I Human Case Week 7 – 28-Year-Old Male with Fatigue &
Cough (2026) COMPLETE CASE REVIEW & SOAP NOTE
PRACTICE GUIDE <UPDATED VERSION>
i-Human Case Review: 28-Year-Old Male with Fatigue & Cough
100 Questions & Answers
Section 1: History of Present Illness (HPI)
1. What is the primary reason for this patient's visit?
A) Fever and chills
B) Shortness of breath and chest pain
C) Fatigue and a persistent cough ✓
D) Weight loss and night sweats
2. How long has the patient been experiencing fatigue and cough?
A) A few days
B) 1-2 weeks
C) Several weeks to a few months ✓
D) Over a year
3. How would you describe the patient's cough?
A) Dry and hacking ✓
B) Wet and productive with green sputum
C) Accompanied by bloody sputum (hemoptysis)
D) A barking cough
4. What makes the patient's cough worse?
A) Lying down flat
B) Physical exertion or talking ✓
C) Eating or drinking
D) There are no specific triggers
5. The patient's fatigue is best described as:
A) Mild and only after work
B) Severe, interfering with daily activities and work ✓
, C) Only present in the mornings
D) Related to poor sleep quality alone
6. What other constitutional symptom is commonly associated with this case?
A) Night sweats ✓
B) Rigors and shaking chills
C) Generalized rash
D) Joint swelling
7. Has the patient experienced any fever?
A) No, he has been afebrile.
B) Yes, low-grade and intermittent, especially in the evenings. ✓
C) Yes, a high-grade fever of 103°F.
D) The patient did not check.
8. What is a key pulmonary symptom the patient might report besides cough?
A) Pleuritic chest pain ✓
B) Wheezing
C) Stridor
D) Cyanosis
9. The patient may report unintentional weight loss. What is a typical range in these
cases?
A) 1-2 pounds
B) 5-10 pounds ✓
C) 15-20 pounds
D) Over 25 pounds
10. What key social history factor is critical to identify in this patient?
A) Tobacco use
B) Alcohol consumption
C) Recent travel
D) Possible exposure to someone with active tuberculosis ✓
Section 2: Past Medical, Surgical, Family, and Social History (PMH/PSH/FH/SH)
11. What is the most relevant aspect of the patient's past medical history?
A) Childhood asthma
B) A history of a positive PPD or Latent TB Infection (LTBI) that was not fully treated ✓
, C) Previous pneumonia
D) Diabetes mellitus
12. The patient's surgical history is most likely:
A) Significant for a previous thoracotomy
B) Non-contributory (no major surgeries) ✓
C) Significant for an appendectomy
D) Unknown
13. What is a crucial question regarding the patient's birth origin?
A) Was he born in the United States?
B) If not born in the US, which country is he from, and how long ago did he immigrate?
✓
C) What city was he born in?
D) It is not relevant.
14. A key risk factor for this patient's condition is:
A) Being immunocompromised (e.g., HIV) ✓
B) Having high cholesterol
C) A family history of heart disease
D) A history of migraines
15. What is the most important element of the social history?
A) The patient's exercise habits.
B) The patient's occupation (e.g., healthcare worker, correctional facility employee). ✓
C) The patient's marital status.
D) The patient's caffeine intake.
16. The patient's family history is most significant for:
A) Coronary artery disease
B) Various cancers
C) Exposure to a family member with TB ✓
D) Autoimmune disorders
17. What substance use history is most relevant?
A) Intravenous drug use ✓
B) Occasional alcohol use
C) Heavy cigarette smoking
D) Marijuana use
, 18. The patient's living situation might be described as:
