Respond to at least two of your colleagues on 2 different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.
Patient Initials: __TC_____ Age: ___15____ Gender: ___Male____
History of Present Illness (HPI): TC is a 15-year-old African-American male high school student who is in 9th grade. He presents to the clinic today with complaints of dull bilateral knee pain. Pateint states that he’s experencing “a catching sensation under my kneecaps.” The patient states that this has been going on for weeks now. He said that his knees really bother him the most when playing basketball, but they still bother him even when he’s walking. He says the pain comes and goes and he rates the pain level as a 5 on a pain scale of 1-10 after taking 200mg of Ibuprofen. His last dose he stated was taken orally 45 minutes ago. He then stated that the pain without pain medicine is was 10/10 before. The patient states that resting and icing his knees helps to alleviate the pain also.
Ibuprofen 200mg PO Q6-8hrs PRN pain
Multi-vitamin PO Daily
Sulfa drugs – Facial Swelling
No Past Medical Hx
No Past Surgical Hx
Patient is in high school. He enjoys playing basketball, football, and baseball. He lives at home with his parents and younger brother and sister.
His immunizations are up to date.
Significant Family History:
P Grandmother- Diabetes
P Grandfather- HTN
M Grandmother- Diabetes, Heart Disease
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M Grandfather- HTN, Hyperlipidemia
Review of Systems:
General: Denies weakness, no recent weight loss/gain, fever, and fatigue.
HEENT: The patient has no headache and no history of head injury. He denies blurred vision, double vision, and visual loss. no hearing loss. No sneezing, runny nose, and congestion. Patient denies a sore throat.
Respiratory: denies a cough and shortness of breath.
CV: Patient denies chest pain, and chest discomfort. Patient exhibits no palpitations or edema.
GI: Denies change in dietary patterns or bowel habits. He denies abdominal pain, nausea, and vomiting or diarrhea., stomach distress or blood in the stool
GU: Patient denies painful urination, frequency, and urgency
MS: Patient has bilateral knee pain for , Patient denies any other joint, muscle, or back pain. Denies any recent injury.