Given these changes from the original case, what is your diagnosis?
What is your diagnostic explanation?
As compared to the long case, this patient is a 12-year-old girl who presents to the ER with severe dyspnea of acute onset. Her parents state that they were having dinner at a local fast food store when their daughter began coughing and gagging. They state that she was perfectly well before this episode occurred and she has never had anything like this previously.
Vital signs: Temp 37 C. P 120, regular, R 32, but difficult to measure because patient is coughing and gagging. BP 125/82.
General: Appears in acute distress. Continuously coughing and gagging. Points to her throat when asked about her problem, but cannot speak because of the coughing and gagging.
Lungs: Breathing is rapid and interrupted by coughing. Mild wheezing can be heard over anterior trachea.
All other PE maneuvers are normal.