosis and a positive heterophile antibody test (monospot test) meet the entire criteria.

Also check this if you still have doubts : https://mospace.umsystem.edu/xmlui/b...pdf?sequence=1
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