NR 509 Week 3 i-Human Virtual Patient Encounter Attempt 3666007 - Amanda Wheaton
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History Notecard by Daniela De Sousa Barbosa on case Amanda Wheaton Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = sore throat Sx = HA Sx = Fever Sx Sx Sx = = = Onset 2 days ago 2 days ago 1 day ago Location throat head body Duration 2 days 2 days noticed last night 101.8 Characteristics “bad” dull, frontal chills? Aggravating swallowing N/a n/a Relieving acetaminophen and ice acetaminophen acetaminophen cream Timing / continuous, comes and goes, n/a Treatments acetaminophen linked to sore throat Severity “sick and miserable” 11 Dull N/a pt stated pain on 1-10 number scale Attempt: 3666007 Report generated on 9/15/2025, 2:10:41 PM America/Denver Management Plan by Daniela De Sousa Barbosa on case Amanda Wheaton Assessment The patient is Amanda Wheaton, a 23-year-old otherwise healthy female presenting with signs and symptoms consistent with acute pharyngitis. Key findings include a sore throat, fever of 101.5°F, pharyngeal erythema with bilateral tonsillar exudates, tender cervical lymphadenopathy, and associated headache. She reports recent contact with a sick roommate and has not received an influenza immunization. Her past medical history includes infectious mononucleosis at age 15. No other constitutional, dermatologic, or cardiovascular symptoms are present. The clinical presentation suggests a likely diagnosis of streptococcal pharyngitis, which warrants confirmatory testing and appropriate antibiotic management to prevent complications such as rheumatic fever and to reduce transmission. The patient remains clinically stable with no signs of airway compromise or systemic illness beyond the current symptoms, indicating outpatient management is appropriate—follow-up recommended to ensure resolution of symptoms and prevent potential complications. Management Plan for Acute Pharyngitis Suspected of Streptococcal Infection Diagnostic Tests: The diagnostic feedback indicates that, despite a negative Rapid Antigen Detection Test (RADT), the patient's clinical presentation—characterized by sore throat, fever, lymphadenopathy, pharyngeal erythema, and absence of cough—suggests streptococcal pharyngitis, especially given the exposure history. An additional test that could be considered is a throat culture, which offers the advantage of identifying other potential pathogens causing pharyngitis and allows for antibiotic susceptibility testing. However, unlike the rapid test, a throat culture requires 24 to 48 hours for results, potentially delaying treatment. Diagnosing suspected Group A streptococcal pharyngitis in accordance with guidelines from the American College of Physicians–American Society of Internal Medicine (ACP-ASIM). Pellegrino et al. (2023) recommend using the Centor clinical decision rule alongside RADTs to improve diagnostic accuracy. Nonetheless, it's important to note that guidelines set for providers have prompted some debate, as they permit physicians to diagnose and treat
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