APA format for SOAP NOTE 3 peer review articles 1 and half pages long please follow below instructions  Analyze the possible conditions from your colleagues' differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition and justify your reasoning  case Study #3   Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked  S Cc: “Earache right ear” HPI: Patient is an 11-year-old Caucasian boy who was brought in by his grandmother after complaining about having a mild earache for the past two days.  Patient states that the pain is worse when he falls asleep and that it has become harder for him to hear, grandmother believes that he feels warm but has not taken his temperature Medications: Patient does not take any medications PMH: No significant illnesses, shots are up to date FH: No history of previous ear concerns no family history of ear disease. During the school year, patient lives at home with his mother, father and he does not have pets. Patient is staying with grandmother and grandfather most of summer SH: Student in public school and is currently on summer break, has been spending a lot of time this summer in the pool per his grandmother that he is spending the summer with. ROS: general: negative for chills fever currently EENT: complains of mild right ear pain and mild hearing loss, denies tinnitus, denies pain in throat, or eye pain O VS: T 100.8, P 94, R 18, BP 98/64 General: Patient appears to be in mild pain, holding head to right side slightly HEENT: right tympanic membrane obscured, ear canal is read and has a musty odor from ear canal with small amount of watery drainage, head is normocephalic without signs of trauma, no nasal drainage, PEARL, no complaints of sore throat, no redness in throat SKIN: Warm and dry, good skin turgor, prominent tan NECK: No lymph node edema or signs of pain on palpation NEUROLOGICAL: No complaints of headache or dizziness Diagnostic results. WBC slightly elevated, low grade temp A Differential Diagnoses: 1) Acute Otitis Externa 2) Acute Otitis Media 3) Pharyngitis Primary diagnoses/presumptive diagnoses: Acute otitis media P – not indicated per template Assessing for a possible ear infection would require additional information from the patient in addition to a physical assessment of the ear and the patient.  Obtaining background information including recent travel, activities, family history, trauma, history of previous illnesses and treatments that have been used for treatment that were successful or not successful. Diagnostic studies used to diagnose the specific pathogen would include obtaining a culture of purulent drainage, simple otoscopy was mostly used for diagnosing AOM (D’silva, 2013) or a more invasive way of evaluating white blood cell elevation is by completing a CBC which is not used as often as visual inspection of the ear canal. White blood cell count (WBC), a cl ...

1. APA format for SOAP NOTE 3 peer review articles 1 and half
pages long please follow below instructions
Analyze the possible conditions from your colleagues'
differential diagnoses. Determine which of the conditions you
would reject and why. Identify the most likely condition and
justify your reasoning
case Study #3 Martha brings her 11-year old grandson, James,
to your clinic to have his right ear checked
S
Cc: “Earache right ear”
HPI: Patient is an 11-year-old Caucasian boy who was brought
in by his grandmother after complaining about having a mild
earache for the past two days. Patient states that the pain is
worse when he falls asleep and that it has become harder for
him to hear, grandmother believes that he feels warm but has
not taken his temperature
Medications: Patient does not take any medications
PMH: No significant illnesses, shots are up to date
FH: No history of previous ear concerns no family history of ear
disease. During the school year, patient lives at home with his
mother, father and he does not have pets. Patient is staying with
grandmother and grandfather most of summer
SH: Student in public school and is currently on summer break,

2. has been spending a lot of time this summer in the pool per his
grandmother that he is spending the summer with.
ROS: general: negative for chills fever currently
EENT: complains of mild right ear pain and mild hearing loss,
denies tinnitus, denies pain in throat, or eye pain
O
VS: T 100.8, P 94, R 18, BP 98/64
General: Patient appears to be in mild pain, holding head to
right side slightly
HEENT: right tympanic membrane obscured, ear canal is read
and has a musty odor from ear canal with small amount of
watery drainage, head is normocephalic without signs of trauma,
no nasal drainage, PEARL, no complaints of sore throat, no
redness in throat
SKIN: Warm and dry, good skin turgor, prominent tan
NECK: No lymph node edema or signs of pain on palpation
NEUROLOGICAL: No complaints of headache or dizziness
Diagnostic results. WBC slightly elevated, low grade temp
A
Differential Diagnoses:
1) Acute Otitis Externa
2) Acute Otitis Media

