Hoarseness: Establishing a Differential Diagnosis – Symptoms Example

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"Hoarseness: Establishing a Differential Diagnosis" is an engrossing example of a paper on symptoms. There are various things that affect the voice of a person. One of such is hoarseness. In this case of a 70-year-old patient, the patient presents with various symptoms that are associated with hoarseness. Therefore, analysis of the case will help in coming up with various deductions. The paper will focus on establishing a differential diagnosis, various questions that may be asked to the patient, and a final diagnostic test. The patient has characteristic common for hoarseness.

The patient complains of recurrent laryngitis, enlargement of lymph nodes, and he also has ‘ smoker cough per patient” . All these symptoms are highly linked to hoarseness. As per the conditions presented by the patient, there are three most common factors leading to the condition. The first likely factors leading to the condition is the upper respiratory tract infection (Knott, 2014). The infection is likely to be associated with the continued occurrence of laryngitis in the patient. The other common cause of the condition is the drying of the laryngeal mucosa (Knott, 2014).

This may explain the enlargement of lymph nodes, lack of sinuses, and “ smoker cough” identified in the patient. The third factor that may explain the conditions is the normal ageing of the voice (Knott, 2014). The patient is described as being 70 years of age, and this may explain the loss of voice. There are various things that are likely to help in identifying the causes of the conditions experienced by the patient. The best thing is to formulate additional questions for the patients in order to get a deeper insight into the extent and causes of the condition.

The first question that can be of help to ask is the time in which hoarseness is likely most to be experienced by the patient (Kim & Rasgon, 2010). The patient is likely to note that there is a particular time in which hoarseness is persistent or most likely to occur in a day.   Hence, it may help to explain the cause of the hoarseness in the patient. Also, the frequency of the condition may also help in identifying the extent of harm to the patient.

The other question should be on voice quality (Kim & Rasgon, 2010). Assessment of the quality of voice may help understand the causes of the condition.   Moreover, one may develop a question concerning the medical history of the patient. There are certain medical conditions that have been associated with alteration of voice (Kim & Rasgon, 2010). Hence, the question can help in supporting of diagnosis in the patient. Another question that may be of help is on the surgical history of the patient. The question may help to understand whether the patient has had any surgery in the past as some of the surgery associated with the endotracheal tube is linked with disruption of voice (Kim & Rasgon, 2010).

The last question should delve into the social aspect of the patient. For example, one may seek to understand the task or profession of the patient. Some tasks or professions are linked with voice changes. For example, certain professions such as singing and task that comprise overuse of the voice are linked with hoarseness (Kim & Rasgon, 2010). The final diagnosis of the condition is possible through a test.

However, the test is only done by professionals. Mostly, the final diagnosis is achieved through the use of laryngeal endoscopy and indirect laryngoscopy (Omori, 2011). The two tests have been proven helpful in the diagnosis of a number of laryngeal conditions. They help in identifying minute details that are associated with the condition. Hence, the use of these tests will help in identifying the extent and causes of the condition with a high rate of precision.  


Kim, J & Rasgon, B. (2010 Spring). The Hoarse Patient: Asking the Right Questions. Perm J, 14(1), 51-53. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912706/

Knott, L. (2014). Hoarseness. Article. Retrieved from http://www.patient.co.uk/doctor/hoarseness-pro.

Omori, K. (2011). Diagnosis of Voice Disorders. JMAJ, 54(4), 248-253. Retrieved from https://www.med.or.jp/english/journal/pdf/2011_04/248_253.pdf.

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