Pharyngitis Case Study Part IChief Complaint:HPI: sore throat 23-year-old white female comes in to t

Pharyngitis Case Study Part IChief Complaint:HPI: sore throat 23-year-old white female comes in to the office today with a 3-day complaint of sore throat. She says it feels like she is “swallowing glass.” She reports subjective fevers and chills.Question #1 What other questions would you ask the patient in the HPI? (15 points)Question #2 STOP! Do not read any further. What are your top 5 differentials just based off of the HPI? Provide your rationale with source. (5 points)PMH: hypertensionPSH: appendectomy 2015Allergies: penicillin – anaphylaxisMedications: acetaminophen 650mg Q6H prn pain or fever, last dose 0900Question #3 Take a closer look at this patient’s medical history. What other question(s) is important to ask? (2 points)Immunizations: reports UTDReview of Systems:General: c/o subjective fevers and chillsSkin, hair, nails: denies rashEyes: denies eye redness or drainageNose/Sinuses: c/o runny, stuffy noseThroat/mouth: c/o sore throat pain Question #4 What other body systems would you consider asking positives and negatives about? (6 points)Vital Signs:101.9, 118 bpm, 16 RR, 108/56, SpO2 99% RAPhysical Exam:General: nontoxic appearing female, in no distress, well-nourishedSkin, hair, nails: no obvious skin rash notedEars: bilateral TMs are without erythema but bulging with clear fluid noted behind eardrumThroat/mouth: oropharynx with erythema, edema. Tonsils 2+ equal bilaterally with exudate. Uvula midline with normal rise and fall. Phonation within normal limits.Neck: tender, submandibular lymph nodes bilaterally. Non-meningismusGastrointestinal: soft, nontender, nondistended. Normoactive bowel sounds throughout Question # 5. This physical exam is incomplete. What other areas are important to assess in the physical exam? (HINT: don’t just stop at the ENT exam.) (6 points)Question #6 What important component(s) of the throat/mouth exam is missing? (2 points)Question #7 What is your Centor Criteria score? (1 point) You take a picture of the patient’s throat and it looks like this:Question #8 Would you order any diagnostic tests for this patient? If yes, what would you order and why. If no, explain why not and what your next step would be. (1 point)Question #9 Did your initial differential list change? Explain why or why not and list your now current list in order of priority. (2 points)Treatment Plan – Two Scenarios – Be Careful!Question #10 You decide to check a strep screen and it is positive. What is the first-line treatment for this adult patient? (HINT: you will need to look at outside resources for this one). (5 points)Question #11 Other than the first-line treatment, what else would you order for this patient? (2 points)Question #12 You decide to check a strep screen and it is negative. What would you order for this patient and why? (2 points)Question #13 What are your follow-up instructions for this patient? (2 points)Question #14 What is your primary diagnosis (do the best you can with the information you have)? (2 points)Question #15 What are your secondary diagnoses? (2 points) Health Science Science Nursing NURS 756 Share QuestionEmailCopy link Comments (0)

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