Peer Responses: Length: A minimum of 275 words per post, not including reference

Peer Responses:
Length: A minimum of 275 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
Based on the details of the case scenario (5-year-old child with cough and wheezing for 2 days, which typically occurs when she is sick, along with an earache in the right ear, and dry scaly patches on the elbow and behind the knee), the differential diagnoses for coughing and wheezing, could be related to asthma, allergic rhinitis, or a viral infection such as RSV (Al-Shamrani, Bagais, Alenazi, Algwaiee & Al-Harbi, 2019). The differential diagnoses for the symptom of ear pain include acute otitis media, otitis externa, or Eustachian tube dysfunction (Coulter & Kwon, 2022). Finally, the differential diagnoses for dry, scaley skin ( multiple causes which an include endogenous, external, systemic, psychiatric, dietary, medication adverse reaction includes atopic dermatitis (eczema), environmental, or fungal (Gade, Matin & Rubenstein, 2022). Based on the symptoms and pediatric susceptibility to certain illnesses the final diagnoses for these symptoms would be asthma, acute otitis media, and atopic dermatitis (eczema). Before concluding the final diagnoses, a thorough history and physical examination would be conducted for the final determination.
Asthma is a chronic respiratory disease, marked by symptoms of coughing, shortness of breath, wheezing, bronchospasm, and chest tightness (Burns, Dunn, Brady, Starr, Blosser & Garzon, 2017). For asthma, the assessment would reveal the severity of the disease and symptoms which would influence the treatment which is based on a classification system based on steps (step 1-intermittent, step 2- mild persistent, step 3- moderate persistent, and step 4- severe persistent) (Burns, et al., 2017). Depending on the severity and pulmonary functioning testing, the prescribed treatment would include a short-acting beta agonist inhaler as a rescue inhaler like albuterol for the mildest step to an inhaled corticosteroid (ICS) and long acting beta agonist (LABA) for the most sever cases for daily maintenance and exacerbations (Lizzo & Cortes, 2022).
For the treatment of acute otitis media is confirmed by the presence of recent abrupt onset of inflammatory symptoms, confirmed by a bulging TM, and erythema, or tugging, holding, or rubbing ear due to pain (Burns, et al., 2017). Treatment would most likely include an antibiotic such as amoxicillin, provided there is no penicillin allergy, along with ibuprofen or acetaminophen for management of pain and/or fever (Burns, et al., 2017). Chronic ear infections would be referred to an ENT specialist.
For atopic dermatitis, treatment would be based on the following factors: dry-itch scratch cycle must be disturbed; followed by treatment of dry skin with the first line therapy of a lubricator to moisturize the skin; if moisturization fails, topical steroids must be used to manage exacerbations topical corticosteroids (TCP’s) are first line treatment to reduce inflammation and pruritus depending on the severity of the dermatitis (seven classes of steroids) or topical calcineurin inhibitors (TCI’s) such as Tacrolimus cream; using non-soap surfactants or synthetic detergents; eliminating triggers (irritants or allergies); and treatment of associated bacterial or viral infections (Burns, et al., 2017). In addition, antihistamines like diphenhydramine can be used to control symptoms at night with a sedating affect to prevent itching (Burns, et al., 2017).
References
Al-Shamrani,A., Bagais, K., Alenzai, A., Algwaiee, M. & Al-Harbi, A. (2019, Jun). Wheezing in children: Approaches to diagnosis and management. International
Journal of Pediatric Adolescent Medicine. 6(2), 68-73. https://doi: 10.1016/j.ijpam.2019.02.003
Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C. & Garzon, D. (2017). Pediatric Primary Care (6th ed.). Elsevier.
Coulter, J. & Kwon, E. (2022, Aug 1). Otalgia. In: StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549830/#:~:text=Differential%
20Diagnosis,-Primary%20Otalgia&text=Bullous%20otitis%20externa%20or%20myringitis,Malignant%20otitis%20externa
Gade, A., Matin, T. & Rubenstein, R. (2022, Nov 15). Xeroderma. In: StatPearls. [Internet]. StatPearls Publishing. Retrieved from www.ncbi.nlm.nih.gov/books/NBK565884/
Nemeth, B. & Evans, J. (2022, Aug 8). Eczema. In: StatPearls. [Internet]. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538209/