kauraabhimanyu
Forum Junior
Topics: 9
Posts: 49
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People this question is from sample questions given on the USMLE.org website. So If u are using it( I dont think anybody does that  ) to assess yourself read no further.
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| kauraabhimanyu
Forum Junior
Topics: 9
Posts: 49
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19 yr old man with general malaise, recurrent sore throat, anorexia, swollen glands and a 4 Kg weight loss over past 5 wks. 4 wks ago a throat culture grew Strep. pyogenes grp A and Patient was started on penicillin. Temp 101.3F examn shows exudative pharyngitis ant. and post. cervical Lymphadenopathy and splenomegaly. LABS:
Hct 37%
WBC 3200
Neutro 55%
Lympho 34%
Platlets 84,000
AST 75u/l
What is the next best step
A) Antiplatlet Antibody titre
B) Bone marrow examination
C) ASO titre
D) screen for hepatitis
E) Serological test for EBV
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| Fred33
Forum Guru
Topics: 103
Posts: 758
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low Ht, lowish WBC, low platelets: pancytopenia.
Diagnosis reasonable on throat culture.
So, Bone marrow to explain "out of proportion" reaction
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| navitha
Forum Elite
Topics: 17
Posts: 296
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B...
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| kauraabhimanyu
Forum Junior
Topics: 9
Posts: 49
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I was waiting for some more answers before replying. anyways here goes. When I answered the Q I too answered bone marrow. But the correct choice is E testing for EBV. Infectious mono can cause pharyngitis, ant and post cervical lymphadenopathy can also incluse inguinal. But Post cervical is charcterstic. It can cause mild elevation of liver enzymes, splenmegaly, mild thrombocytopenia and relative lymphocytosis. and patient may develop superadded strep throat infection. Plus throat cultures are positive in a lot of normal people too.
Edited by kauraabhimanyu on 02/10/10 - 12:47 PM
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