Before any tests can be prescribed, it is always necessary to have a main diagnosis and a series of differential diagnoses to act as guidance so as to ensure the right tests are being conducted. This helps to save both time and resources which would have been wasted in conducting a lot of unnecessary examinations (Sullivan, 2012). In this case, Richard’s diagnosis will be determined by the already identified symptoms and physical characteristics.
The main diagnosis is an allergic rhinitis, which has been identified basing on his symptoms noted from the physical exam (Dains, Baumann & Scheibel, 2016). To prove this, additional tests must be conducted. First, allergy skin tests are conducted, which feature immediate testing of hypersensitivity. Specific allergens are introduced on the skin while the resulting reaction is taken into account. Second, a test known as fluorescence enzyme immunoassay (FEIA) is also performed. This test directly analyses the quantity of immunoglobulin which is a form of antibody against a specific antigen. Therefore, if the patient is experiencing an allergic reaction, this level of immunoglobulin will be high. These two tests are directly related to the suspected condition. Therefore, they are the most relevant tests which could have been performed to determine whether or not the patient is actually suffering from the suspected condition (LeBlond, Brown & DeGowin, 2014).
The differential diagnosis of this condition include; One, non allergic rhinitis is also suspected as it tends to have similar symptoms. However, from the tests conducted, there would be no elevated levels of immunoglobulin. Two, viral sinusitis is also suspected as it tends to feature similar symptoms as well as sore throat, headaches, and even discolored mucus. Three, Acute sinusitis is also listed as a differential diagnosis since it features nasal congestion and discolored nasal mucus that is also noted in this patient. Four, cold and flu is yet another differential diagnosis owing to the fact that the patient is producing a lot of mucus and is also sneezing. Lastly, chronic sinusitis is also listed as it tends to have severe symptoms that are almost similar to what the patient is experiencing.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby. (chapter 15,21,25,30,32,38)
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical. Chapter 7, “The Head and Neck” (pp. 178–301)
Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis. Chapter 5, “SOAP Notes” (pp. 91–118)