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Congestion

  • Common ddx

    • seasonal allergies, allergies, sinusitis, URTI, common cold, allergic rhinitis, nasal polyp
  • Serious ddx

    • flu, RSV, nasopharyngeal cancer
  • Labs

    • CBC
    • ESR, ANCA if suspect vasculitis
    • patch testing if suspect allergies
    • consider sinus aspiration if chronic sinusitis
    • biopsy if suspect malignancy
  • Other

    • Vasculitis, snorting
  • HPI

    • onset: acute vs chronic, new vs old
    • seasonality
    • severity
    • alleviation
    • aggravation, triggering factors
  • ROS

    • fever
    • skin: rash, urticaria, pruritus
    • head: sinus pressure
    • eyes: eye itch, lacrimation,
    • ENT: nose itch, runny nose, congestion, sneezing, sore throat, oral/facial edema
    • cardio: chest pain
    • pulm: dyspnea, cough, sputum
    • GI: diarrhea, nausea, vomiting
  • PMH

    • allergies to food, drugs
    • asthma
  • FH

  • SH

    • pets at home
    • carpets
    • exposure to allergens
  • Meds

    • new meds
    • antibiotics
    • lotions
  • Allergies

  • Px

    • vitals: fever, BP
    • general and respiratory distress
    • skin: rash, urticaria
    • head: sinus tenderness, facial edema
    • eyes: conjunctivitis
    • ENT: mucosal membranes, edema, rhinitis, oral edema
    • cardio
    • pulm: stridor, wheezing

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.