A) Homeless or living in a shelter ✓
B) Living alone in a spacious apartment
C) Living with his parents
D) Not a relevant factor
19. What vaccination history is important to review?
A) COVID-19 booster status
B) Whether he received the BCG vaccine as a child ✓
C) His annual influenza vaccine
D) Tetanus shot status
20. A review of systems would be positive for all of the following EXCEPT:
A) Anorexia
B) Chills
C) Dyspnea on exertion
D) Hematochezia (blood in stool) ✓
Section 3: Physical Examination
21. What is the patient's most likely general appearance?
A) Acutely ill and in respiratory distress
B) Chronically ill, fatigued, and cachectic ✓
C) Healthy and robust
D Anxious and diaphoretic
22. The patient's vital signs would most likely show:
A) Bradycardia and hypotension
B) Low-grade fever and tachycardia ✓
C) Hypertension and tachypnea
D) Normal vitals
23. On lung auscultation, what finding is most characteristic?
A) Clear breath sounds bilaterally
B) Bilateral crackles (rales) in the apices ✓
C) Wheezing throughout all lung fields
D) Diminished breath sounds at the bases
Cough (2026) COMPLETE CASE REVIEW & SOAP NOTE
PRACTICE GUIDE <UPDATED VERSION>
i-Human Case Review: 28-Year-Old Male with Fatigue & Cough
100 Questions & Answers
Section 1: History of Present Illness (HPI)
1. What is the primary reason for this patient's visit?
A) Fever and chills
B) Shortness of breath and chest pain
C) Fatigue and a persistent cough ✓
D) Weight loss and night sweats
2. How long has the patient been experiencing fatigue and cough?
A) A few days
B) 1-2 weeks
C) Several weeks to a few months ✓
D) Over a year
3. How would you describe the patient's cough?
A) Dry and hacking ✓
B) Wet and productive with green sputum
C) Accompanied by bloody sputum (hemoptysis)
D) A barking cough
4. What makes the patient's cough worse?
A) Lying down flat
B) Physical exertion or talking ✓
C) Eating or drinking
D) There are no specific triggers
5. The patient's fatigue is best described as:
A) Mild and only after work
B) Severe, interfering with daily activities and work ✓
, C) Only present in the mornings
D) Related to poor sleep quality alone
6. What other constitutional symptom is commonly associated with this case?
A) Night sweats ✓
B) Rigors and shaking chills
C) Generalized rash
D) Joint swelling
7. Has the patient experienced any fever?
A) No, he has been afebrile.
B) Yes, low-grade and intermittent, especially in the evenings. ✓
C) Yes, a high-grade fever of 103°F.
D) The patient did not check.
8. What is a key pulmonary symptom the patient might report besides cough?
A) Pleuritic chest pain ✓
B) Wheezing
C) Stridor
D) Cyanosis
9. The patient may report unintentional weight loss. What is a typical range in these
cases?
A) 1-2 pounds
B) 5-10 pounds ✓
C) 15-20 pounds
D) Over 25 pounds
10. What key social history factor is critical to identify in this patient?
A) Tobacco use
B) Alcohol consumption
C) Recent travel
D) Possible exposure to someone with active tuberculosis ✓
Section 2: Past Medical, Surgical, Family, and Social History (PMH/PSH/FH/SH)
11. What is the most relevant aspect of the patient's past medical history?
A) Childhood asthma
B) A history of a positive PPD or Latent TB Infection (LTBI) that was not fully treated ✓
, C) Previous pneumonia
D) Diabetes mellitus
12. The patient's surgical history is most likely:
A) Significant for a previous thoracotomy
B) Non-contributory (no major surgeries) ✓
C) Significant for an appendectomy
D) Unknown
13. What is a crucial question regarding the patient's birth origin?
A) Was he born in the United States?
B) If not born in the US, which country is he from, and how long ago did he immigrate?
✓
C) What city was he born in?
D) It is not relevant.
14. A key risk factor for this patient's condition is:
A) Being immunocompromised (e.g., HIV) ✓
B) Having high cholesterol
C) A family history of heart disease
D) A history of migraines
15. What is the most important element of the social history?
A) The patient's exercise habits.
B) The patient's occupation (e.g., healthcare worker, correctional facility employee). ✓
C) The patient's marital status.
D) The patient's caffeine intake.
16. The patient's family history is most significant for:
A) Coronary artery disease
B) Various cancers
C) Exposure to a family member with TB ✓
D) Autoimmune disorders
17. What substance use history is most relevant?
A) Intravenous drug use ✓
B) Occasional alcohol use
C) Heavy cigarette smoking
D) Marijuana use
, 18. The patient's living situation might be described as:
A) Homeless or living in a shelter ✓
B) Living alone in a spacious apartment
C) Living with his parents
D) Not a relevant factor
19. What vaccination history is important to review?
A) COVID-19 booster status
B) Whether he received the BCG vaccine as a child ✓
C) His annual influenza vaccine
D) Tetanus shot status
20. A review of systems would be positive for all of the following EXCEPT:
A) Anorexia
B) Chills
C) Dyspnea on exertion
D) Hematochezia (blood in stool) ✓
Section 3: Physical Examination
21. What is the patient's most likely general appearance?
A) Acutely ill and in respiratory distress
B) Chronically ill, fatigued, and cachectic ✓
C) Healthy and robust
D Anxious and diaphoretic
22. The patient's vital signs would most likely show:
A) Bradycardia and hypotension
B) Low-grade fever and tachycardia ✓
C) Hypertension and tachypnea
D) Normal vitals
23. On lung auscultation, what finding is most characteristic?
A) Clear breath sounds bilaterally
B) Bilateral crackles (rales) in the apices ✓
C) Wheezing throughout all lung fields
D) Diminished breath sounds at the bases
