Question

Please Write Succinct: Depression

• Review of Systems: Associated symptoms and Risk Factors
• Findings on Focused Physical Ex
• Five Differential Diagnosis

See example below for question #1:

1. Sore Throat

ROS:

Associated symptoms: fever, redness or eye discomfort, sneezing, wheezing, cough, runny nose, postnasal drip, GERD like symptoms, fatigue, muscle ache, n/v, and diarrhea.

Risk Factors:

Smoking, new sexual partners, irritant exposure, medications, and chronic health problems.

Red flags:

drooling, unable to swallow, unable to lie down, restless, unable to stay still, and unable to talk.

PE findings:

Epiglottis- severe illness with signs of upper airway obstruction such as restlessness, stridor, difficulty breathing, drooling, inability to swallow and high fever signals epiglottis and requires immediate referral. Further examination with a tongue blade could trigger laryngospasms and lead to airway obstruction.

Peritonsillar retropharyngeal abscess- orthopnea, dyspnea, symmetrical swelling, abscess, trismus.

Viral pharyngitis: Erythema, edema of throat, tender posterior cervical nodes.

GAS: temp more than 101.5, exudate anterior cervical lymphadenopathy.

Mononucleosis: presence or absence of pharyngeal exudate, posterior cervical lymphadenopathy, splenomegaly.

Gonococcal pharyngitis: pharyngeal exudate bilateral cervical lymphadenopathy

Inflammation: sinus tenderness, pale or swollen pharynx, postnasal drainage visible, no fever or lymphadenopathy.

Aphthous Stomatitis: shallow ulcers, no vesicles; indurated papules that progress to 1 cm ulcers; ulcer has yellow membrane and red halo; no fever or nodes.

Herpes simplex Lesions: perioral lesions; lymph adenitis; vesicles on palate, pharynx gingiva.

Herpetic pharyngitis: vesicles, ulcers, or exudate of the oral and pharyngeal mucosa.

Candidiasis: curd like white plaques that bleed when scraped off.

Differential diagnosis:

Viral Pharyngitis, Streptococcal Pharyngitis, peritonsillar or retropharyngeal abscess, Mononucleosis, Epiglottis, gonococcal pharyngitis, Herpangina, Vincent angina, Aphthous stomatitis, HSV type 1, Candidiasis, GERD.

Answer 1

Review of systems:

1-associated symptoms: hopless outlook , lost interest, increased fatigue and sleep problems, anxiety, rapid heart rate, increased sweating, muscle twitching, trouble focusing, irritability, changes in appetite and weight, uncontrollable emotions, looking at death.

Risk factors: death aur loss of close one, conflicts, physical sexual or emotional abuse, family history, chronic medical conditions, personal history of traumatic brain injury.

Red flags: unexplained aches and pains, inability to concentrate, disruption in sleep habits, changes in appetite and eating, irritability education and moodiness.

PE findings: weight loss, fatigue,GI problems-nausea, diarrhoea, constipation.

Bipolar disorder: episodes of of mood swings ranging from depressive lows to manic highs, reduce the need for sleep, loss of touch.

Borderline personality disorder: unstable moods, relationship, behaviour, emotional instability.

Anxiety: increase the heart rate, increased sweating ,trumbling ,trouble focusing

Obsessive compulsive disorder: excessive thoughts and repeated behaviour.

Differential diagnosis: bipolar disorder, anxiety, borderline personality disorder, obsessive compulsive disorder,drug induced mood disorders, hypothyroidism, vitamin b12 deficiency.