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Real exam 2026/2027 latest update
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This document presents a comprehensive iHuman virtual patient case study for a 4-year-old child, Max King, presenting with a chief complaint of "leaking stool in his underwear." The case includes detailed guidance on history taking using the OLDCARTS mnemonic, documentation of vital signs and physical examination findings, and differential diagnosis formulation. Expert feedback identifies constipation and encopresis as primary diagnoses, with hypothyroidism and gluten-sensitive enteropathy (celiac disease) as additional must-not-miss considerations. The document provides diagnostic test selection (TSH, FT4, abdominal x-ray), interpretation of results, and a comprehensive treatment plan including dietary modifications, stool softeners, bowel retraining, and follow-up recommendations.
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