What Questions Would you Ask to Gather Diagnostic Information?
In the case of Robert Ross, it would be proper to ask the patient particular questions in order to identify his diagnosis and prescribe medicine. This person has such symptoms as acute chest pain, palpitations, fever, and malaise. These signs tell that there is a chance of him having a viral syndrome, as the patient’s previous medical history is almost empty. Therefore, it would be right to ask Ross if he is allergic to something because many medicaments can cause by-effects that might even worsen his condition. Also, it would be advantageous to ask the patient if he has traveled somewhere recently because there is a possibility to catch a virus during one’s vacation. Another essential question to ask Robert would be about his chest, which will give the doctor information of possible traumas or injuries in it.
How Would you Diagnose and Manage this Seventeen-Year-Old Male symptom that Includes Palpitations, Fever, and Malaise?
I would diagnose the case of Robert Ross with palpitations, fever, and malaise by completing all the required examinations and checking the results of all the necessary analyses that the patient will be obliged to undergo (Than et al., 2014). However, the most suitable diagnosis is myocarditis. Initial management would include such procedures as obtaining serial electrocardiograms, providing antipyretics for fever, and performing a bedside transthoracic echocardiogram.
Which Diagnostic Studies Would you Recommend for this Patient?
I would recommend the diagnostic studies below for implementation in this case due to uncertain explanations of the patient and such infrequent medical occurrence. The most crucial physical exams that would be beneficial for diagnosing Ross’s disease are the blood pressure and pulse measurements, palpating the person’s abdomen in order to feel any issues (Ukena et al., 2014). Also, it is important to make the lungs auscultation because any pain in the chest might cause defects and harm to other neighboring organs. Moreover, his heart needs auscultation as well to prevent any possible damage to it.
What Physical Exam Findings Would be Concerning to you and Why?
Robert’s chief complaint is his chest pain, which also remains the most significant problem (MSAP). Some other physical examination findings are given below and can be provisionally categorized, regarding their relationship to the MSAP. The results showed that such symptoms as palpitations, dyspnea, chills, malaise, myalgias, severe tachypnea, tachycardia, and ectopy are related to the patient’s MSAP.
What Would be Three Differentials in this Case?
Based on the results of analyses and physical examination, three differential diagnoses might be considered in this case. For instance, similar symptoms can be observed in such occurrences as pneumonia, sepsis, and systematic inflammatory response syndrome. It is essential to remember that there are some life-threatening diagnoses (acute coronary artery syndrome, pericarditis, and pulmonary embolism) that must be considered when a patient presents with acute chest pain.
What is the Treatment for Robert and Education for the Family?
Robert’s medical treatment will include constant cardiac monitoring and intravenous therapy, which is intended to relieve the patient’s pain and to liquidate his symptoms. These observations and treatment will identify the patient’s condition and will stimulate his health and immune system (Weitsman, Weisz, Keren, & Hasin, 2016). Education for his family would be to make Robert take medicine regularly and attend every procedure that was recommended by his doctor in order to remain healthy and conscious.
Than, M., Aldous, S., Lord, S. J., Goodacre, S., Frampton, C. M., Troughton, R.,… Richards, A. M. (2014). A 2-hour diagnostic protocol for possible cardiac chest pain in the emergency department. JAMA Internal Medicine, 174(1), 51-58. Web.
Ukena, C., Kindermann, M., Mahfoud, F., Geisel, J., Lepper, P. M., Kandolf, R.,… Kindermann, I. (2014). Diagnostic and prognostic validity of different biomarkers in patients with suspected myocarditis. Clinical Research in Cardiology, 103(9), 743-751. Web.
Weitsman, T., Weisz, G., Keren, A., & Hasin, T. (2016). Prompt benefit of early immunosuppressive therapy in acute lymphocytic myocarditis with persistent heart failure. Clinical Research in Cardiology, 105(9), 794-796. Web.