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NR 602: Avery Brook 10 year old patient with Slipping grades ,snoring and inattention Top differential: OSA (#1) Pediatric Differential Diagnosis Case Study (OSA, Hypothyroidism, ADHD). Includes history table, physical exam findings, diagnostic worku

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NR 602: A 10-year-old child (Avery Brook) presents with slipping grades as the chief complaint in an outpatient clinic setting. This comprehensive pediatric differential diagnosis case study covers the complete clinical reasoning process: history taking with pivotal concepts table (onset, school behavior, sleep quality, vision/hearing, attention, mood, medical history, family history of ADHD and hypothyroidism, social history including parental separation), physical examination findings (vitals, growth with BMI 85th percentile, periorbital edema, tonsillar hypertrophy, neurologic exam showing poor short-term recall), case problem formulation, ranked differential diagnosis (1. Obstructive Sleep Apnea, 2. Hypothyroidism, 3. ADHD inattentive type, 4. Adjustment disorder, 5. Vision/hearing impairment, 6. Iron deficiency anemia), diagnostic workup including polysomnography and TSH/free T4, and management plan. Perfect for NP students, PA students, medical students, and residency training.

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Institution
Primary Care Of The Childbearing And Childrearing
Course
Primary Care of the Childbearing and Childrearing

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NR 602: Avery Brook 10 year old patient with Slipping grades
,snoring and inattention Top differential: OSA (#1) Pediatric
Differential Diagnosis Case Study (OSA, Hypothyroidism, ADHD).
Includes history table, physical exam findings, diagnostic workup,
and plan. For NP students Latest case 2026




1. Chief Complaint

"Slipping grades" for an unspecified duration in a 10-year-old child.




2. History Feedback (40% of grade)


Pivotal Concepts Addressed – History Table

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Institution
Primary Care of the Childbearing and Childrearing
Course
Primary Care of the Childbearing and Childrearing

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