Medical Emergencies · single question
A patient presents with bilateral lymphadenopathy, fever, and palatal petechiae. Which test should be performed?
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Correct answer: A. Monospot Test (for Infectious Mononucleosis)
Monospot Test for Infectious Mononucleosis (A). The classic triad of infectious mononucleosis (EBV):
• Bilateral lymphadenopathy (posterior cervical > anterior)
• Fever
• Pharyngotonsillitis + palatal petechiae (characteristic finding — petechiae at the junction of the hard and soft palate in ~50% of cases)
• + Splenomegaly, fatigue, exudative tonsillitis
• Monospot test (heterophile antibody test) is the rapid screening test. Positive in ~85% of EBV mononucleosis.
• Dental significance: Avoid dental procedures during acute phase due to splenomegaly (risk of rupture with any Trendelenburg) and lymphadenopathy. Amoxicillin/ampicillin causes a rash in EBV patients — avoid!
• Bilateral lymphadenopathy (posterior cervical > anterior)
• Fever
• Pharyngotonsillitis + palatal petechiae (characteristic finding — petechiae at the junction of the hard and soft palate in ~50% of cases)
• + Splenomegaly, fatigue, exudative tonsillitis
• Monospot test (heterophile antibody test) is the rapid screening test. Positive in ~85% of EBV mononucleosis.
• Dental significance: Avoid dental procedures during acute phase due to splenomegaly (risk of rupture with any Trendelenburg) and lymphadenopathy. Amoxicillin/ampicillin causes a rash in EBV patients — avoid!
- A. Throat culture tests for bacterial infections like strep. The SPECIFIC test for this mono presentation is the Monospot.
- B. The Monospot test (heterophile antibody test) is the rapid diagnostic test for INFECTIOUS MONONUCLEOSIS (EBV infection). The classic triad: fever + pharyngitis + lymphadenopathy, with palatal petechiae as a pathognomonic finding.
- C. RPR tests for syphilis — not the appropriate test for this presentation.
- D. CBC may show lymphocytosis and atypical lymphocytes — but the SPECIFIC diagnostic test is the Monospot/heterophile antibody test.
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