COPD Exacerbation OSCE Guide: iHuman Week 3 Case Study & Checklist

Master the iHuman Week 3 Case: 60-Year-Old Female

with SOB (COPD) –With Soap Note Graded A+ .

,� CASE OVERVIEW (HIGH-YIELD)


Patient: 60-year-old female

Chief Complaint: “Shortness�of�breath”

Most Likely Diagnosis: Chronic Obstructive Pulmonary Disease exacerbation




� QUICK CLINICAL THINKING


👉 Older patient + smoking history + progressive SOB = COPD until proven otherwise




📋 SUBJECTIVE (HISTORY)


🗣️ HPI (OLDCARTS Format)


Onset: Gradual, worsening over days/weeks


Location: Chest


Duration: Chronic with acute worsening


Character: Breathlessness, chest tightness


Aggravating factors: Activity, cold air


Relieving factors: Rest, inhalers (partial relief)


Timing: Worse with exertion

,Severity: Moderate�→�severe




❗ Key Symptoms to Ask (EXAM GOLD)


Dyspnea on exertion ✔


Chronic cough ✔


Sputum production ✔


Wheezing ✔


Fatigue ✔


Chest tightness ✔




🚨 Red Flags


Cyanosis


Confusion


Severe respiratory distress


Use of accessory muscles

, � Past History


Smoking (VERY IMPORTANT 🚩)


Prior diagnosis of COPD


Hospitalizations for breathing problems


Vaccination status




💊 Medications


Bronchodilators


Steroids


Oxygen use




👨👩👧 Social History


Smoking pack-years


Occupational exposure (dust, chemicals)




🔍 OBJECTIVE (PHYSICAL EXAM)