Mononucleosis

HISTORY:

‍FatigueSore throatFever for ‍ ‍hoursdays

‍fatigue

‍hypersomnia

‍sore throat

‍swollen tonsils

‍fever, up to ‍°, over ‍ ‍hoursdays

‍headache

‍body aches

‍swollen lymph nodes

‍rash

‍loss of appetite

‍night sweats

‍jaundice

‍nausea

‍dyspnea, ‍at reston exertion

‍petechiae

‍dizziness

Worsening factors: ‍nonephysical exertioncognitive activitystress

Treatments tried: ‍none, ‍effectiveineffective



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Head: ‍normocephalicatraumaticnormal scalprashlesion

Eyes: -R: ‍normal, -L: ‍normal, ‍

Ears: -R: ‍normal, -L: ‍normal

Nose: ‍normal

Throat: ‍normalrednessexudate

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Musculoskeletal: joints ‍ ‍normal, ‍no limited ROM

Mental status: ‍alert, ‍oriented, speech ‍clear, mood ‍normal, thought process ‍organized, ‍no suicidal ideation, judgment ‍good



ASSESSMENT:

‍Infectious mononucleosis ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍CBC, ‍creatinine, ‍electrolytes, ‍LFTs, ‍CRP, ‍Monospot test, ‍EBV antibodies

- Throat culture

- Rest and hydration

- ‍Analgesics

- Avoidance of contact sports or heavy lifting

- Avoid alcohol

- ‍SchoolWork leave for ‍ ‍daysweeks

- Follow-up in ‍ ‍daysweeks with repeat LFTs

- Return if symptoms worsen or if new symptoms develop

- Go to ER if severe abdominal pain, shortness of breath, or difficulty swallowing occurs