When did you first notice the soreness in your throat

QUESTION

What further questions do you have for Mary on this visit?O – : When did you first notice the soreness in your throat? Has this occurred in the past? If so, howmany times?L – Throat involvementD – How long have you had the sore throat?C – Since onset, have you noticed a change when you swallow? Have you noticed any drainage ormucous from throat If so, how would you describe the drainage? Have you noticed any redness, swelling,or white spots?A – Does eating or drinking affect the pain? Does swallowing and or talking affect your throat?R – Are you experiencing pain? If so, on a scale 0-10 what would you rate your pain? Have you takenanything that helps alleviate the pain?T – Have you taken anything that helps alleviate the pain? Have you tried pain medication or throatlozenges?Differential Diagnoses:Pharyngitis/Sore ThroatStrep throat – Patients can experience a severe and sudden sore throat without coughing, sneezing, orother cold symptoms. Pain or difficulty with swallowing. Fever over 101°F (38.3°C). Swollen lymph nodesin the neck, and white or yellow spots or coating on the throat and tonsils. Strep throat is caused by abacterium known as Streptococcus pyogenes, or group A streptococcus (Nakhoul & Hickner, 2013).Rationale: Mary presents in clinic with complaints of a sore throat and hurts worse when she swallows.Tumors – Cancerous tumors of the throat, tongue or larynx can cause a sore throat. Other signs orsymptoms may include hoarseness, difficulty swallowing, noisy breathing, a lump in the neck, and bloodin saliva or phlegm (Waldman et al., 2013).Rationale: Mary presents with a sore throat.Viral infections- Viral illnesses that cause a sore throat include a common cold, Flu (influenza),mononucleosis (mono), measles, chickenpox, and croup (Falsey et al., 2014).Rationale: Mary presents to clinic with a sore throat that is worse when she swallows. She has adaughter at home that is getting over a cold.Based on your differential diagnoses list, what focused PE would you perform? What labs or diagnostictests, if any, would you order?Vital signs. Complete physical assessment of the head, ears, eyes, nasal, looking down throat, palpatingthe neck to check for swollen glands, and listening to heart and lungs. I would order a throat swab for arapid strep test as well.

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