Differential Diagnosis and Management

Differential Diagnosis and Management

(Differential Diagnosis and Management)

No Plegarism please,  will be checked with Turnitin. 

Will need minimum of 300 words, APA Style, double spaced, times new romans, font 12, and and (3 references with intext citations )

“Ear Pain in Scuba Diver: Differential Diagnosis and Management”

Discussion:

When evaluating a patient presenting with ear pain after scuba diving, it is crucial to inquire about associated symptoms to understand the full clinical picture. Some associated symptoms to ask about include:

• Any history of ear infections or previous ear trauma
• Presence of fever, nasal congestion, or sore throat indicating a possible upper respiratory tract infection
• Any history of hearing loss or tinnitus
• Any recent changes in altitude or air pressure exposure other than scuba diving

The time course of the symptoms is important in distinguishing among different causes of ear pain. Acute onset of ear pain after scuba diving suggests barotrauma or middle ear squeeze, while a gradual onset may indicate otitis media or external otitis.

The age of the patient is also a significant factor. Young adults like the 21-year-old woman in this case are more likely to engage in activities like scuba diving, which increases the likelihood of barotrauma.

To aid in diagnosis, several diagnostic tests may be useful:

• Otoscopy to examine the external ear canal and tympanic membrane for signs of infection or injury
• Audiometry to assess hearing loss or changes in hearing threshold
• Tympanometry to evaluate middle ear function and pressure
• CT or MRI imaging may be necessary if complications such as mastoiditis or inner ear involvement are suspected

Based on the patient’s presentation, a differential diagnosis flowsheet could include:

1. Barotrauma: Diagnosis supported by acute onset of symptoms after scuba diving, tympanic membrane perforation on otoscopy, and normal audiometry. Management involves analgesia and avoidance of further pressure changes.
2. Otitis Media: Considered if there is evidence of middle ear inflammation on otoscopy, such as erythema or effusion. Treatment may include antibiotics and pain management.
3. External Otitis: Suspected if there are signs of inflammation or discharge in the external ear canal. Management involves topical antibiotic and corticosteroid drops.
4. Inner Ear Barotrauma: If symptoms persist despite conservative management, inner ear involvement should be considered, requiring referral to an otolaryngologist for further evaluation and management.

In conclusion, thorough history-taking, consideration of associated symptoms, and understanding of the patient’s age and activity history are essential in diagnosing and managing ear pain after scuba diving. Incorporating appropriate diagnostic tests and differential diagnosis flowsheets can aid in accurate diagnosis and effective treatment planning.

No Plegarism please,  will be checked with Turnitin. 

Case and Discussion

A 21-year-old women comes to your office with a 2 day history of right ear pain. She reports that the ear pain began shortly after taking scuba diving lessons. She describes the pain as “a pressure” and also notes “crackling” in the right ear and periodically feeling dizzy.

Please answer questions below in discussion board response.

• What other associated symptoms should you ask about?
• How does the time course help to distinguish among different causes of ear pain?
• How does the age of the patient help with narrowing the diagnostic possibilities?
• What diagnostic tests do you want to include to help you with your diagnosis?
• Create a differential diagnosis flowsheet for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials.