Your patient complains of hoarseness yet denies smoking, alcohol use, and recent upper respiratory infection. Which question is appropriate to examine the aggravating factors?
a. "Does drinking fluids or warm drinks help alleviate the hoarseness?"
b. "Do you have any pain in your neck or throat?"
c. "Have you been singing, yelling, or talking excessively recently?"
d. "Is your hoarseness continuous, or does it come and go?"
C
Aggravating factors related to hoarseness include inhalation of chemicals or noxious fumes, smoking, overuse of voice, alcohol use, recent upper respiratory infections, recent head and neck surgery, intubation, and neck trauma; therefore, the appropriate question to ask is option "c." Manifestations associated with hoarseness include fever, sore throat, malaise, reflux, and vocal cord mass. Option "b" examines for associated manifestations. Option "a" is appropriate to examine for alleviating factors. The question in option "d" is related to the timing of the hoarseness.
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