i-Human Case Week 7 – 28-Year-Old Male (Fatigue &
Cough) (2026) FULL PRACTICE CASE SUMMARY &
SOAP NOTE LEARNING GUIDE
History of Present Illness (HPI) & Past History
1. What is the primary reason for this patient's visit?
a) Fever and chills
b) Chest pain and palpitations
c) Fatigue and a persistent cough ✓
d) Shortness of breath and wheezing
2. How long has the patient been experiencing fatigue?
a) A few days
b) 1-2 weeks
c) 3-4 weeks ✓
d) Several months
3. How would you characterize the patient's cough?
a) Dry and hacking ✓
b) Productive with green sputum
c) Productive with bloody sputum
d) Accompanied by a wheeze
4. The patient mentions his cough is worse at night. This is a classic symptom of which
condition?
a) Pneumonia
b) Asthma ✓
c) Bronchitis
d) GERD
5. What key social history factor is highly relevant to this case?
a) He works in construction.
b) He is a former smoker.
c) He has a history of recent international travel.
d) He is a medical resident working long hours with significant stress. ✓
6. The patient reports "swollen glands" in his neck. What are you palpating for?
a) Thyroid nodules
, b) Lymphadenopathy ✓
c) Carotid artery bruits
d) Tracheal deviation
7. He denies fever, but reports frequent "night sweats." This symptom, with fatigue and
lymphadenopathy, is classically associated with?
a) Bacterial pneumonia
b) Viral upper respiratory infection
c) More serious systemic illnesses like lymphoma or TB ✓
d) Anxiety disorder
8. What pertinent negative in his review of systems helps rule out other conditions?
a) No hemoptysis ✓
b) No weight gain
c) No insomnia
d) No joint pain
9. He has no significant past medical history. This is documented as:
a) PMH: Non-contributory
b) PMH: Unknown
c) PMH: None ✓
d) PMH: Asthma
10. His only medication is an over-the-counter cough syrup. This is documented in which
section?
a) Past Medical History
b) Family History
c) Allergies
d) Medications ✓
11. He has no known drug allergies. This is documented as:
a) NKDA ✓
b) NKA
c) ADL's independent
d) No medications
12. What key element of his social history is a major risk factor for burnout and illness?
a) He drinks alcohol socially.
b) He is a resident physician with sleep deprivation and high stress. ✓
, c) He lives alone.
d) He exercises regularly.
Physical Examination
13. On general inspection, the patient appears fatigued. What is another key objective
finding?
a) Acutely distressed
b) Pale and diaphoretic
c) Well-appearing but tired ✓
d) Cyanotic
14. Vital signs: Temperature 98.8°F (37.1°C). This is best described as:
a) Febrile
b) Afebrile ✓
c) Hypertensive
d) Hypothermic
15. Vital signs: Heart rate 105 bpm. This is defined as:
a) Bradycardia
b) Normal sinus rhythm
c) Tachycardia ✓
d) Irregular rhythm
16. Vital signs: Respiratory rate 18 breaths/minute. This is:
a) Tachypneic
b) Bradypneic
c) Within normal limits ✓
d) Agonal
17. Palpation of the neck reveals bilateral, mobile, non-tender lymph nodes. This
description is more suggestive of:
a) Acute bacterial infection
b) Metastatic cancer
c) Reactive lymphadenopathy (from viral or other causes) ✓
d) Thyroiditis
18. On lung auscultation, you hear clear breath sounds bilaterally. This finding helps rule
out:
a) Pneumonia ✓
b) Lymphoma
, c) Mononucleosis
d) GERD
19. The absence of wheezing makes which diagnosis less likely?
a) Acute Bronchitis
b) Asthma ✓
c) Pharyngitis
d) Fatigue syndrome
20. The cardiac exam reveals a tachycardic rate but no murmurs. This tachycardia is most
likely due to:
a) Structural heart disease
b) Stress and fatigue ✓
c) Pericarditis
d) Anemia
21. Abdominal exam is soft, non-tender, with no hepatosplenomegaly. The absence of
splenomegaly is a pertinent negative for:
a) Pneumonia
b) Mononucleosis ✓
c) GERD
d) Bronchitis
Differential Diagnosis
22. Based on the initial HPI, what is the LEAST likely diagnosis?
a) Viral Syndrome
b) Bacterial Pneumonia ✓
c) Mononucleosis
d) Stress/Exhaustion
23. The triad of fatigue, persistent cough, and lymphadenopathy should raise suspicion
for:
a) Influenza
b) Mycoplasma pneumoniae
c) Epstein-Barr Virus (EBV)/Mononucleosis ✓
d) Streptococcal pharyngitis
24. In a young, otherwise healthy adult with these symptoms, what serious condition
must be considered?
