Sore Throat

Question 1

What key history would you obtain from a patient that complained of a sore throat?

Answer 1

Duration
Fever
ENT symptoms (ear pain, URI)
Odynophagia
Swollen glands
\+/- Cough
Rash
Sick contacts
HIV risk factors

Question 2

What key physical exams would you do for a patient that complains of a sore throat?

Answer 2

Vital signs
ENT exam 
Oral thrush
Tonsillar exudate
Lymphadenopathy
Lung exam
Abdominal exam
Skin exam

Question 3

26 yo F presents with sore throat, fever, severe fatigue and loss of appetite for the past week. She also reports epigastric and LUQ discomfort. She has cervical lymphadenopathy and a rash. Her boyfriend recently experienced similar symptoms. Differentials?

Answer 3

Infectious Mononucleosis
Viral or bacterial pharyngitis
Acute HIV infection
Secondary syphilis

Question 4

26 yo F presents with sore throat, fever, severe fatigue and loss of appetite for the past week. She also reports epigastric and LUQ discomfort. She has cervical lymphadenopathy and a rash. Her boyfriend recently experienced similar symptoms. Differentials: infectious mononucleosis, hepatitis, viral or bacterial pharyngitis, acute HIV infection, secondary syphilis. Workup?

Answer 4

CBC, peripheral smear
Monospot test
Throat culture
AST/ALT/bilirubin/alkaline phosphatase
HIV antibody and viral load
Anti-EBV antibodies
VDRL/RPR

Question 5

26 yo M presents with a sore throat, fever, rash, and weight loss. He has a history of IV drug abuse and sharing needles. Differentials?

Answer 5

HIV, acute retroviral syndrome
Infectious mononucleosis
Hepatitis
Viral pharyngitis
Streptococcal tonsilitis/scarlet fever
Secondary syphilis

Question 6

26 yo M presents with a sore throat, fever, rash, and weight loss. He has a history of IV drug abuse and sharing needles. Differentials: HIV (acute retroviral syndrome), infectious mononucleosis, hepatitis, viral pharyngitis, streptococcal tonsilitis/scarlet fever, secondary syphilis. Workup?

Answer 6

CBC, peripheral smear
HIV antibody and viral load
CD4 count
Monospot test
Throat culture
VDRL/RPR
AST/ALT/bilirubin/alkaline phosphatase

Question 7

26 yo F presents with fever and sore throat. Differentials?

Answer 7

Pharyngitis (viral or bacterial)
Mycoplasma pneumonia
Acute HIV Infection
Infectious mononucleosis

Question 8

26 yo F presents with fever and sore throat. Differentials: pharyngitis (viral or bacterial), mycoplasma pneumonia, acute HIV infection, infectious mononucleosis. Workup?

Answer 8

Throat swab for culture and rapid streptococcal antigen
Monospot test
CBC
HIV antibody and viral load