SOLVED1384

Chief Complaint: Ms. Bowen is an 18 year old student who presents to her PCP with a sore throat, headache, fever and fatigue. ROS-She has felt unwell for 5 days and is concerned that her symptoms have not improved. On further questioning, she has not had a cough and has had no nasal drainage. A couple of her friends at school are suffering the same symptoms. She has otherwise been fit and well. She has recently started on a birth control pill and has no known allergies. She does not smoke and drinks a glass of wine a week. She has no recent travel. Objective exam: She is febrile to 102 degrees F, Throat is red, nasal passages are clear, tonsils that are slightly enlarged. Positive palpable lumps in her neck (5) which are firm, tender, subcutaneous and in the posterior triangle. The lumps are relatively mobile and are not warm or pulsatile. She has splenomegaly on abdominal exam. Work the case up using the VINDICATE mnemonic and present in SBAR format your diagnosis, differentials, testing and plan for treatment.
SCIENCE
HEALTH SCIENCE
NURSING

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