Diagnostic Reasoning and Rationale for acute illness
Pick one problem from the list provided below. Discuss and include your rationales using.
- What questions need to be asked and what body part needs to be examined?
- What diagnostic tests need to be obtained and why?
- How would you handle abnormal finding?
- What will be your list of differentials?
Problems commonly seen in the Primary Care setting:
- runny nose
- cough
- diarrhea
- pharyngitis
- dysuria
- rash
Include at least 3 references
Expert Solution Preview
Introduction:
In diagnosing acute illnesses, proper questioning, examination, and diagnostic testing are crucial for accurate diagnosis and treatment. This assignment will focus on one common problem seen in primary care settings, and discuss the necessary steps for diagnostic reasoning.
Problem: Runny nose
Questions to ask and body part examination:
1. Duration of symptoms
2. Presence of fever
3. Presence of sore throat or cough
4. Any recent travel or exposure to sick individuals
Body part examination:
1. Inspection of the nasal cavity for mucosal erythema and nasal discharge
2. Palpation of the sinuses for tenderness
Diagnostic tests:
1. Rapid antigen test for streptococcal pharyngitis
2. Rapid influenza test
3. Allergy testing if needed
Handling abnormal findings:
1. Treat bacterial infections with antibiotics
2. Symptomatic treatment for viral infections
3. Referral to an allergist for allergy diagnosis and treatment
List of differentials:
1. Sinusitis
2. Influenza
3. Allergic rhinitis
4. Bacterial pharyngitis
References:
1. Wald, E. R., Guerra, N., Byers, C., & Casselbrant, M. L. (2012). Diagnostic and therapeutic considerations in children with acute sinusitis. Pediatric Annals, 41(8), e1-e9.
2. CDC (2019). Rapid diagnostic testing for influenza. Retrieved from
3. Wallace, D. V., Dykewicz, M. S., Bernstein, D. I., Blessing-Moore, J., Cox, L., Khan, D. A., … & Lang, D. M. (2008). The diagnosis and management of rhinitis: an updated practice parameter. Journal of Allergy and Clinical Immunology, 122(2), S1-S84.