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Original Question

Danny Rivera visited the office today with complaints of a cough and tiredness. Danny reports a cough lasting four to five days, which he describes as “watery and gurgly.” The cough worsens at night, disrupting his sleep and causing general fatigue. He also has pain in his right ear and mild throat soreness. His mother treated his cough with over-the-counter medicine, but it was only temporarily effective. Danny frequently has a cold and runny nose and had frequent ear infections as a child. He has a history of pneumonia in the past year. He denies fever, headache, dizziness, trouble breathing, shortness of breath. Respiratory: Chest is symmetric with no visible abnormalities. Respiratory rate is increased, but no acute distress. Patient able to speak full sentences. Breath sounds clear to auscultation. Negative bronchophony. Chest wall resonant to percussion. Expected fremitus, equal bilaterally. Spirometry: FVC 1.78L, FEV1 1.549L (FEV1/FVC: 87%) HEENT: Mucus membranes are moist and pink, nasal cavities patent with clear nasal discharge. Erythema and cobblestoning in the back of throat. Erythema noted on tonsils and posterior oropharynx. Right Tympanic membrane is red and inflamed, no discharge noted bilaterally. Right cervical lymph node enlarged with reported tenderness. give rational for each diagnosis based on symptoms provided. Diagnosis Common cold, acute sinitius, ear infection, allergies, asthma, strep throat

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