A 16-Year-Old Boy Comes to the Emergency Department Due to Sore

question 163

Multiple Choice

A 16-year-old boy comes to the emergency department due to sore throat and fever.  He started having a mild sore throat after returning from summer camp about a week ago, and it has worsened in the last 2 days.  The patient also has right neck pain and earache but no cough or shortness of breath.  He does not use tobacco or illicit drugs and is not sexually active.  Temperature is 38.8 C (102 F) , blood pressure is 118/74 mm Hg, and pulse is 104/min.  Enlarged and tender cervical lymph nodes are present.  The patient is not able to fully open his mouth, but examination of the oral cavity shows pooling of saliva, a large right tonsil with swelling of the right soft palate, and deviation of the uvula to the left.  Ear examination shows normal tympanic membranes.  A rapid test for Streptococcus pyogenes is negative.  Which of the following is the most likely diagnosis?

• A)Acute epiglottitis
• B)Acute tonsillitis
• C)Adenoidal hypertrophy
• D)Herpangina
• E)Infectious mononucleosis
• F)Peritonsillar abscess

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Definitions:

Visual Perception

The capability to understand the immediate surroundings through the analysis of information found in visible light.

Sensory Impressions

Perceptions or feelings resulting from the stimulation of the senses, including sight, sound, smell, touch, and taste.

Middle Ear

The portion of the ear internal to the eardrum, and external to the oval window of the cochlea, containing the three auditory ossicles.

Basilar Membrane

A membrane that lies coiled within the cochlea.