It is november and you are working in a small, rural, emergency department serving a community who is currently going through a flu epidemic. your next patient is a 4-year-old boy who was brought in by his mother for a sore throat and fever that started two nights ago. she says he has a mild cough, and is complaining of headaches as well. since last night, he has had a decreased appetite and hasn't been his normal, active self. she also wants you to know that he is allergic to eggs and latex, and uses an inhaler once a month for asthma like symptoms. on physical exam you note an erythematous throat, clear rhinorrhea, and rhonchi on auscultation. a rapid strep test was performed in the office and is negative. his last well child check was 14 months ago, and his mother says she knows he is due for another but her schedule has been too busy. what is the next best step in management? a. flu shotb. amoxicillin therapyc. flumist (influenza vaccine, live intranasal)d. tamiflu (oseltamivir phosphate)e. influenza test.

The patient is a 4 year old boy who was brought in by his mother for a sore throat and fever that started two nights ago. She says he has a mild cough, and is complaining of headaches as well.

The next best step in management is to make an i n f l u e n z a test.

Explanation:

The flu  is a respiratory infection caused by a virus, it is usually transmitted from one person to another when they touch the same surfaces or cough.

The test helps the doctor find out if the patient have it so he/she can get treated effectively, early treatment can reduce flu symptoms.

The most common kind of test results can be ready in half and hour . And in this case  the best solution is to procede with the test first of all, given the fact that the patient is only 4 years old and has risk factors (allergies , uses an inhaler ) .  

It does not require any special preparations and if the result is positive the doctor can give him/her specific medication to prevent complications and in case of negative result the doctor may ask for more tests to make a diagnosis of which is the virus that is causing the symptoms.