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Kaplan Test Prep and Admissions (Kaptest.com)

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jean robert
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02/02/08 - 01:43 AM

A previously healthy 27 y.o man presents with one week of increasingly severe sore throat, fever, fatigue and headache. His temperature is 39 C. orally. He has palpable anterior cervical adenopathy and petechiae over his trunk and oral mucosae but lacks a pharyngeal exudate. His liver is palpable 3 cm below the right costal margin and his spleen tip is also palpable. His sclerae are anicteric. . What is the identity of the predominating white blood cell in a blood smear?

a) Basophil

b) CD 8 + lymphocyte

c) CD 16 + lymphocyte

d) CD 21 + lymphocyte

e) Eosinophil

f) Monocyte

g) PMN leukocuyte

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rugsal
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02/02/08 - 04:16 AM

F ??

docdoc9
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02/02/08 - 10:23 AM

d. CD21 lymphocyte

infectious mononucleosis

Tiff
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02/02/08 - 12:15 PM

B. CD8 Tcells

bactitech
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02/02/08 - 09:14 PM

Patient is on the old side for IM. Most patients I see who are positive are late teens early twenties. Twenty seven is getting up there....

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jean robert
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02/02/08 - 11:34 PM

Tiff wrote:
B. CD8 Tcells

This is a case of infectious mononucleosis caused by the EBV. This virus infects B lymphocytes by attaching to the CD21 receptor , but the cells that will predominate in a blood film will be reactive T cells, which would be CD8+ T lymphocytes.

CD21+ lymphocytes are the cells infected and destroyed by the virus.

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pr20
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02/03/08 - 12:00 PM

I have a small doubt.....Infectious mononucleosis means rise in the count of mononuclear leukocytes which includes monocytes and lymphocytes....but monocytes is also an option in the question.
So in IM,along with lymphocyte count does monocyte count increases or not???

new_n_lost
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02/03/08 - 05:56 PM

pr20 wrote:
I have a small doubt.....Infectious mononucleosis means rise in the count of mononuclear leukocytes which includes monocytes and lymphocytes....but monocytes is also an option in the question.
So in IM,along with lymphocyte count does monocyte count increases or not???

Yes they all increase.

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pr20
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02/03/08 - 06:11 PM

So both B and F are correct answers???

new_n_lost
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02/03/08 - 06:19 PM

#10

The question asks you "What is the identity of the predominating white blood cell in a blood smear"

hence the answer becomes CD +8 Lynphocyte.

monocytes do increase but the massive atypical lymphocytosis is usually by antigenically stimulated T-cells

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pr20
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02/04/08 - 10:42 AM

#11

Thnx for the clarification.

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