Question

An 18 year-old male presents complaining of severe fatigue for 6 days, a terrible sore throat, and a fever. On examination, you note soft palate petechiae, posterior cervical adenopathy and splenomegaly. He has no prior history of anemia. His liver enzymes are elevated. Which of the following CBC reports is most likely?

a. HGB normal; Lyrnphocytosis with 15% atypical lymphocytes
b. HGB normal; Monocytosis with 15% atypical monocytes.
c. HGB low; Lymphocytosis with target cells
d. HGB low; Monocytosis with atypical lymphocytes noted
e. HGB low; Monocytosis with atypical lymphocytes noted

Answer 1

The most likely CBC report for the described 18-year-old patient's condition is 'HGB normal; Lymphocytosis with 15% atypical lymphocytes', suggesting infectious mononucleosis.

Step-by-step explanation:

The most probable CBC report for an 18-year-old male with severe fatigue, a sore throat, fever, soft palate petechiae, posterior cervical adenopathy, splenomegaly, and elevated liver enzymes is a. HGB normal; Lymphocytosis with 15% atypical lymphocytes. This presentation including atypical lymphocytes, and the absence of anemia, is characteristic of infectious mononucleosis, commonly caused by the Epstein-Barr virus (EBV).

Anemia is not typically present in the early stage of the disease. The elevated white blood cell count with a significant percentage of atypical lymphocytes reflects the body's immune response to the viral infection. This type of lymphocytosis is linked to the body's production of more lymphocytes to fight the infection, with some of them appearing abnormal or 'atypical' because they are activated immune cells.