ACTUAL iHuman Case Study — Layla Stevens (18‑Month‑Old
Female) Reason for Encounter: Vomiting and Diarrhea
, SECTION 1: CASE OVERVIEW & DEMOGRAPHICS
1.1 Patient Information
• Patient Name: Layla Stevens
• Age: 18 months
• Gender: Female
, • Height: 2 ft 6 in (76 cm)
• Weight: 26.0 lb (11.8 kg)
• Reason for Encounter: Vomiting and diarrhea
• Setting: Outpatient clinic with laboratory capabilities
• Assignment Mode: Learning mode
1.2 Source of History
• Primary informant: Mother/primary caregiver
• Reliability: Good; caregiver provides detailed observations
• Important Note: In an 18-month-old, caregiver observations are especially important
because the child may not be able to describe symptoms reliably
1.3 Chief Complaint (CC)
"Layla has been vomiting and having diarrhea for the past several days."
SECTION 2: HISTORY OF PRESENTING ILLNESS (HPI)
2.1 Onset and Duration
• Acute onset approximately 3 days prior to presentation
• Symptoms began abruptly while child was in usual state of health
• Vomiting began first, followed by diarrhea several hours later
2.2 Vomiting Characteristics
• Description: Non-bilious, non-bloody emesis
• Content: Initially partially digested food, progressing to clear fluid
• Frequency:
o Day 1: Approximately 5–6 episodes
o Day 2: Decreasing to 2–3 episodes
• Timing: Primarily occurs in the morning and after attempts at oral feeding
• Aggravating Factors: Attempts to feed solids worsen vomiting
2.3 Diarrhea Characteristics
Female) Reason for Encounter: Vomiting and Diarrhea
, SECTION 1: CASE OVERVIEW & DEMOGRAPHICS
1.1 Patient Information
• Patient Name: Layla Stevens
• Age: 18 months
• Gender: Female
, • Height: 2 ft 6 in (76 cm)
• Weight: 26.0 lb (11.8 kg)
• Reason for Encounter: Vomiting and diarrhea
• Setting: Outpatient clinic with laboratory capabilities
• Assignment Mode: Learning mode
1.2 Source of History
• Primary informant: Mother/primary caregiver
• Reliability: Good; caregiver provides detailed observations
• Important Note: In an 18-month-old, caregiver observations are especially important
because the child may not be able to describe symptoms reliably
1.3 Chief Complaint (CC)
"Layla has been vomiting and having diarrhea for the past several days."
SECTION 2: HISTORY OF PRESENTING ILLNESS (HPI)
2.1 Onset and Duration
• Acute onset approximately 3 days prior to presentation
• Symptoms began abruptly while child was in usual state of health
• Vomiting began first, followed by diarrhea several hours later
2.2 Vomiting Characteristics
• Description: Non-bilious, non-bloody emesis
• Content: Initially partially digested food, progressing to clear fluid
• Frequency:
o Day 1: Approximately 5–6 episodes
o Day 2: Decreasing to 2–3 episodes
• Timing: Primarily occurs in the morning and after attempts at oral feeding
• Aggravating Factors: Attempts to feed solids worsen vomiting
2.3 Diarrhea Characteristics
