I-HUMAN CASE STUDY EXAM (60-Year-Old with Shortness of
Breath: CHF vs Respiratory Workup) LATEST 2025
Case Overview
A 60-year-old patient presents with progressive shortness of breath. The goal
of this case study exam is to evaluate the learner’s ability to perform a focused
history, physical examination, diagnostic interpretation, clinical judgment,
differential diagnosis, and management planning consistent with i-Human /
NGN-style expectations.
Patient Profile
Age: 60 years
Gender: Male
Chief Complaint: “I feel short of breath, especially when I lie down.”
History of Present Illness:
o SOB for 3 weeks, worsening over last 3 days
o Difficulty breathing when lying flat (needs 2–3 pillows)
o Wakes up at night gasping for air
o Mild chest tightness, no sharp pain
o Productive cough with frothy sputum
Past Medical History:
o Hypertension (15 years)
o Type 2 Diabetes Mellitus
o Hyperlipidemia
Social History:
,I-HUMAN CASE STUDY EXAM (60-Year-Old with Shortness of
Breath: CHF vs Respiratory Workup) LATEST 2025
o Former smoker (30 pack-years, quit 5 years ago)
o Occasional alcohol use
Vital Signs
BP: 158/96 mmHg
HR: 108 bpm
RR: 26 breaths/min
Temp: 36.8°C
SpO₂: 90% on room air
Physical Examination Findings
General: Anxious, labored breathing
Lungs: Bilateral crackles at bases, decreased air entry
Cardiovascular: S3 gallop present, tachycardia
Extremities: Bilateral pitting edema (2+)
Neck: Jugular venous distention present
, I-HUMAN CASE STUDY EXAM (60-Year-Old with Shortness of
Breath: CHF vs Respiratory Workup) LATEST 2025
Question
Which symptom is most suggestive of left-sided heart failure?
A. Wheezing
B. Orthopnea
C. Fever
D. Hemoptysis
Correct Answer: B. Orthopnea
Rationale: Orthopnea occurs due to pulmonary congestion when lying flat, a
classic sign of left-sided CHF.
Question
Which physical finding best supports a diagnosis of congestive heart failure?
A. Clubbing of fingers
B. S3 heart sound
C. Hyperresonance on percussion
D. Dry mucous membranes
Correct Answer: B. S3 heart sound
Rationale: An S3 gallop is strongly associated with ventricular volume overload
seen in CHF.
Breath: CHF vs Respiratory Workup) LATEST 2025
Case Overview
A 60-year-old patient presents with progressive shortness of breath. The goal
of this case study exam is to evaluate the learner’s ability to perform a focused
history, physical examination, diagnostic interpretation, clinical judgment,
differential diagnosis, and management planning consistent with i-Human /
NGN-style expectations.
Patient Profile
Age: 60 years
Gender: Male
Chief Complaint: “I feel short of breath, especially when I lie down.”
History of Present Illness:
o SOB for 3 weeks, worsening over last 3 days
o Difficulty breathing when lying flat (needs 2–3 pillows)
o Wakes up at night gasping for air
o Mild chest tightness, no sharp pain
o Productive cough with frothy sputum
Past Medical History:
o Hypertension (15 years)
o Type 2 Diabetes Mellitus
o Hyperlipidemia
Social History:
,I-HUMAN CASE STUDY EXAM (60-Year-Old with Shortness of
Breath: CHF vs Respiratory Workup) LATEST 2025
o Former smoker (30 pack-years, quit 5 years ago)
o Occasional alcohol use
Vital Signs
BP: 158/96 mmHg
HR: 108 bpm
RR: 26 breaths/min
Temp: 36.8°C
SpO₂: 90% on room air
Physical Examination Findings
General: Anxious, labored breathing
Lungs: Bilateral crackles at bases, decreased air entry
Cardiovascular: S3 gallop present, tachycardia
Extremities: Bilateral pitting edema (2+)
Neck: Jugular venous distention present
, I-HUMAN CASE STUDY EXAM (60-Year-Old with Shortness of
Breath: CHF vs Respiratory Workup) LATEST 2025
Question
Which symptom is most suggestive of left-sided heart failure?
A. Wheezing
B. Orthopnea
C. Fever
D. Hemoptysis
Correct Answer: B. Orthopnea
Rationale: Orthopnea occurs due to pulmonary congestion when lying flat, a
classic sign of left-sided CHF.
Question
Which physical finding best supports a diagnosis of congestive heart failure?
A. Clubbing of fingers
B. S3 heart sound
C. Hyperresonance on percussion
D. Dry mucous membranes
Correct Answer: B. S3 heart sound
Rationale: An S3 gallop is strongly associated with ventricular volume overload
seen in CHF.
