I- HUMAN CASE STUDY WEEK 4 FOR AN 18-
MONTH-OLD MALE (86 CM / 12.7 KG) —
REASON FOR ENCOUNTER: COUGH (CLASS
6541) LATEST UPDATE
1. General Case Information
Case title & summary:
18-month-old male with 4 days of cough, rhinorrhea, intermittent low-grade fever,
and nocturnal worsening. Focus: differentiate viral URI, bronchiolitis, pneumonia,
reactive airways, and foreign-body aspiration; assess need for ED management vs
outpatient supportive care.
Reason for encounter:
Parent reports persistent cough that disrupts sleep and reduces oral intake.
Patient demographics:
, • Age: 18 months
• Sex: Male
• Height: 86 cm (2′10″)
• Weight: 12.7 kg (20 lb)
• Growth: Appears age-appropriate per parent report and prior well-child
records
Case mode: Learning mode (Class 6541)
Case location: Pediatric clinic with pulse oximetry, X-ray, and basic lab access
Attempts allowed: Unlimited (learning)
2. Chief Complaint (CC)
Parent: “My toddler has been coughing for four days and his sleep and eating are
worse.”
• Onset: 4 days ago
• Course: Gradually worse at night; occasionally “wet” sounding cough
• Severity: Mild–moderate; causes awakenings and decreased appetite
• Associated: Clear rhinorrhea, one day of low-grade fever (max ~37.9°C), no
vomiting, no witnessed choking
3. History of Present Illness (HPI)
, • Cough began after rhinorrhea; initially intermittent dry cough, now more
frequent and worse when supine.
• No audible wheeze reported at home, but parent notes “breathing faster”
with coughing episodes.
• Drinks liquids but has eaten less solids for last 48 hours. Still has adequate
wet diapers.
• Attends daycare; several classmates had colds in past 2 weeks.
• No known TB exposure, no travel, no household smokers.
• Immunizations reportedly up to date for age (including DTaP, Hib, PCV,
MMR per schedule).
• No prior hospitalizations; one prior mild viral URI.
4. Past Medical History (PMH)
• Full-term birth, normal development.
• No history of prematurity, chronic lung disease, congenital heart disease, or
recurrent severe respiratory infections.
• No known food/drug allergies.
5. Medications & Allergies
Current meds: Occasional acetaminophen given at home for fever.
Allergies: None known.
MONTH-OLD MALE (86 CM / 12.7 KG) —
REASON FOR ENCOUNTER: COUGH (CLASS
6541) LATEST UPDATE
1. General Case Information
Case title & summary:
18-month-old male with 4 days of cough, rhinorrhea, intermittent low-grade fever,
and nocturnal worsening. Focus: differentiate viral URI, bronchiolitis, pneumonia,
reactive airways, and foreign-body aspiration; assess need for ED management vs
outpatient supportive care.
Reason for encounter:
Parent reports persistent cough that disrupts sleep and reduces oral intake.
Patient demographics:
, • Age: 18 months
• Sex: Male
• Height: 86 cm (2′10″)
• Weight: 12.7 kg (20 lb)
• Growth: Appears age-appropriate per parent report and prior well-child
records
Case mode: Learning mode (Class 6541)
Case location: Pediatric clinic with pulse oximetry, X-ray, and basic lab access
Attempts allowed: Unlimited (learning)
2. Chief Complaint (CC)
Parent: “My toddler has been coughing for four days and his sleep and eating are
worse.”
• Onset: 4 days ago
• Course: Gradually worse at night; occasionally “wet” sounding cough
• Severity: Mild–moderate; causes awakenings and decreased appetite
• Associated: Clear rhinorrhea, one day of low-grade fever (max ~37.9°C), no
vomiting, no witnessed choking
3. History of Present Illness (HPI)
, • Cough began after rhinorrhea; initially intermittent dry cough, now more
frequent and worse when supine.
• No audible wheeze reported at home, but parent notes “breathing faster”
with coughing episodes.
• Drinks liquids but has eaten less solids for last 48 hours. Still has adequate
wet diapers.
• Attends daycare; several classmates had colds in past 2 weeks.
• No known TB exposure, no travel, no household smokers.
• Immunizations reportedly up to date for age (including DTaP, Hib, PCV,
MMR per schedule).
• No prior hospitalizations; one prior mild viral URI.
4. Past Medical History (PMH)
• Full-term birth, normal development.
• No history of prematurity, chronic lung disease, congenital heart disease, or
recurrent severe respiratory infections.
• No known food/drug allergies.
5. Medications & Allergies
Current meds: Occasional acetaminophen given at home for fever.
Allergies: None known.
