A patient presents to the clinic with symptoms of a sore throat, nasal congestion, watery eyes, sneezing, malaise, and a nonproductive cough. The nurse notes that the patient's temperature is normal. Based on this information, which of the following is the most likely diagnosis?
influenza
Strep Throat
Rhinitis
Bacterial pharyngitis
The Correct Answer is C
A. Influenza: Influenza typically presents with a high fever, muscle aches, and fatigue, which are not present in this case.
B. Strep Throat: Strep throat usually presents with a sore throat, high fever, and swollen lymph nodes, not nasal congestion or watery eyes.
C. Rhinitis: Rhinitis, particularly allergic rhinitis, causes symptoms such as sneezing, nasal congestion, watery eyes, and malaise without fever, making it the most likely diagnosis.
D. Bacterial Pharyngitis: Bacterial pharyngitis often presents with a sore throat, fever, and swollen lymph nodes, but typically does not include nasal congestion or watery eyes.
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Correct Answer is D
Explanation
A. Pain in the neck when the patient flexes their head towards the chest. This describes nuchal rigidity, not Kernig sign.
B. Involuntary flexion of the hips and knees when the neck is flexed. This describes Brudzinski sign, not Kernig sign.
C. Photophobia and headache triggered by bright light. These are symptoms of meningitis, but they are not specific to Kernig sign.
D. Pain and resistance when attempting to extend the patient's leg from a flexed position. A positive Kernig sign is when there is pain and resistance to leg extension from a flexed hip and knee position, indicating meningeal irritation.
Correct Answer is B
Explanation
A. Interferon Gamma Release Assays (IGRAs): IGRAs are useful for detecting TB infection but do not confirm active TB disease. They measure the immune response to TB bacteria but don’t differentiate between latent and active infection.
B. Sputum culture: Sputum culture is the gold standard for confirming active TB because it identifies Mycobacterium tuberculosis bacteria directly, confirming active infection.
C. Tuberculin Skin Test (TST): The TST can indicate TB infection but cannot distinguish between latent and active TB, making it unsuitable as a confirmatory test for active disease.
D. Chest X-ray: A chest X-ray can show signs suggestive of TB but cannot confirm the presence of TB bacteria, so it is not definitive for diagnosing active TB.