I- HUMAN CASE STUDY WEEK 4 FOR AN 18-MONTH-
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OLD CHILD WITH COUGH (HEIGHT: 2'10" / 86 CM; W
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EIGHT: 12.7 KG / 28 LB) FULL AND LATEST CASE 2026
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Location: Outpatient pediatric clinic (lab and x-ray available)
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Reason for encounter
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Parent concerned: “He’s been coughing a lot, not eating well, and breathing seems faster.
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”
,1. General Case Information v v
Case title & summary
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v18-month-
old toddler with 5 days of progressive cough, nasal congestion, decreased oral intake,
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vand nighttime worsening of cough. Case emphasizes pediatric respiratory illness eva
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luation (viral bronchiolitis, croup, pneumonia, pertussis, asthma/reactive airways), a
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ge-appropriate diagnostics, dosing, and safe outpatient vs inpatient management.
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Patient demographicsv
Name: (Marvin? — patient is anonymized)
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Age: 18 months v v
Sex: Male (assume male unless otherwise specified)
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Height: 86 cm (2'10") v v v
Weight: 12.7 kg (28 lb) v v v v
BMI: ≈17.2 kg/m² (weight/height²) — within expected toddler range
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Case mode: Learning mode
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Case location: Outpatient pediatric clinic with point-of-care testing and imaging
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Attempts allowed: Unlimited v v
2. Chief Complaint (CC) v v
“My toddler has had a cough for five days and isn’t acting like himself —
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not eating much and breathing faster.”
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Primary symptom: cough (day & night; worse at night)
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Onset: 5 days ago v v v
Course: progressively more frequent, occasional cough spells with slight p
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ost-tussive vomiting yesterday v v
Associated: nasal congestion, low- v v v
grade fevers (parent measured 38.2°C once), decreased oral intake, less ac
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tive, brief periods of noisy breathing when upset
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No known choking episode, no known foreign body ingestion
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, 3. History of Present Illness (HPI)
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History: Previously healthy 18-month-old developed rhinorrhea and low-
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grade fever 5 days ago; cough began shortly after and has slowly increased. Pa
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rent reports cough is mostly dry but sometimes produces small amounts of clea
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r sputum. Nighttime cough is worse and causes multiple awakenings. Yesterda
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y had 1 episode of non-bloody, non-bilious post-
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tussive vomiting after prolonged coughing.
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Feeding: Reduced intake of solids and fluids over the last 48 hours; fewer w
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et diapers (≈4 in 24 hrs vs usual 6–8).
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Respiratory distress: Mild; parent notes faster breathing and “noisy” i
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nspiration when crying. No cyanosis seen. v v v v v
Exposures: Attends daycare; multiple classmates with colds last week. No k
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nown TB or TB exposure. No recent travel. No pets causing concern. No par
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ental smoking in home. v v v
Immunizations: Reported up-to- v v
date for age (DTaP, Hib, PCV, MMR/Var given at 12 months). Influenza vac
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cine status depends on season —
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vassume not yet given this season unless otherwise stated.
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Previous episodes: No prior reactive airway disease or wheeze history. No
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NICU or chronic lung disease. v v v v
Red flags denied: No choking episode, seizure, lethargy, neck stiffness, or p
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ersistent high fever. v v
4. Past Medical History (PMH)
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Born full term, no NICU stay
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No chronic medical conditions
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No history of prematurity, congenital heart disease, cystic fibrosis, or r
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ecurrent pneumonias v
Growth and development previously normal for age
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OLD CHILD WITH COUGH (HEIGHT: 2'10" / 86 CM; W
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EIGHT: 12.7 KG / 28 LB) FULL AND LATEST CASE 2026
v v v v v v v v v v
Location: Outpatient pediatric clinic (lab and x-ray available)
v v v v v v v
Reason for encounter
v v
Parent concerned: “He’s been coughing a lot, not eating well, and breathing seems faster.
v v v v v v v v v v v v v
”
,1. General Case Information v v
Case title & summary
v v v
v18-month-
old toddler with 5 days of progressive cough, nasal congestion, decreased oral intake,
v v v v v v v v v v v v
vand nighttime worsening of cough. Case emphasizes pediatric respiratory illness eva
v v v v v v v v v v
luation (viral bronchiolitis, croup, pneumonia, pertussis, asthma/reactive airways), a
v v v v v v v v
ge-appropriate diagnostics, dosing, and safe outpatient vs inpatient management.
v v v v v v v v
Patient demographicsv
Name: (Marvin? — patient is anonymized)
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Age: 18 months v v
Sex: Male (assume male unless otherwise specified)
v v v v v v
Height: 86 cm (2'10") v v v
Weight: 12.7 kg (28 lb) v v v v
BMI: ≈17.2 kg/m² (weight/height²) — within expected toddler range
v v v v v v v v
Case mode: Learning mode
v v v
Case location: Outpatient pediatric clinic with point-of-care testing and imaging
v v v v v v v v v
Attempts allowed: Unlimited v v
2. Chief Complaint (CC) v v
“My toddler has had a cough for five days and isn’t acting like himself —
v v v v v v v v v v v v v v
not eating much and breathing faster.”
v v v v v v
Primary symptom: cough (day & night; worse at night)
v v v v v v v v
Onset: 5 days ago v v v
Course: progressively more frequent, occasional cough spells with slight p
v v v v v v v v v
ost-tussive vomiting yesterday v v
Associated: nasal congestion, low- v v v
grade fevers (parent measured 38.2°C once), decreased oral intake, less ac
v v v v v v v v v v
tive, brief periods of noisy breathing when upset
v v v v v v v
No known choking episode, no known foreign body ingestion
v v v v v v v v
, 3. History of Present Illness (HPI)
v v v v
History: Previously healthy 18-month-old developed rhinorrhea and low-
v v v v v v v
grade fever 5 days ago; cough began shortly after and has slowly increased. Pa
v v v v v v v v v v v v v
rent reports cough is mostly dry but sometimes produces small amounts of clea
v v v v v v v v v v v v
r sputum. Nighttime cough is worse and causes multiple awakenings. Yesterda
v v v v v v v v v v
y had 1 episode of non-bloody, non-bilious post-
v v v v v v v
tussive vomiting after prolonged coughing.
v v v v
Feeding: Reduced intake of solids and fluids over the last 48 hours; fewer w
v v v v v v v v v v v v v
et diapers (≈4 in 24 hrs vs usual 6–8).
v v v v v v v v
Respiratory distress: Mild; parent notes faster breathing and “noisy” i
v v v v v v v v v
nspiration when crying. No cyanosis seen. v v v v v
Exposures: Attends daycare; multiple classmates with colds last week. No k
v v v v v v v v v v
nown TB or TB exposure. No recent travel. No pets causing concern. No par
v v v v v v v v v v v v v
ental smoking in home. v v v
Immunizations: Reported up-to- v v
date for age (DTaP, Hib, PCV, MMR/Var given at 12 months). Influenza vac
v v v v v v v v v v v v
cine status depends on season —
v v v v v
vassume not yet given this season unless otherwise stated.
v v v v v v v v
Previous episodes: No prior reactive airway disease or wheeze history. No
v v v v v v v v v v v
NICU or chronic lung disease. v v v v
Red flags denied: No choking episode, seizure, lethargy, neck stiffness, or p
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ersistent high fever. v v
4. Past Medical History (PMH)
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Born full term, no NICU stay
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No chronic medical conditions
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No history of prematurity, congenital heart disease, cystic fibrosis, or r
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ecurrent pneumonias v
Growth and development previously normal for age
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