Answer:USMLE step 2 Mcq 196:A mother notes that her eight year old son has mild weight loss and a prolonged low grade fever over about two weeks




Correct Answer: E

Infectious mononucleosis is probably transmitted by saliva Symptoms include fever, sore throat, swollen glands and feeling tired. Sometimes, the liver and spleen are affected. Duration is from one to several weeks. The disease is very rarely fatal. Very young children may not have any symptoms after being infected While peak incidence occurs in 15- to 17-year-olds, the infection may occur in any age, being most often diagnosed between ages 10 to 35 years. Infectious mononucleosis may begin slowly with fatigue, malaise, headache and sore throat. The sore throat becomes progressively worse, often with enlarged tonsils covered with a whitish-yellow fibrinous exudate. The lymph nodes in the neck are frequently enlarged and painful. A pink measles-like rash may occur in approximately 1 out of 5 individuals with mono. Four out of five patients with mononucleosis who are given ampicillin or amoxicillin for their throat infection will develop the rash but it is significantly darker and denser than the rash in those not given medication. Symptoms of mononucleosis gradually subside over a period of weeks to a month. The disease is generally self limiting.


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