Question

1.  At the Integris hospital, a 5-year old Caucasian male child in good general health and physical condition was presented at the Saturday walk-in clinic by his mother. He was brought in because he had a fever, was cranky and had complained of a sore throat for about 24 hours. On physical examination by the attending resident, the patient had a fever of 39.3C, and he had considerable swelling and drainage of the pharynx and in the conjunctivae. His tonsils were enlarged and coated with a white patchy exudate. He had a red throat and swollen anterior cervical lymph nodes. His ears were clear. His chest sounded clear and he had no additional remarkable findings on routine examination.

a) What would be your presumptive diagnosis for this child? Why?

b) What diagnostic testing would be indicated to follow this exam?

c) What is the most likely treatment for this illness? Why is it important?

d) What factors of this case allowed you to make a presumptive diagnosis?

e) Lastly, are there any preventative advice that you would give to the mother?

Answer 1

1. For the presumptive diagnosis of the patient and looking at the symptoms of the patient it has been cleared that the patient must be suffering from any viral infection or any other infectious disease where the white spots on the tonsils is seen. Thus the swab test can be done for the diagnosis process of the patient and normal swab will be taken fo=rom him/her and then checked for the presence of pathogen in it.

2. After the diagnosis has been it the result of the diagnosis should ideally show the viral particles or the pathogen which is present in the swab. This has to be done by spreading the sample on the agar plate and isolation of the pathogens. If the viral sample is present then the plaque formation will take place and in other cases the colonies will form.

3. The most likely treatment for this condition is providing him with the ibuprofen which works form the severe inflammation and will help in reducing down the inflammation. Along with that the antipyretic drug should be provided to the patient for reducing the fever level of the patient and the oral thrush should be subscribed in its treatment with the salt and water solution.

4. the fever which has been patient suffering from, the white spots on the tonsils, cough, swollen cervical lymph nodes are the indications that this is the case of the viral infection and thus the presumptive diagnosis with the swab of the patient has to take place.

5. This can be the case of the tonsillitis which causes such spots on the tonsils and that can have some other preventive advice such as follows:

• Drink warm liquids throughout the treatment on this disease
• Do not smoke cigarettes or drink alcohol which can act as the irritant and will increase the inflammation in that particular region