A male college freshman is seen at the college health service complaining of general fatigue, a sore throat, and swollen lymph nodes in his neck. A throat culture is done, and blood is drawn for hematology studies and a rapid MonoSlide test. Hematology results show a normal hemoglobin value and a slight increase in the white cell count, with many large, reactive lymphocytes seen in the differential. A rapid strep test is negative, but a second swab is cultured on sheep blood and incubated, with the result to be read in 18 hours. Result from the MonoSlide test is positive. Questions What laboratory tests could exclude or include the possible diagnoses? Why did the patient have an increased white blood count with abnormal appearing lymphocytes?

A male college freshman is seen at the college health service complaining of general fatigue, a sore throat, and swollen lymph nodes in his neck. A throat culture is done, and blood is drawn for hematology studies and a rapid MonoSlide test. Hematology results show a normal hemoglobin value and a slight increase in the white cell count, with many large, reactive lymphocytes seen in the differential. A rapid strep test is negative, but a second swab is cultured on sheep blood and incubated, with the result to be read in 18 hours. Result from the MonoSlide test is positive. Questions What laboratory tests could exclude or include the possible diagnoses? Why did the patient have an increased white blood count with abnormal appearing lymphocytes?