Differential Diagnoses Paper

The patient that I have chosen for my diagnostic reasoning paper is a 47-year-ol-Hispanic female. The presenting problem that I have chosen to use as my patient’s chief complaint is back pain. The only other clues that I have to use in order to help narrow my focus is that she is a female, she is 47-years-old, and she is Hispanic. I do not know how long she has been experiencing pain or how severe her pain is. Given these parameters, I will “cast a wide net” as I evaluate my patient and create my list of differential diagnoses.

Ms. T is an eight year old African American female that presents to Dr. Bill’s Kids today with complaints of her tonsils bothering her again. She has been to this office three times in the past three months with complaints of swollen tonsils and painful swallowing. Each time, she has tested positive for Group A Streptococcus also known as GAS. Her mother is with her today and reports that she had strep throat in the past multiple times about two or three times a year, but it is becoming much more frequent. She began complaining of scratchy throat in the morning and at night, but the symptoms quickly progressed to painful swallowing of solids and liquids. Popsicles are the only thing she will even consider eating at this time because they alleviate the pain.

The multidisciplinary team meeting is an example of the process in action. Many clinicians are present. Most will be in a position to help formulate the most appropriate management for the patient. The doctor directly responsible presents the present situation and the relevant background. The assessment will include a discussion with the clinician to clarify the clinical findings and a joint review of the results of all relevant investigations. Recommendations will be agreed by all present. These will be documented in the patient's records for implementation.

A. its unprofessional and may lead to a delay in court hearing or process until it is better understood, or corrected. (Sieter chapter 4)

Creating a plan and executing each step of the plan might sound simple to do, but for many individuals, many of them must have the next step of maintenance just in case they deviate from the plan (Miller & Rollnick, 2002). Maintenance is the next step in change in which the individual must either maintain their steps in change or relapse and change their ways (Miller & Rollnick, 2002). This step is also the last step and the longest step for individuals in which finishing this step might take up to months or even years to accomplish (Miller & Rollnick, 2002). Also in this step the individuals might relapse and go back to their previous ways in which at that time the clients would want to know why they relapsed or ways to prevent it (Miller

Patient J.B. presented the office with chief complaints of coughs and sore throat that lasted about seven days. These symptoms are typically seen in respiratory tract infection or inflammation that is caused by viruses or bacteria. The initial differential diagnoses included Influenza, cough, common cold, community-acquired pneumonia, acute bronchitis, acute pharyngitis, and postnasal drip syndrome based on the chief complaints. The reason that why these differential diagnoses were considered is because they all have coughs as the symptom. Some of these differential diagnoses have both coughs and sore throat. JD, et al. (2017) states that Influenza A or B viruses can cause a dry cough and sore throat. Troullos,

Streptococcus pharyngitis is a bacterial infection of the throat caused by Streptococcus pyogenes, also known as group A Streptococcus. It can causes throat pain, difficulty with swallowing, red and swollen tonsils which can be accompanied with white patches or streaks of pus, red spots on the palate, swollen lymph glands in the neck, fever, headache, rash, stomach ache, and fatigue. It can lead to more serious conditions such as scarlet fever, inflammation of the kidneys, and rheumatic fever. When Streptococcus pharyngitis is suspected, usually a rapid antigen test is run but a throat culture also needs to be done. Treatment is usually Penicillin and Amoxicillin for children. Nursing intervention for Streptococcus pharyngitis is to make sure the patient gets plenty of rest and also to push fluids to keep the back of the throat lubricated and to prevent dehydration (http://www.mayoclinic.org/diseases-conditions/strep-throat/basics/definition/con-20022811).

