Differential Diagnosis for 37yo Female with Sore Throat, Tachypnea, and Hypertension

• Single Most Likely Diagnosis
  • Hypertensive crisis: The patient's significantly elevated blood pressure (BP 188/102) without mention of fever or chest pain suggests a hypertensive emergency. The sore throat could be incidental or related to stress or anxiety, which can also contribute to elevated blood pressure. Tachypnea might be a response to the stress of the hypertensive crisis.
• Other Likely Diagnoses
  • Anxiety or panic attack: The combination of tachypnea, sore throat (possibly from hyperventilation), and hypertension could be indicative of an anxiety or panic attack. These conditions can cause significant physiological symptoms, including rapid breathing and elevated blood pressure.
  • Pharyngitis: Although the primary complaint is sore throat, which could suggest pharyngitis, the absence of fever makes this less likely. However, it remains a possibility, especially if the sore throat is the primary concern and the hypertension and tachypnea are secondary or unrelated.
• Do Not Miss Diagnoses
  • Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, tachypnea, and other symptoms due to excessive catecholamine release. Although rare, missing this diagnosis could be catastrophic.
  • Thyrotoxic crisis: Although not directly suggested by the symptoms provided, a thyrotoxic crisis can cause tachypnea, hypertension, and potentially sore throat due to increased sympathetic activity. It's a life-threatening condition that requires immediate attention.
  • Airway obstruction: Conditions such as epiglottitis or foreign body obstruction could cause sore throat and tachypnea. The absence of fever and chest pain does not rule out these potentially life-threatening conditions.
• Rare Diagnoses
  • Carotid body tumor: A rare tumor that can cause hypertension due to its effect on the carotid body's baroreceptors. It might also cause local symptoms such as sore throat due to its location.
  • Hyperthyroidism: While not as immediately life-threatening as some other conditions, untreated hyperthyroidism can lead to significant morbidity. It could potentially cause tachypnea and hypertension, though the sore throat would be less directly related.