A 10-year-old boy is brought by his mother to the PMHNP for evaluation of a sudden onset of obsessions, compulsions, and tics. During the history and exam, the PMHNP learns that the child recently had strep throat. What is the most likely diagnosis?

Choice A reason: Tourette’s syndrome is characterized by chronic motor and vocal tics beginning before age 18, but sudden onset following infection is atypical. Choice B reason: PANDAS is marked by a sudden onset of OCD-like symptoms and/or tics following a streptococcal infection, which matches this patient’s history and symptom presentation. Choice C reason: While OCD could be considered, the sudden onset after strep infection is more indicative of PANDAS rather than primary OCD. Choice D reason: Neurodevelopmental disorders are chronic and present earlier in development, not as sudden post-infectious changes, making this diagnosis less likely.