Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Friday, January 25, 2008

The Hypochondriac

Beverage alert: swallow before reading.

34-year-old man, confirmed hypochondriac, presents with less than twenty-four hours of sore throat and fever. No cough; no nasal symptoms.

Vital signs:
  • Weight: 151
  • Temp: 99.7
  • Pulse: 84
  • Resp: 12
Exam:

Ears with pearly TMs bilaterally; throat somewhat injected, but without exudates or lesions; nose clear, pink turbinates, no discharge; lungs clear; heart regular without murmurs or gallops.

I go to palpate his neck for enlarged lymph nodes and as I do, I ask, "Does it hurt here?"

His response: "Should it?"

11 Comments:

At Fri Jan 25, 06:52:00 PM, OpenID whitecoatrants said...

Watch - he'll be the one with the retropharyngeal abscess that turns into mediastinitis.

 
At Fri Jan 25, 07:34:00 PM, Blogger Manda said...

I assume he got an antibiotic, amoxicillan for ten days, maybe zithromax? Maybe kickndhiney?

 
At Fri Jan 25, 07:41:00 PM, Blogger #1 Dinosaur said...

He got a strep test -- which was negative -- followed by instructions to drink plenty of fluids, rest, take tylenol as needed, and a huge laugh from me. (I've known him a very long time.)

(And yes, he specifically said I could blog it.)

 
At Sat Jan 26, 03:26:00 AM, Blogger SeaSpray said...

Funny and he is obviously a good sport! :)

 
At Sat Jan 26, 04:13:00 AM, Blogger Elaine said...

glad I toook your advice about not drinking!

 
At Sat Jan 26, 10:39:00 AM, Blogger Femail doc said...

Sounds like he was following the lead of some of our presidential candidates.

 
At Sat Jan 26, 09:41:00 PM, Anonymous TK said...

I am glad that not everyone gets an antibiotic for every rapid strep negative sore throat. BTW, I love your Dinosaur rules.

 
At Sun Jan 27, 02:02:00 AM, Blogger tk said...

lmao!

 
At Sun Jan 27, 11:44:00 PM, Anonymous Ami said...

So I'm curious, he understands he's a hypochondriac. Knowing that, doesn't he ever say "That's just the hypochondria blowing this sore throat out of proportion?"

That was funny, though.

 
At Mon Jan 28, 10:42:00 AM, Anonymous Anonymous said...

I wouldn't bet 100 percent on the rapid strep test.

A few years ago I had what appeared to be strep on the tonsils - painful and covered with white blotches but no swelling, no fever, no other symptoms.

The rapid strep was negative but they cultured it anyway, and two days later they called me to say yes, it was strep.

It happens.

 
At Wed Jan 30, 08:10:00 AM, Anonymous Anonymous said...

What part of the neck were you palpating? I've had "sore throat" patients who turned out to be DeQuervain's thyroiditis.

 

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