NR 509 Week 3 i-Human Virtual Patient Encounter Attempt 3976528 - Jenna James
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History Notecard by Tammy Peirce on case Jenna James 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. Sx =sore Sx = Sx = Sx = HPI throat Sx = fever Sx = Headache swollen/tender chills Painful lymph nodes swallowing Onset 2 days ago 2 days ago 2 days ago 2 days ago 2 days ago Location Throat/all over Head Neck General Throat Duration constant Not always the same/intermittent Characteristics “like an ice pick” Dull/mild swollen and “some “hurts so tender to touch mild much when chills” I swallow” Aggravating swallowing hurts to touch swallowing Relieving “OTC acetaminophen acetaminophen medications (acetaminophen) maybe, just for a bit. Ice cream or a cold drink helps for a while” Timing / comes and Treatments goes;"seems to be tied to my other symptoms" Severity Very bad reported 101.8 mild headdache F Attempt: 3976528 Report generated on 7/25/2026, 2:21:30 PM America/Denver Management Plan by Tammy Peirce on case Jenna James SOAP Note: Acute Group A Streptococcal Pharyngitis S – Subjective Chief Complaint (CC): Sore throat, mild headache, swollen lymph nodes/neck, and fever History of Present Illness (HPI): The patient’s clinical presentation is consistent with acute Group A Streptococcal (GAS) pharyngitis, as evidenced by the acute onset of severe sore throat, fever, tonsillar exudates, tender anterior cervical lymphadenopathy, absence of cough, and recent household exposure to confirmed GAS infection. The diagnosis is confirmed by a positive rapid antigen detection test (RADT), which supports the initiation of targeted antibiotic therapy. According to the Infectious Diseases Society of America (IDSA, 2025), patients with confirmed GAS pharyngitis should receive appropriate antibiotic treatment to reduce symptom duration, decrease transmission risk, and prevent potential complications, including acute rheumatic fever The patient's symptoms are concerning for acute GAS pharyngitis based on the acute onset of fever, sore throat, absence of cough, tonsillar findings, tender cervical lymphadenopathy, and known household exposure to sick contact. Clinical features alone cannot reliably distinguish GAS pharyngitis from viral pharyngitis; therefore, diagnostic testing is recommended when GAS infection is suspected (Infectious Diseases Society of America [IDSA], 2025). Past Medical History (PMH): Remote history of infectious mononucleosis at age 15. No recent recurrent throat infections. Medications: Acetaminophen as needed for pain and fever. Drospirenone/ethinyl estradiol (combined oral contraceptive) 3mg/0.02mg tab 1 tab QD — patient reports current use. Allergies: No known drug allergies (NKDA). Family History: Non-contributory. Social History: Lives with roommate/college student. Denies tobacco use. Reports occasional alcohol use. Review of Systems (ROS) General: Well-developed, non-distressed female. Positive for fever
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