1. Allergic Conjunctivitis – Often presents with stringy, white mucus, itching, and bilateral involvement but can start in one eye. Common triggers include pollen, pet dander, and dust.
2. Viral Conjunctivitis – Typically associated with watery discharge, redness, and possible recent upper respiratory infection. Highly contagious.
3. Bacterial Conjunctivitis: It usually has thick, purulent discharge (yellow/green) with eyelid matting in the morning. It is often unilateral but can spread.
4. Dry Eye Syndrome (Keratoconjunctivitis Sicca) – Can cause stringy mucus discharge, irritation, and foreign body sensation, worsened by environmental factors (wind, screens, etc.).
5. Dacryocystitis – Infection of the lacrimal sac, causing excessive tearing, discharge, and possible swelling near the inner corner of the eye.
6. Blepharitis – Chronic eyelid inflammation that can cause stringy discharge, crusting of the eyelashes, and irritation. Often associated with meibomian gland dysfunction.
7. Contact Lens-Related Conjunctivitis – If the patient wears contact lenses, irritation and mucus discharge can result from improper lens hygiene or allergic reactions to lens solution. NURS-6512 Week 3: Assignment 1 Differential Diagnosis Exercise quiz

Working Diagnosis: Allergic Conjunctivitis

Rationale:

• Primary Symptoms: The patient describes a white, stringy discharge that is present all day, aligning with allergic conjunctivitis rather than bacterial or viral causes.
• No Pain or Vision Issues: The patient denies eye pain, foreign body sensation, or vision disturbances, making keratitis, foreign objects, scratched cornea, and glaucoma less likely.
• No Thick or Purulent Drainage: Bacterial conjunctivitis typically has a thick yellow/green discharge with eyelid crusting in the morning, which the patient does not describe.
• No Watery or Mucous Discharge: Viral conjunctivitis typically presents with watery, mucous-like discharge and is often associated with an upper respiratory infection, which was not reported.
• Chronic and Consistent Discharge: The persistent white, stringy drainage all day aligns most closely with allergic conjunctivitis, which is characterized by consistent clear-to-white mucus production without significant worsening overnight.

Differential Diagnosis for Chronic Nighttime Cough

1. Gastroesophageal Reflux Disease (GERD)—A dry, non-productive cough that worsens at night when lying down is a classic symptom of GERD, which is caused by acid irritating the upper airway. Improvement with drinking water may also suggest this diagnosis.

2. Postnasal Drip (Upper Airway Cough Syndrome – UACS) – Even though the patient denies congestion or nasal stuffiness, silent postnasal drip can cause irritation and a dry nighttime cough.

3. Asthma (Cough-Variant Asthma) – Nighttime cough is a common symptom of cough-variant asthma, even without wheezing or shortness of breath.

4. ACE Inhibitor-Induced Cough—If the patient is taking an ACE inhibitor (e.g., lisinopril, enalapril), it could cause a persistent dry cough, typically worsening at night.

5. Allergic Rhinitis – Environmental allergens (e.g., dust mites, pet dander) may irritate, leading to nighttime coughing. The absence of nasal congestion does not rule this out.

6. Heart Failure (Mild or Early Stage) – A dry cough that worsens at night when lying flat can indicate fluid buildup in the lungs, though the patient denies other symptoms like shortness of breath or swelling.

7. Habit Cough (Psychogenic Cough) – A persistent dry cough with no apparent cause, often worsened by specific situations (e.g., lying down), may be psychogenic. NURS-6512 Week 3: Assignment 1 Differential Diagnosis Exercise quiz

I choose GERD has well

Differential Diagnoses for Right Upper Quadrant (RUQ) Abdominal Pain

1. Cholelithiasis (Gallstones) – Intermittent, postprandial RUQ pain, worsened by fatty foods, radiates to the shoulder/back, nausea, and clay-colored stools suggest biliary involvement.

2. Cholecystitis (Inflamed Gallbladder) – Persistent RUQ pain after eating, nausea, and potential radiation to the back/shoulder. Typically associated with fever, which this patient does not have, but still a consideration.

3. Biliary Colic – Severe, crampy RUQ pain after meals, particularly after fatty foods, with nausea and shoulder radiation; transient and resolves after a few hours.

4. Choledocholithiasis (Common Bile Duct Stones)—Gallstones lodged in the common bile duct can cause RUQ pain, nausea, and clay-colored stools (due to bile duct obstruction), but they usually present with jaundice, which is not reported.

5. Peptic Ulcer Disease (PUD) – Epigastric pain, sometimes radiating to the back, nausea, worsened or improved by food, and may not respond well to antacids or PPIs (as seen in this case). Less likely, given the RUQ localization.

6. Hepatitis or Liver Disease – RUQ discomfort, nausea, and clay-colored stools could suggest liver dysfunction, though the sharp, crampy nature of pain is less typical.

7. Pancreatitis – Severe epigastric or RUQ pain radiating to the back, nausea, and worsening with fatty meals could indicate gallstone-induced pancreatitis. However, lack of vomiting or fever makes this less likely.