ABSTRACT
An 18-year-old school student of East African origin presents with a 2-week history of lethargy, myalgia, rigors with hot flushes and intermittent pyrexia. Neither she nor any close contacts have been travelling recently. Examination reveals enlarged anterior and posterior chain lymph nodes in the neck. A blood film reveals the presence of Downey bodies, thrombocytosis and an increase in the lymphocyte count to 50 per cent of total leucocytes. This girl is likely to have:
A. Tuberculosis B. Toxoplasmosis C. Human immunodeficiency virus infection D. Lymphoma E. Infectious mononucleosis
2. Neck lumps (2)
A 16-year-old girl presents with a smooth, round and painless lump in the midline of the neck, of which she feels very self conscious. On examination, it is firm, transilluminates and is painless to touch. In addition, it moves up when the patient is asked to take a sip of water. This is likely to be a:
A. Papillary carcinoma of the thyroid B. Goitre C. Thyroglossal cyst D. Lingual thyroid E. Sebaceous cyst
3. Neck lumps (3)
A 45-year-old female business executive presents with a swelling in the midline of the neck and features of hyperthyroidism secondary to Graves’ disease. Following a course of antithyroid medication, a subtotal thyroidectomy is performed. Raised titres of which immunoglobulin would be expected in this individual?
