MALE PRESENTING WITH FATIGUE AND
COUGH: FULL SUMMARY & DETAILED SOAP
NOTE
, 1. Page Preview
Case Title: i-Human Case Week #7
Patient Information:
Name: Not specified
Age: 28 years
Height: 5'7" (170 cm)
Weight: 150.6 lb (68.2 kg)
Reason for Encounter: Cough and fatigue
Location: Outpatient clinic with X-ray, ECG, and laboratory
capabilities
Case Instructions:
Mode: Learning Mode — feedback appears after submission of
questions, and a final performance overview is generated at the
end of the case.
Attempts Available: Only 1 attempt is permitted for this
assignment.
2. History
Chief Complaint (CC):
Cough and fatigue.
History of Present Illness (HPI):
A 28-year-old male presents to the outpatient clinic with complaints
of cough and fatigue. The cough has been present for several days,
described as persistent and occasionally productive. The patient also
reports increasing tiredness and reduced energy levels. No reports of
chest pain, hemoptysis, or shortness of breath. He denies recent travel,
contact with sick individuals, or exposure to environmental irritants.