Throat Pain

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of sore throat

Rated at ‍012345678910 / 10 ‍

Described as ‍scratchyburning

Radiation ‍none to ‍

Pattern ‍constantintermittent

Worsening factors: ‍noneswallowing

Alleviating factors: ‍none, ‍effectiveineffective

Contact with individual with strep throat: ‍YesNo



Associated symptoms: *Try using right-click for negatives*

‍pain with swallowing

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍sputum, ‍clearwhiteyellowgreen

‍runny nose, ‍clearcolored

‍nasal congestion

‍difficulty breathing

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍rash

‍headache, ‍diffuse, ‍persistentintermittent, ‍pressurethrobbing, ‍mild

‍earache

‍swollen lymph nodes

‍voice changes

‍redness in throat

‍white patches/pus on tonsils

‍swelling in throat

‍drooling

‍muffled voice

‍inability to open mouth fully



Contributing factors:

‍exposure to individuals with strep throat

‍exposure to individuals with similar symptoms

no history of: ‍strep throat, ‍tonsillitis, ‍mononucleosis, ‍environmental allergies





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Eyes: conjunctiva/sclera ‍normal, lids/lashes ‍normal

Ears: tympanic membranes ‍normal ‍, auditory canal ‍ on ‍rightleft, hearing ‍intact

Nose: ‍clear, discharge ‍clear, ‍

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Skin: ‍rashlesions on ‍





ASSESSMENT:

‍Pharyngitis ‍likelysuspectedpossible

DDx: viral pharyngitis, bacterial pharyngitis, acute sinusitis, postnasal drip, allergic rhinitis, GERD, tonsillitis, mononucleosis, laryngopharyngeal reflux, HIV acute infection, thrush, herpangina, diphtheria, peritonsillar abscess, retropharyngeal abscess, throat cancer, foreign body in the throat, smoking-related irritation





PLAN:

Investigations:

- Rapid strep test

- Throat swab

- Chlamydia and gonorrhea throat swab

- Blood work: ‍CBC, ‍monospot test, ‍LFTs, ‍CRP, ‍ß-hCG

Treatments:

- ‍Analgesics

- ‍Antibiotics

- Dexamenthasone 10mg po once

- Tantum lozenges

- Salt water gargles 4 times daily

- Rest and hydration

- Limit contact with others

Further care:

- Follow-up in ‍ ‍daysweeks

- Return if not better after 72 hrs or before if worsens

- Referral to ENT specialist if symptoms persist