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Fever and adenopathy

Clinical Discipline(s)/Organ System(s)
Infectious Diseases, Microbiology, Otorhinolaryngology, Haematology
Progress Test Topic(s)
Infectious disease
A 27 year old NZ European man presents with fever, drenching sweats and malaise for the last 8 days. He also complains of a sore throat and anorexia for the last 2 days. On examination he has mildly enlarged tonsils, widespread cervical, axillary and inguinal lymphadenopathy, but no hepatosplenomegaly.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Anatomy and function of reticuloendothelial system
   - Classification and function of lymphocyte types
   - Microbiology of herpes viruses, particularly Epstein-Barr virus (EBV) and cytomegalovirus (CMV)
   - Microbiology of human immunodeficiency virus (HIV)
   - Pharmacology of anti-retroviral medication, fluconazole and tenofovir
Clinical and Communication Skills 
   - History from a patient with fever and adenopathy
   - Examination of a patient for adenopathy and hepatosplenomegaly
   - Differential diagnosis of
   - Differential diagnosis of fever of unknown origin
   - Interpret serum antibody tests for EBV and CMV infection (IgG vs IgM)
   - Enquire about sexual history, risk behaviours for HIV infection; discuss need for HIV test and implications of a positive result
   - Management of infectious mononucleosis
   - Describe potential clinical outcomes following HIV infection; infections in immunocompromised patients
Personal and Professional Skills 
   - Understand issues related to confidentiality and stigma of HIV infection
Hauora Māori 
   - Appropriate and timely engagement with whānau
Population Health 
   - Epidemiology of EBV and CMV infection in New Zealand
   - Epidemiology of HIV infection in New Zealand and internationally
   - Awareness of social and demographic determinants of infectious disease
   - Prevention of HIV infection
Conditions to be considered relating to this scenario
glandular fever (EBV and CMV mononucleosis)
Less common but 'important not to miss'
lymphoma, HIV, pyrexia of unknown origin, Kaposi sarcoma
toxoplasmosis, cat scratch disease, tuberculosis