American Board of Internal Medicine (ABIM) Certification Practice Exam

Which symptom is NOT typically associated with mononucleosis?

1. Fatigue

2. Sore throat with tonsillar exudates

3. Joint pain

4. Posterior cervical lymphadenopathy

The correct answer is: Joint pain

Mononucleosis, often caused by the Epstein-Barr virus, is characterized by a combination of symptoms, some of which are highly indicative of the condition. Fatigue is one of the hallmark features, frequently reported by patients experiencing prolonged tiredness that can last for weeks or months. A sore throat with tonsillar exudates is common, resulting from the inflammation of the tonsils and lymphatic tissues typically involved in viral infections. Posterior cervical lymphadenopathy is another classic sign; the infection often leads to swollen lymph nodes in the posterior region of the neck, which is a key diagnostic indicator for healthcare providers. In contrast, joint pain is not a typical symptom associated with mononucleosis. While some patients might experience discomfort or aches that could include joint pain, this is generally not a primary feature of the illness. Symptoms such as fatigue, sore throat, and lymphadenopathy are much more prominent in the clinical presentation of mononucleosis, making joint pain less relevant as a characteristic symptom of the disease.