Differential & Work-up: Sore throat, Cough & Shortness of Breath Flashcards
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.
- Infectious mononucleosis
- Hepatitis
- Viral or bacterial pharyngitis
- Acute HIV infection
- Secondary syphilis
WORK UP FOR:
- Infectious mononucleosis
- Hepatitis
- Viral or bacterial pharyngitis
- Acute HIV infection
- Secondary syphilis
- CBC with differential & peripheral smear
- Monospot test
- Throat culture
- AST/ALT /bilirubin/alkaline phosphatase
- HIV antibody and viral load
- Anti-EBV antibodies
- VDRL/RPR
26 yo M presents with sore throat, fever, rash, and weight loss. He has a history of IV drug abuse and sharing needles.
- HIV, acute retroviral syndrome
- Infectious mononucleosis
- Hepatitis
- Viral pharyngitis
- Streptococcal tonsillitis/Scarlet fever
- Secondary syphilis
WORK UP FOR:
- HIV, acute retroviral syndrome
- Infectious mononucleosis
- Hepatitis
- Viral pharyngitis
- Streptococcal tonsillitis/Scarlet fever
- Secondary syphilis
- CBC with differential & peripheral smear
- Throat culture
- HIV antibody and viral load
- CD4 count
- Monospot test
- LFTs
- VDRL/RPR
46 yo F presents with fever and sore throat.
- Pharyngitis (bacterial or viral)
- Mycoplasma pneumonia
- Acute HIV infection
- Infectious mononucleosis
WORK UP FOR:
- Pharyngitis (bacterial or viral)
- Mycoplasma pneumonia
- Acute HIV infection
- Infectious mononucleosis
- Centor criteria
- Throat swab for culture & rapid streptococcal antigen
- Monospot test
- CBC
- Serologic test (cold agglutinin titer) for Mycoplasma
- HIV antibody and viral load
30 yo M presents with shortness of breath, cough, and wheezing that worsen in cold air. He has had multiple, similar episodes in the past 4 months.
- Asthma
- GERD
- Bronchitis
- Pneumonitis
WORK UP FOR:
- Asthma
- GERD
- Bronchitis
- Pneumonitis
- CBC
- CXR
- Peak flow measurement
- PFTs
56 yo F presents with shortness of breath and a productive cough that has lasted for at least 3 months bronchitis each year over the past 2 years. She is a heavy smoker.
- COPD-chronic bronchitis
- COPD-emphysema
- Bronchiectasis
- Lung Cancer
- Tuberculosis
WORK UP FOR:
- COPD-chronic bronchitis
- COPD-emphysema
- Bronchiectasis
- Lung Cancer
- Tuberculosis
- CBC
- Sputum Gram stain and culture
- CXR
- PFTs
- CT-chest
- QuantiFERON-TB Gold
58 yo M presents with 1 week of pleuritic chest pain, fever, chills, and cough with purulent yellow sputum. He is a heavy smoker with preexisting COPD.
- Pneumonia
- COPD exacerbation (bronchitis)
- Lung abscess
- Lung cancer
- Tuberculosis
- Pericarditis
WORK UP FOR:
- Pneumonia
- COPD exacerbation (bronchitis)
- Lung abscess
- Lung cancer
- Tuberculosis
- Pericarditis
- CBC
- Sputum Gram stain and culture
- CXR
- CT-chest
- ECG
- QuantiFERON-TB Gold
25 yo F presents with 2 weeks of nonproductive cough. Three weeks ago, she had a sore throat and a runny nose.
- Atypical pneumonia
- Asthma
- URI-associated cough (“ postinfectious”)
- Postnasal drip
- GERD
WORK UP FOR:
- Atypical pneumonia
- Asthma
- URI-associated cough (“ postinfectious”)
- Postnasal drip
- GERD
- CBC
- Induced sputum Gram stain and culture
- CXR
- IgM detection for Mycoplasma pneumoniae
- Urine Legionella antigen
65 yo M presents with 6 months of worsening cough accompanied by hemoptysis, dyspnea, weakness, and weight loss. He is a heavy smoker.
- Lung cancer
- Tuberculosis
- Lung abscess
- COPD
- Vasculitis ( eg. granulomatosis with polyangiitis)
- Interstitial lung disease
- CHF
WORK UP FOR:
- Lung cancer
- Tuberculosis
- Lung abscess
- COPD
- Vasculitis ( eg. granulomatosis with polyangiitis)
- Interstitial lung disease
- CHF
- CBC
- Sputum Gram stain, culture, and cytology
- CXR
- CT-chest
- QuantiFERON-TB Gold
- ANCA
- Bronchoscopy
- Echocardiography
55 yo M presents with increased dyspnea and sputum production for the past 3 days. He has COPD and stopped using his inhalers last week. He stopped smoking 2 days ago.
- COPD exacerbation (bronchitis)
- Lung cancer
- Pneumonia
- URI
- CHF
WORK UP FOR:
- COPD exacerbation (bronchitis)
- Lung cancer
- Pneumonia
- URI
- CHF
- CBC
- CXR
- ABG
- PFTs
- Sputum Gram stain and culture
- CT-chest
- Echocardiography
34 yo F nurse presents with worsening cough of 6 weeks’ duration accompanied by weight loss, fatigue, night sweats, and fever. She has a history of contact with tuberculosis patients at work.
- Tuberculosis
- Pneumonia
- Lung abscess
- Vasculitis
- Lymphoma
- Metastatic cancer
- HIV/AIDS
- Sarcoidosis
WORK UP FOR:
- Tuberculosis
- Pneumonia
- Lung abscess
- Vasculitis
- Lymphoma
- Metastatic cancer
- HIV/AIDS
- Sarcoidosis
- CBC
- PPD/QuantiFERON-TB Gold
- Sputum Gram stain, acid-fast stain, and culture
- CXR
- CT-chest
- Bronchoscopy
- HIV antibody
- Lymph node biopsy
35 yo M presents with shortness of breath and cough. He has had unprotected sex with multiple sexual partners and was recently exposed to a patient with active tuberculosis.
- Tuberculosis
- Pneumonia (including Pneumocystis jirovecii)
- Bronchitis
- Asthma
- Acute HIV infection
- CHF (cardiomyopathy)
WORK UP FOR:
- Tuberculosis
- Pneumonia (including Pneumocystis jirovecii)
- Bronchitis
- Asthma
- Acute HIV infection
- CHF (cardiomyopathy)
- CBC
- PPD/QuantiFERON-TB
- Gold
- Sputum Gram stain, acid-fast stain, silver stain, and culture
- CXR
- HIV antibody
- Echocardiography
50 yo M presents with a cough that is exacerbated by lying down at night and improved by propping up on three pillows. He also reports exertional dyspnea.
- CHF
- Cardiac valvular disease
- GERD
- Pulmonary Fibrosis
- COPD
- Post-nasal drip
WORK UP FOR:
- CHF
- Cardiac valvular disease
- GERD
- Pulmonary Fibrosis
- COPD
- Post-nasal drip
- CBC
- CXR
- ECG
- Echocardiography
- PFTs
- BNP
- CT-chest
60 yo M presents with worsening dyspnea of 6 hours’ duration and a cough that is accompanied by pink, frothy sputum.
- Pulmonary edema
- Pneumonia
- CHF
- Mitral valve stenosis
- Arrythmia
- Asthma
WORK UP FOR:
- Pulmonary edema
- Pneumonia
- CHF
- Mitral valve stenosis
- Arrhythmia
- Asthma
- CXR
- ECG
- CBC
- ABG
- PFTs
- BNP