Differential Diagnosis
- Single most likely diagnosis
- Asthma: This is the most likely diagnosis given the patient's symptoms of wheezing when pushing air out of the chest and a dry cough. Asthma is a common condition that can start at any age and is characterized by inflammation and constriction of the airways.
- Other Likely diagnoses
- Allergic rhinitis: The patient's symptoms of a nose that shifts between being dry and needing to be blown could be indicative of allergic rhinitis, which is a common condition that can cause nasal congestion, runny nose, and coughing.
- Vocal cord dysfunction: This condition can cause wheezing and coughing, especially when speaking or singing, and may be considered as a possible diagnosis given the patient's symptoms.
- Gastroesophageal reflux disease (GERD): GERD can cause coughing and wheezing, especially at night or when lying down, and may be considered as a possible diagnosis given the patient's symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pneumonia: Although the patient does not produce mucus, pneumonia can still be a possibility, especially if the patient has a high fever or other systemic symptoms.
- Pulmonary embolism: This is a life-threatening condition that can cause sudden onset of wheezing, coughing, and shortness of breath, and should be considered as a possible diagnosis, especially if the patient has a history of deep vein thrombosis or other risk factors.
- Cardiac conditions (e.g. heart failure): Cardiac conditions can cause wheezing and coughing, especially if the patient has a history of heart disease or other risk factors.
- Rare diagnoses
- Cystic fibrosis: Although the patient is 24 years old, cystic fibrosis can still be a possibility, especially if the patient has a family history of the condition or other symptoms such as recurrent infections or malabsorption.
- Bronchiectasis: This is a rare condition that can cause chronic coughing and wheezing, and may be considered as a possible diagnosis if the patient has a history of recurrent infections or other symptoms.
- Alpha-1 antitrypsin deficiency: This is a rare genetic condition that can cause chronic obstructive pulmonary disease (COPD) and may be considered as a possible diagnosis if the patient has a family history of the condition or other symptoms.