Section E　Spoken English

Role play

Directions：A patient got headache，on and off for about 2 weeks，and he went to clinic for help.2 students work in pairs to demonstrate the conversation，one plays the role of doctor，the other of patient.

Discussion

Directions：Work in groups and discuss with your partners，then answer the following questions with detailed analysis.

A 13-year-old male presents to the Emergency Department with a chief complaint of sore throat and fever for the past 2 days.He reports that his younger sister has been ill for the past week with “the same thing”.The patient has no other medical problems，takes on medications，and has no allergies.He denies any recent history of cough，rash，nausea，vomiting，or diarrhea.He denies any recent travel and has completed the full series of childhood immunizations.

On examination，the patient has a temperature of 38.5℃，a heart rate of 104 beats per minute，blood pressure 118/64 mmHg，a respiratory rate of 18 breaths per minute，and an oxygen saturation of 99% on room air.Oto-Rhino-Laryngogical （head，ears，eyes，nose，throat） exam reveals erythema of the posterior oropharynx with tonsillar exudates，but no uvular deviation or significant tonsillar swelling.Neck exam reveals mild tenderness of anterior lymph nodes.His neck is supple.The chest and cardiovascular exams are unremarkable，and his abdomen is non-tender with normal bowel sounds and no hepatosplenomegaly.His skin is without rash.

1.What is the most likely diagnosis？

2.What is your next step？

3.What are potential complications？