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Asked by Rizzo1969

 

Please for the below Scenario provide

Symptoms

6 Possible differential Diagnosis’

What labs, and tests need to be ordered to prove differentials

treatment plan

nursing education 

 

Infectious Disease DDA

 

Grace is a 32 year old single Chinese Female who presents with a non-tender lump under her left arm.  She noted it 2 weeks ago during SBE.  She also reports fatigue, scratchy throat, low grade fever and occasional night sweats. She has been off of her BCP for 1 year. Her last GYN exam was 2 years ago. She was sexually active until 4 weeks ago, when she did have unprotected vaginal intercourse.

 

Grace is an international computer analyst.  She usually travels to Singapore.  Her latest trip was 4 weeks ago; she works 14 hours a day.

 

No allergies; no medications; no chronic health problems.  No surgeries.  One glass of wine per day; 10-12 cups of coffee per day.

 

ROS:

 

OB/GYN:     menses @ age 13; g0 p0 a0; has never had a mammogram

                    hx of genital herpes in 1998 with outbreaks 1-2 times/year;

                    no Acyclovir needed in the past 6 months; she currently denies

                    dysuria, frequency, vaginal d/c or painful intercourse

 

PE:

VS:               98.4-68-18    110/60         5’6″    130#

General:      Pleasant female; NAD

HEENT:         normocephalic; PERRLA; no evidence of retinopathy; throat clear;

                    tm’s unremarkable

Neck:           bilateral posterior [multiple] palpable cervical lymph nodes; 1-2 cm. 

                    in size; no thyromegaly 

Lungs:          CTA a/p

Heart:          RRR; no clubbing, cyanosis or edema; no m/g/r

Breast:         left axillary node 3 cm.; nontender; mobile no other

 lymphadenopathy; no breast mass, no discharge no nipple

inversion

Abdomen:  spleen 2 cm. below left costal margin; no hepatomegaly;

                    BS X 4 quadrants; bilateral inguinal lymph nodes, enlarged 

                    2 cm.

          

 

SCIENCE
HEALTH SCIENCE
NURSING
NURS 5461

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