, Wheezing and Dyspnea in a 15-Year-Old:
Differentiating New-Onset Asthma from
Other Etiologies – Complete SOAP Notes,
History Questions, Physical Exam &
Management Plan
Table of Contents
1. Case Overview & Instructions (Page 1-2)
2. Step 1: The Encounter & Chief Complaint (Page 3)
3. Step 2: The History of Present Illness (HPI) & Statement (Pages 4-7)
o 2.1. HPI Statement (15%)
o 2.2. Key History Questions & Findings (Within 50-Question Limit)
4. Step 3: Complete History (Pages 8-13)
o 3.1. Past Medical History
o 3.2. Family History
o 3.3. Social History
o 3.4. Review of Systems (ROS)
5. Step 4: Physical Exam (Pages 14-17)
o 4.1. Vital Signs & General Appearance
o 4.2. Head, Eyes, Ears, Nose, Throat (HEENT)
o 4.3. Cardiovascular
o 4.4. Respiratory
o 4.5. Abdominal & Extremities
o 4.6. Neurological
6. Step 5: Differential Diagnoses & Diagnostic Testing (Pages 18-22)
o 5.1. Initial Differential Diagnoses (20%)
o 5.2. Appropriate Diagnostic Testing (10%)
o 5.3. Updated Differential with Rankings
7. Step 6: Final Diagnosis & Plan (Pages 23-27)
o 6.1. Final Diagnosis
,o 6.2. Comprehensive Plan (30%)
Immediate Management
Medications
Patient Education
Follow-up
Referrals
8. Step 7: Clinical Exercises (Pages 28-29)
o 7.1. Clinical Exercise 1: Pathophysiology of New-Onset Asthma
o 7.2. Clinical Exercise 2: Differential Diagnosis of Wheezing in Adolescents
9. Step 8: Reflection & Summary (Page 30)
10. References (Page 31)
Page 1: Case Overview & Instructions
I-Human Case: Wheezing and Dyspnea in a 15-Year-Old
Case Title: A 15-Year-Old Male with Wheezing and Dyspnea
Student Instructions:
This case study is designed to simulate a real-world clinical encounter where diagnostic
reasoning is critical. You will assume the role of the healthcare provider evaluating a 15-
year-old patient presenting with wheezing and dyspnea. The focus of this case is on
differentiating new-onset asthma from other potential etiologies including cardiac,
infectious, structural, and psychogenic causes.
Your goal is to navigate the diagnostic reasoning process systematically, moving from
initial encounter to final management while demonstrating clinical reasoning at each
step.
Key Requirements:
History Questions: You are limited to 50 questions. Use them strategically to gather
efficient and relevant data that helps narrow the differential.
Due Date: Please adhere to the due date listed on Canvas. i-Human platform dates are
for administrative purposes only; the Canvas date is final for assignment submission.
, Academic Integrity: By submitting this assignment, you confirm that the work
contained within is your own.
Grading Rubric Breakdown:
Section Percentage of Grade
a) HPI Statement 15%
b) History (including ROS) 10%
c) Physical Exam 10%
d) Diagnostic Testing 10%
e) Differential Diagnoses (selection & ranking) 20%
f) Plan (covering all critical components) 30%
g) Clinical Exercises 5%
Page 2: Case Overview & Instructions (Continued)
The Diagnostic Reasoning Process:
This case emphasizes the importance of differentiating between various etiologies of
wheezing and dyspnea in an adolescent patient. The key to minimizing medical errors is
developing a comprehensive differential diagnosis (clinical "card list") and strategically
selecting tests to either "rule in" or "rule out" these diagnoses.
Learning Objectives:
Upon completion of this case, the student will be able to:
1. Differentiate between common and life-threatening causes of wheezing and dyspnea in
adolescents.
Differentiating New-Onset Asthma from
Other Etiologies – Complete SOAP Notes,
History Questions, Physical Exam &
Management Plan
Table of Contents
1. Case Overview & Instructions (Page 1-2)
2. Step 1: The Encounter & Chief Complaint (Page 3)
3. Step 2: The History of Present Illness (HPI) & Statement (Pages 4-7)
o 2.1. HPI Statement (15%)
o 2.2. Key History Questions & Findings (Within 50-Question Limit)
4. Step 3: Complete History (Pages 8-13)
o 3.1. Past Medical History
o 3.2. Family History
o 3.3. Social History
o 3.4. Review of Systems (ROS)
5. Step 4: Physical Exam (Pages 14-17)
o 4.1. Vital Signs & General Appearance
o 4.2. Head, Eyes, Ears, Nose, Throat (HEENT)
o 4.3. Cardiovascular
o 4.4. Respiratory
o 4.5. Abdominal & Extremities
o 4.6. Neurological
6. Step 5: Differential Diagnoses & Diagnostic Testing (Pages 18-22)
o 5.1. Initial Differential Diagnoses (20%)
o 5.2. Appropriate Diagnostic Testing (10%)
o 5.3. Updated Differential with Rankings
7. Step 6: Final Diagnosis & Plan (Pages 23-27)
o 6.1. Final Diagnosis
,o 6.2. Comprehensive Plan (30%)
Immediate Management
Medications
Patient Education
Follow-up
Referrals
8. Step 7: Clinical Exercises (Pages 28-29)
o 7.1. Clinical Exercise 1: Pathophysiology of New-Onset Asthma
o 7.2. Clinical Exercise 2: Differential Diagnosis of Wheezing in Adolescents
9. Step 8: Reflection & Summary (Page 30)
10. References (Page 31)
Page 1: Case Overview & Instructions
I-Human Case: Wheezing and Dyspnea in a 15-Year-Old
Case Title: A 15-Year-Old Male with Wheezing and Dyspnea
Student Instructions:
This case study is designed to simulate a real-world clinical encounter where diagnostic
reasoning is critical. You will assume the role of the healthcare provider evaluating a 15-
year-old patient presenting with wheezing and dyspnea. The focus of this case is on
differentiating new-onset asthma from other potential etiologies including cardiac,
infectious, structural, and psychogenic causes.
Your goal is to navigate the diagnostic reasoning process systematically, moving from
initial encounter to final management while demonstrating clinical reasoning at each
step.
Key Requirements:
History Questions: You are limited to 50 questions. Use them strategically to gather
efficient and relevant data that helps narrow the differential.
Due Date: Please adhere to the due date listed on Canvas. i-Human platform dates are
for administrative purposes only; the Canvas date is final for assignment submission.
, Academic Integrity: By submitting this assignment, you confirm that the work
contained within is your own.
Grading Rubric Breakdown:
Section Percentage of Grade
a) HPI Statement 15%
b) History (including ROS) 10%
c) Physical Exam 10%
d) Diagnostic Testing 10%
e) Differential Diagnoses (selection & ranking) 20%
f) Plan (covering all critical components) 30%
g) Clinical Exercises 5%
Page 2: Case Overview & Instructions (Continued)
The Diagnostic Reasoning Process:
This case emphasizes the importance of differentiating between various etiologies of
wheezing and dyspnea in an adolescent patient. The key to minimizing medical errors is
developing a comprehensive differential diagnosis (clinical "card list") and strategically
selecting tests to either "rule in" or "rule out" these diagnoses.
Learning Objectives:
Upon completion of this case, the student will be able to:
1. Differentiate between common and life-threatening causes of wheezing and dyspnea in
adolescents.
