How to Answer Differential Diagnosis With Questions (Complete Guide)
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What This Question Is About
This question relates to differential diagnosis with and requires a structured academic response.
How to Approach This Question
Structure your response with introduction, analysis, and conclusion.
Key Explanation
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Original Question
differential diagnosis with ICD 10 codes, including positive and negatives for each diagnosis. the most likely diagnosis and required test for the following patient. History of Present Illness: A 25-year-old man with a history of asthma and diabetes presents as a new patient with a 4-day history of a sore throat that had worsened overnight. His throat initially started hurting 4 to 5 days ago; however, he now has associated subjective fever, chills, and pain upon swallowing. The pain is burning, constant, rated 8/10, and it radiates to his left ear. He has been taking ibuprofen the last 4 days without significant relief. The patient has had sore throats prior to this episode, but he has “never had pain like this before.” Previous episodes typically occurred with symptoms of a “cold” and lasted 1 to 2 days. He is able to tolerate soft foods and liquids. He is accompanied today by his father. Review of Systems: positive for fever, chills, odynophagia, trismus, and otalgia. His ROS is negative for malaise, fatigue, nausea, vomiting, cough, SOB, hemoptysis, abdominal pain, neck pain, and rash. Past Medical History: type 2 diabetes and asthma, both well controlled. Social History: He is married and has one daughter. He denies tobacco use, drinks “a few” beers on the weekend, smokes marijuana on occasion, and denies other recreational drugs. Family History: His father is well, with chronic, uncomplicated diabetes and hypertension. His mother is alive and well with chronic hypertension complicated by chronic kidney disease. Allergies: No known drug allergies; no known food allergies. Medications: Albuterol inhaler two puffs inhaled, q4h to q6h. Metformin 500 mg PO BID. Physical Examination: Vitals: T 38.1°C (100.5°F), P 103, R 18, BP 132/78, SpO2 99%, 90.72 kg (200 lbs), 182.88 cm (72 in.), BMI 27.12. General: Ill-appearing male sitting on the bed, in mild distress related to pain. Patient is speaking in short sentences, and his voice is muffled and low pitch in quality. Psychiatric: Cooperative, mildly anxious secondary to pain. Skin: No rashes or abnormal pigmentation noted. Head: Atraumatic, normocephalic. Neck: Supple, no bruits appreciated, trachea midline, no thyromegaly appreciated, lymphadenopathy noted with tender to palpation at site of the left submandibular region and along the left superficial cervical chain. Eyes: Conjunctiva pink and moist, PEERLA, EOMI. ENT/Mouth: Bilateral TM intact, pearly gray in color, cone of light noted, serous fluid appreciated on the left; no erythema or exudates noted. Mucosa pink and moist; no lesions, swelling, or drainage noted in nose. Difficulty opening his mouth. Buccal mucosa slightly dry, posterior pharynx is erythematous, mild white tonsillar exudate bilateral, (2+) tonsillar enlargement on the right, (3+) tonsillar enlargement on the left, and deviation of the uvula toward the right noted. Lungs: Normal A/P diameter; non-labored breathing; symmetric chest wall expansion; no chest wall tenderness to palpation; breath sounds clear to auscultation bilaterally, without wheezing, rales, or rhonchi. Heart: Regular rate and rhythm, S1 and S2 present (normal); no murmurs, rubs, or gallops. Abdomen: Non-distended, positive BS, soft, non-tender; no masses or splenomegaly appreciated. Neurologic: Alert and oriented to person, time, and place. Cranial nerves II to XII grossly intact.
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