3. 3) Pharyngitis
Primary diagnoses/presumptive diagnoses: Acute otitis media
P – not indicated per template
Assessing for a possible ear infection would require additional
information from the patient in addition to a physical
assessment of the ear and the patient. Obtaining background
information including recent travel, activities, family history,
trauma, history of previous illnesses and treatments that have
been used for treatment that were successful or not successful.
Diagnostic studies used to diagnose the specific pathogen would
include obtaining a culture of purulent drainage, simple
otoscopy was mostly used for diagnosing AOM (D’silva, 2013)
or a more invasive way of evaluating white blood cell elevation
is by completing a CBC which is not used as often as visual
inspection of the ear canal. White blood cell count (WBC), a
classical inflammation marker, is also used in many scoring
systems during routine daily clinical practice (Kutlucan et al.,
n.d.). Using data from a CBC can also provide information
about the patient’s overall health.
Otitis externa
Acute otitis externa is the most common infection of the
external auditory canal (Demirel et al., 2018). Ball describes
(2015) symptoms of otitis externa as having watery to purulent
and thick drainage mixed with pus with a musty odor and
usually occurs after swimming.
Acute otitis media
Acute otitis media is one of the most frequent bacterial

4. infections in children, and one of the primary reasons for the
prescription of antibiotics by pediatricians (Intakorn, n.d.).
Otitis media can have an abrupt onset with fever, feeling of a
blockage, and interferes with sleep. The middle ear fills with
pus causing conductive hearing loss (Ball).
Acute pharyngitis:
Acute respiratory infections are one of the most common
diseases, accounting for one of the main causes of patient visits
to community health centers and hospitals (Yuniar, 2017). Ball
(2015) describes a patient with acute pharyngitis as having a
sore throat with deferred pain in ears and dysphagia with fever,
malaise, fetid breath, abdominal pain and headache.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., Stewart,
R. W. (2015). Seidel's guide to
physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Demirel, H., Arlı, C., Özgür, T., İnci, M., & Dokuyucu, R.
(2018). The Role of Topical
Thymoquinone in the Treatment of Acute Otitis Externa; an
Experimental Study in
Rats. Journal of International Advanced Otology, 14(2), 285–
289.
https://doi-
org.ezp.waldenulibrary.org/10.5152/iao.2017.4213
D’silva, L., Parikh, R., Nanivadekar, A., & Joglekar, S. (2013).
A Questionnaire-Based Survey

5. of Indian ENT Surgeons to Estimate Clinic Prevalence of Acute
Otitis Media, Diagnostic
Practices, and Management Strategies. Indian Journal of
Otolaryngology & Head & Neck
Surgery, 65, 575–581.
https://doi-org.ezp.waldenulibrary.org/10.1007/s12070-012-
0545-
2
Intakorn, P., Sonsuwan, N., Noknu, S., Moungthong, G., Pircon,
J.-Y., Liu, Y., … Hausdorff, W.
P. (n.d.). Haemophilus influenzae type b as an important cause
of culture-positive acute
otitis media in young children in Thailand: a tympanocentesis-
based, multi-center, cross-
sectional study. BMC PEDIATRICS, 14.
https://doi-org.ezp.waldenulibrary.org
/10.1186/1471-2431-2431-14-157
Kutlucan, L., Kutlucan, A., Basaran, B., Dagli, M., Basturk, A.,
Kozanhan, B., … Kos, M. (n.d.).
The predictive effect of initial complete blood count of
intensive care unit patients on
mortality, length of hospitalization, and nosocomial
infections. EUROPEAN REVIEW
FOR MEDICAL AND PHARMACOLOGICAL

6. SCIENCES, 20(8), 1467–1473.
Retrieved from
https://ezp.waldenulibrary.org/login?url=https://search.ebscohos
t.com/login.aspx?direct=t
rue&db=edswsc&AN=000380260000006&site=eds-
live&scope=site
Yuniar, C. T., Anggadiredja, K., & Islamiyah, A. N. (2017).
Evaluation of Rational Drug Use for
Acute Pharyngitis Associated with the Incidence and Prevalence
of the Disease at Two
Community Health Centers in Indonesia. Scientia
Pharmaceutica, 85(2), 1–10.
https://doi-
org.ezp.waldenulibrary.org/10.3390/scipharm85020022