a) Congestive Heart Failure
Cough) (2026) FULL PRACTICE CASE SUMMARY &
SOAP NOTE LEARNING GUIDE
History of Present Illness (HPI) & Past History
1. What is the primary reason for this patient's visit?
a) Fever and chills
b) Chest pain and palpitations
c) Fatigue and a persistent cough ✓
d) Shortness of breath and wheezing
2. How long has the patient been experiencing fatigue?
a) A few days
b) 1-2 weeks
c) 3-4 weeks ✓
d) Several months
3. How would you characterize the patient's cough?
a) Dry and hacking ✓
b) Productive with green sputum
c) Productive with bloody sputum
d) Accompanied by a wheeze
4. The patient mentions his cough is worse at night. This is a classic symptom of which
condition?
a) Pneumonia
b) Asthma ✓
c) Bronchitis
d) GERD
5. What key social history factor is highly relevant to this case?
a) He works in construction.
b) He is a former smoker.
c) He has a history of recent international travel.
d) He is a medical resident working long hours with significant stress. ✓
6. The patient reports "swollen glands" in his neck. What are you palpating for?
a) Thyroid nodules
, b) Lymphadenopathy ✓
c) Carotid artery bruits
d) Tracheal deviation
7. He denies fever, but reports frequent "night sweats." This symptom, with fatigue and
lymphadenopathy, is classically associated with?
a) Bacterial pneumonia
b) Viral upper respiratory infection
c) More serious systemic illnesses like lymphoma or TB ✓
d) Anxiety disorder
8. What pertinent negative in his review of systems helps rule out other conditions?
a) No hemoptysis ✓
b) No weight gain
c) No insomnia
d) No joint pain
9. He has no significant past medical history. This is documented as:
a) PMH: Non-contributory
b) PMH: Unknown
c) PMH: None ✓
d) PMH: Asthma
10. His only medication is an over-the-counter cough syrup. This is documented in which
section?
a) Past Medical History
b) Family History
c) Allergies
d) Medications ✓
11. He has no known drug allergies. This is documented as:
a) NKDA ✓
b) NKA
c) ADL's independent
d) No medications
12. What key element of his social history is a major risk factor for burnout and illness?
a) He drinks alcohol socially.
b) He is a resident physician with sleep deprivation and high stress. ✓
, c) He lives alone.
d) He exercises regularly.
Physical Examination
13. On general inspection, the patient appears fatigued. What is another key objective
finding?
a) Acutely distressed
b) Pale and diaphoretic
c) Well-appearing but tired ✓
d) Cyanotic
14. Vital signs: Temperature 98.8°F (37.1°C). This is best described as:
a) Febrile
b) Afebrile ✓
c) Hypertensive
d) Hypothermic
15. Vital signs: Heart rate 105 bpm. This is defined as:
a) Bradycardia
b) Normal sinus rhythm
c) Tachycardia ✓
d) Irregular rhythm
16. Vital signs: Respiratory rate 18 breaths/minute. This is:
a) Tachypneic
b) Bradypneic
c) Within normal limits ✓
d) Agonal
17. Palpation of the neck reveals bilateral, mobile, non-tender lymph nodes. This
description is more suggestive of:
a) Acute bacterial infection
b) Metastatic cancer
c) Reactive lymphadenopathy (from viral or other causes) ✓
d) Thyroiditis
18. On lung auscultation, you hear clear breath sounds bilaterally. This finding helps rule
out:
a) Pneumonia ✓
b) Lymphoma
, c) Mononucleosis
d) GERD
19. The absence of wheezing makes which diagnosis less likely?
a) Acute Bronchitis
b) Asthma ✓
c) Pharyngitis
d) Fatigue syndrome
20. The cardiac exam reveals a tachycardic rate but no murmurs. This tachycardia is most
likely due to:
a) Structural heart disease
b) Stress and fatigue ✓
c) Pericarditis
d) Anemia
21. Abdominal exam is soft, non-tender, with no hepatosplenomegaly. The absence of
splenomegaly is a pertinent negative for:
a) Pneumonia
b) Mononucleosis ✓
c) GERD
d) Bronchitis
Differential Diagnosis
22. Based on the initial HPI, what is the LEAST likely diagnosis?
a) Viral Syndrome
b) Bacterial Pneumonia ✓
c) Mononucleosis
d) Stress/Exhaustion
23. The triad of fatigue, persistent cough, and lymphadenopathy should raise suspicion
for:
a) Influenza
b) Mycoplasma pneumoniae
c) Epstein-Barr Virus (EBV)/Mononucleosis ✓
d) Streptococcal pharyngitis
24. In a young, otherwise healthy adult with these symptoms, what serious condition
must be considered?
a) Congestive Heart Failure
