A 19-year-old male visits his primary care physician with a sore throat, swollen

Question

A 19-year-old male visits his primary care physician with a sore throat, swollen lymph nodes, and extreme fatigue. During the visit, the nurse finds that he has a fever. The patient reports that he is attending his second year of college at a local university. The physician performs a physical examination, which confirms large, swollen, painful lymph nodes. He decides to send the patient to the office laboratory for blood work. He orders a complete blood count (CBC) and viral and bacterial studies.

A. The patient may have a bacterial infection.

B. The patient may have a viral infection.

C. The patient may be having an allergic reaction.

2 The following viral studies are performed for the patient. Based on these results and the CBC results, what is the most likely viral infection?

•HIV 1/2: Negative

•MonoSpot: Positive

3 EBV is known as the “kissing disease” because it spreads through oral contact with infected saliva. What innate immune mechanisms did EBV overcome to cause an infection in this patient?

A. Contact with broken skin

B. Inhalation of virus particles in the air

C. Exposure to virus through mucous membranes

D. Ingestion of virus

Within the infected epithelial cells, the virus replicates and lyses the host cells, releasing infectious virons. With this information in mind, what part of the patient’s adaptive immunity was activated in response to this specific virus?

A. Natural killer (NK) cells recognized the unknown antigens on the EBV cell wall.

B. Neutrophils phagocytized the virus.

C. The virus was coated with CRP in preparation for phagocytosis.

D. B cells produced antibodies to viral antigens.

5-The patient’s symptoms of fever and painful, swollen lymph nodes are caused by what innate immune mechanisms?

A. Cytokines cause an increased permeability of vessels, allowing fluid and cells to flow to the tissues (inflammation).

B. Contact with foreign antigens shuts down the lymphatic cellular traffic for 24 hours to allow for blast formation of the B cells in preparation of antibody production.

6-About 50% of patients with EBV develop splenomegaly. Based on what you know about the organs of the immune system, why would this condition develop?

A. The spleen is part of the lymphatic system and host to most of the body’s lymphoid tissue, which activates with EBV contact.

B. EBV causes obstruction of blood flow from the portal vein.

C. EBV causes red blood cells to lyse and thus causes the spleen to work harder to pluck abnormal cells out of circulation.

can you please explain why you chose those answers as well.

i need the unswers as soon as possible, please.

CBC results Continue to questions Reference Range 40% WBC 13.3 x 103 /uL 4.8-10.8 x 103/uL Neutrophils RBC 4.5 x 109/L 4.7-6.1 x 109/L Lymphocytes 53% 20% of lymphocytes are atypical 17% Hgb 14.1 g/dL 14-18 g/dL Monocytes Eosinophils 42% Hct 42%-52% 80-100 fL MCV 92 fL Basophils 27-31 pg Absolute neutrophils 5.32 MCH 27 pg MCHC 33% 7.05 32% -36% Absolute lymphocytes 11.5%-14.5% Absolute monocytes 0.93 RDW 14.3% Plt 325 x 109/L 150-450 x 109/L Absolute eosinophils 0 7.4-10.4 fL MPV 9.5 fL Absolute basophils 0 Reference Range 60%-70%. 20%-30% 5%-10% 0%-5% 0%-2% 1.4-6.5 x 103 /uL 1.2-3.4 x 103 /uL 0.1-0.6 x 103/uL 0-0.5 x 103 /uL 0-0.2 x 103/uL

Explanation / Answer

1) b- viral infection

not bacterial because in that case the absolute neutrophil count should have shot up and high eosinophils should have been detected had it been an allergic reaction.

2) EBV viral infection. The monospot test is a heterophile antibody (antibodies against external antigens) test to detect infectious mononucleosis caused by Epstein Barr Virus(EBV).

3) c]- contact to mucous membranes. This is what will happen when saliva is exchanged during kissing.

4) D]- B cells produce antibodies againsts viral antigens

5) B] this is because the virus attacks the lymph nodes, multiply and to fight thm the lymph nodes of the body tend to produce more and more immune cells, resulting in a blockade.

6) A] Since EBV attacks or hijacks the B-cells too, the immune system comes under immense pressure to fight back. This results in a condition known as immune hyperplasia where the immene cells tend to burst in number to be able to fight the viral overload

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