The “Seven Attributes” for the assessment of Miss B is a systematic approach to the assessment and documentation of a chief compliant of a patient (Bickley, 2017, p. 9). The systematic approach of the “Seven Attributes” of a patient’s chief complaint with result in a thorough assessment and lead to a sound diagnosis (Bickley, 2017, p9.) The methodical approach of addressing the complaint will ensure that all vital aspects are assessed and explored in order to diagnose and treat. A complete

Otitis Externa is most often caused by Staphylococcus aureus and Pseudomonas aeruginosa. Acute otitis media can be caused by bacterial or viral pathogens. Some of the pathogens associated with acute otitis media (AOM) include, S. pneumoniae, H. influenza, M. catarrhalis, and Streptococcus pyogenes. The common cold or rhinosinusitis is likely caused by rhinoviruses, adenoviruses, coronaviruses, enteroviruses, influenza and parainfluenza viruses, and respiratory syncytial virus (Burns, Dunn, Brady, Starr, & Blosser, 2013). Acute bacterial rhinosinusitis (ABRS) is a result of the S. pneumoniae, H. influenza, M. catarrhalis and/or B-hemolytic streptococci bacterias. Sore throats or acute pharyngitis is 90 percent of the time caused by a viruse. Bacterial sore throats are often a result of the group A streptococci bacteria. According to Burns et al., 2013, Mycoplasma pneumoniae, Chlamydia pneumoniae, groups C and G streptococci, and Arcanobacterium hemolyticum can cause acute pharyngitis. Pathogens that typically cause infections of the tonsils include B-hemolytic streptococci, group D streptococcus, and S. pneumonia (Burns, et al., 2013). The pathogens involved in acute cervical adenitis include B-hemolytic strep, staphylococcus, B. heneslae, viruses, and atypical

Although, Susan changed her major several times she never finished college. Susan chose different majors to try and find what fit best for her. With all of the majors, she tried she couldn’t find one that she enjoyed long enough to complete the program. Susan went to community college for three years. During the three years she was enrolled she majored in nursing, business administration, education, and sociology. Susan admits that she has never been really good at school, and she only chose two of the majors because her friends chose them.

One must do a system review with each complaint that a patient comes with, because it can be related to some other issue that is currently happening. L. Pepper stipulates that there are 8 ways to help your Doctor make the right diagnosis, they

Compare the reviewer's level and category with the level and category checked on the patient encounter form. Does it match?

Problem lists are used to track both acute and chronic conditions related to the care of the patient (Garlee, 2012). The purpose of the problem list is to ensure that everyone who touches the patient knows what conditions are present (Garlee, 2012) The problem list is important because it ties everyone involved in providing health care all understand the same circumstances that exist to prevent medical errors. It is stated in the text, that all clinic staff should be able to easily see the current problems for a patient and view the history of problems. Please note, that the conclusion or diagnosis is not a problem to be listed in the problem list portion of the patient medical record. It is important to not confuse diagnosis with problems, they are not the same. The problem list is important because it is an updated version of the current status of the patient. The problem list is always updated during each patient visits to the doctor, and prior to any blood work or procedures are done on patients. The problem list is also important because symptoms are liable to change or fluctuate in between doctor visits. That is why problem list are update every doctors visit. Problem list can be viewed to see what symptoms are trending and what symptoms are regressing. Problem list are important in this sense so health care providers can prioritize patient symptoms as those that are trending to become top priority and those that are fading away to be low priority.

For some reason my sister also gets strep a lot, they told us it was due to eating a lot of ice. My sister also has never had tonsillitis. While doing research I found that Strep and tonsillitis both are an infection causing the throat to become sore. The only real difference is with strep the patient will experience sever soreness to their throat. With tonsillitis the tonsils are inflamed and strep it‘s a specific bacteria that also inflame the throat. I’ve attached a great article on the difference between the two

Tonsillitis is inflammation of the tonsils, with particular reference to the palatine tonsils , two ovoid bodies of about 2,5 - 3,5 cm in length and two in width consist of lymphoid tissue and placed at the sides of the throat, immediately behind and above the base of the tongue. The tonsils are exposed to inflammation, usually viral, bacterial, more rarely, resulting in enlargement of themselves and with referred pain in the throat and in some cases ear.