Which group of lymph node is classically involved in IMN:
Correct Answer: Posterior cervical
Description: Ans: a (Posterior cervical) Ref: Harrison, 16th ed, p. 1046In IMN. the classical group of lymph node involved is posterior cervical nodes.Infectious mononucleosisThe disease is caused by Ebstein -Burr virus (EB V), a gamma herpes virus.Saliva is the main means of spread, either by droplet infection or environmental contamination in childhood, or by kissing among adolescents and adults.Clinical features* Lymphadenopathy especially posterior cervical* Pharyngeal inflammation* Fever, non specific skin rash* Palatal petechiae* Periorbital edema* Splenomegaly* Clinical or biochemical evidence of hepatitisInvestigation20% or more of the peripheral lymphocytes must have atypical morphology- Characteristic heterophile antibody in serum detected by Paul -Bunnell test or monospot (slide test)- Specific EBV serology (immunoflourescence) can be used to confirm the diagnosis.TreatmentAspirin gargles to relieve sore throatIf throat culture yields a haemolytic streptococcus, then erythromycin is prescribedAmoxicillin should be avoided because it causes maculopapular rash in patients with IMN.Note-Diseases caused by EBV virus* IMN* Nasopharyngeal carcinoma* Burkitt's Lymphoma* Hodgkin's Lymphoma* B cell Lymphoma* Post organ transplant lymphomaHTLV-1- Adult T cell leukaemiaHepatitis C- Lympho plasmacytic lymphomaH.Pylori- Gastric MALT lymphomaHHV-8- Primary effusion lymphoma multicentric Castle man's disease.
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