HIMANSHU GUPTA

GROUP : 627

TASK 1:

Clinical Diagnosis:

The clinical diagnosis in this case is infectious mononucleosis.

Etiology:

Infectious mononucleosis is primarily caused by the Epstein-Barr virus (EBV), a member of the
herpesvirus family.

Laboratory Tests:

1. Monospot test: To detect heterophile antibodies produced during EBV infection.

2. Complete blood count (CBC): To check for leukocytosis and the presence of atypical lymphocytes.

3. Liver function tests (LFTs): To assess liver involvement, as EBV infection can cause hepatitis.

Differential Diagnosis:

1. Streptococcal pharyngitis: Similar presentation, but negative streptococcal antigen test helps rule this
out.

2. Acute HIV infection: Can present with similar symptoms, but the presence of atypical lymphocytes
and negative streptococcal test suggest otherwise.

3. Cytomegalovirus (CMV) infection: Another viral cause of infectious mononucleosis, but less common
than EBV.

4. Acute tonsillitis: Similar symptoms, but negative streptococcal antigen test and presence of atypical
lymphocytes help differentiate.

Treatment Complication:

complication of treating infectious mononucleosis with amoxicillin : maculopapular rash.

TREATMENT:

- Rest: Advise plenty of rest.

- Hydration: Encourage adequate fluid intake, water or electrolyte solutions.

- Pain and fever relief: Use over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen
(Advil, Motrin).

- Avoid strenuous activities: Prevent spleen rupture by avoiding heavy lifting and contact sports.

- Symptomatic relief: Use throat lozenges, warm salt water gargles, and humidifiers.

TASK 2:

Clinical Signs of Diphtheria of the Pharynx in Children:

- Sore throat: Typically severe and may worsen rapidly.

- Difficulty swallowing: Due to the presence of a pseudomembrane in the throat.

- Low-grade fever: Usually present but can be variable.

- Grayish-white membrane: Forms over the throat and tonsils, potentially causing airway obstruction.

- Enlarged lymph nodes: Particularly in the neck region.

- Hoarseness or voice changes: Resulting from throat inflammation and obstruction.

- Malaise and weakness: Common systemic symptoms accompanying the infection.

- Bull neck appearance: Swelling of the neck due to enlarged lymph nodes.

Task 3: Laboratory Testing for Mumps:

1. Viral culture: To isolate and identify the mumps virus from a swab of the throat or other affected
areas.

2. Polymerase chain reaction (PCR): Detects mumps viral RNA in clinical specimens such as saliva or
urine, providing a rapid and sensitive diagnosis.

3. Serum antibody testing: Measures mumps-specific IgM antibodies, indicating acute infection, or IgG
antibodies, indicating past infection or immunity.

4. Complete blood count (CBC): To assess for leukocytosis, which may indicate an inflammatory
response to the infection.

5. Salivary amylase levels: May be elevated due to mumps-induced parotitis, supporting the diagnosis.

6. Imaging studies: Ultrasound or MRI of the salivary glands may be performed if complications such as
orchitis or meningitis are suspected.
TASK 4 :

 Pallor - Anemia (various infectious causes)

 Splenomegaly - Malaria, Typhoid fever, Infectious mononucleosis
 Macular-papular rash - Measles, Rubella, Dengue fever
 Tonsillitis - Streptococcal pharyngitis, Infectious mononucleosis, Diphtheria
 Lymphadenopathy - Epstein-Barr virus infection, Streptococcal pharyngitis, Toxoplasmosis
 Hepatomegaly - Viral or Bacterial hepatitis, Malaria, Infectious mononucleosis
 Asphyxia - Pertussis (Whooping cough), Diphtheria, Severe viral pneumonia
 Weight loss - Tuberculosis, HIV/AIDS, Chronic viral hepatitis
 Genital involvement - Syphilis, Gonorrhea, Genital herpes
 Toxic Shock - Staphylococcal or Streptococcal toxic shock syndrome
 Catarrhal symptoms - Common cold, Influenza
 Hoarseness of voice - Viral laryngitis
 Heart involvement - Viral myocarditis, Bacterial endocarditis
 Conjunctival hemorrhages - Ebola virus disease, Dengue hemorrhagic fever
 CNS symptoms - Bacterial meningitis, Viral encephalitis, Cerebral malaria
 Cough - Pneumonia, Bronchitis, Tuberculosis

TASK :5:

Chronic Myeloid Leukemia (CML)

Reason:

- Increased WBC count, particularly with elevated neutrophils and monocytes, is characteristic of
leukemia.

- Increased MCV and RDW suggest abnormal red blood cell morphology, common in leukemia.

- Decreased lymphocyte count can occur in leukemia due to the overproduction of abnormal white
blood cells.

- Decreased RBC count, hemoglobin, and hematocrit indicate anemia, which is common in leukemia due
to bone marrow infiltration.

- Decreased platelet count is typical in leukemia and can lead to bleeding tendencies.

Task 6: Questions in Epidemiological History Interviewing:

1. Exposure History:

- Have you traveled recently? Where?

 - Have you been in close contact with anyone who was ill?

- Have you been exposed to any sick animals or contaminated environments?

2. Contact History:

- Have any family members, friends, or colleagues been sick recently?

- Have you attended any large gatherings or events where illness may have spread?

- Do you live or work in close quarters with others?

3. Occupational History:

- What is your occupation? Are you exposed to any occupational hazards?

- Do you work in healthcare or another high-risk setting?

4. Social History:

- Do you engage in any high-risk behaviors, such as unprotected sex or drug use?

- Do you live in communal settings, such as dormitories or nursing homes?

5. Immunization History:

- Are you up-to-date on your vaccinations?

- Have you received any recent vaccinations or booster shots?

6. Travel History:

- Have you traveled to any regions with known outbreaks or endemic diseases?

- Did you receive any vaccinations or prophylactic treatments before traveling?

Task 7: Differential Diagnosis for Whooping Cough (Pertussis):

1. Bronchiolitis: Common in infants and young children, caused by respiratory syncytial virus (RSV) or
other viral pathogens.

2. Asthma: Characterized by recurrent episodes of wheezing, coughing, and difficulty breathing.

3. Viral Respiratory Infection: Such as respiratory syncytial virus (RSV), parainfluenza virus, or
adenovirus.

4. Allergic Rhinitis: Allergens can trigger persistent coughing spells, especially in children.

5. Gastroesophageal Reflux Disease (GERD): Chronic cough may result from reflux of stomach acid into
the esophagus.
6. Cystic Fibrosis:Inherited disorder leading to thick mucus production in the airways, causing persistent
cough and recurrent respiratory infections.

Task 8: Tactics of Treatment for the Patient with Croup Syndrome:

1. Cool Mist Therapy: Use a humidifier or take the child into a steamy bathroom to help alleviate airway
inflammation and reduce coughing.

2. Steroid Therapy:Oral or inhaled corticosteroids can help reduce airway inflammation and improve
symptoms.

3. Nebulized Epinephrine:Administered in severe cases to rapidly reduce airway swelling and improve
breathing.

4. Oxygen Therapy: Supplemental oxygen may be necessary if the child's oxygen levels are low due to
airway obstruction.

5. Fluids and Rest: Encourage plenty of fluids and adequate rest to support the child's recovery and
prevent dehydration.

6. Monitoring: Monitor the child's breathing, oxygen saturation, and overall condition closely, especially
if symptoms worsen or if there are signs of respiratory distress.