A 26-year-old female who gave birth 1 month ago presents with ...

[cdr_15]

A 26-year-old female who gave birth 1 month ago presents with sudden development of fever, neck pain, sore throat with dysphagia, and radiation of pain to the ear. Which of the following conditions is most important to consider?
 
  A. Diptheria
  B. Epiglottitis
  C. Thyroiditis
  D. Otitis media

Question 2

Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of:
 
  A. Thrush
  B. Laryngeal cancer
  C. Carotidynia
  D. Thyroiditis

[aruss1303]

Answer to Question 1

ANS: C
Painful subacute thyroiditis involves inflammation of the thyroid gland. A variant, postpartum thyroiditis occurs within 6 months of giving birth and is generally painless. Although the etiology of painful subacute thyroiditis is not clear, it may have a viral trigger. Patients commonly complain of pain in the throat and/or neck, with radiation to an ear. Onset is described as relatively sudden, and associated symptoms include fever, malaise, and achiness. The throat pain may be associated with dysphagia.

Answer to Question 2

ANS: B
Hoarseness may result from squamous cell cancer of the larynx as well as from malignancies within the pulmonary tree, neck, and throat. The risk of malignancy as a cause for hoarseness is greatest in patients with a history of cigarette smoking and/or alcohol abuse. The history usually reveals a progressive onset of hoarseness that has persisted for weeks. The physical examination specific to a complaint of hoarseness should include the ears, nose, throat, neck, lungs, and CNs (particularly CN IX and CN X). When hoarseness is persistent or laryngeal structural disorders are considered, laryngoscopy should be performed to view any redness, edema, motion, and masses or polyps.