Get Answer: Pharyngitis Case Study Question Guide
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Original Question
Pharyngitis Case Study Part I Chief Complaint: sore throat HPI: 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: hypertension PSH: appendectomy 2015 Allergies: penicillin – anaphylaxis Medications: acetaminophen 650mg Q6H prn pain or fever, last dose 0900 Question #3 Take a closer look at this patient’s medical history. What other question(s) is important to ask? (2 points) Immunizations: reports UTD Review of Systems: General: c/o subjective fevers and chills Skin, hair, nails: denies rash Eyes: denies eye redness or drainage Nose/Sinuses: c/o runny, stuffy nose Throat/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% RA Physical Exam: General: nontoxic appearing female, in no distress, well-nourished Skin, hair, nails: no obvious skin rash noted Ears: bilateral TMs are without erythema but bulging with clear fluid noted behind eardrum Throat/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-meningismus Gastrointestinal: 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)
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