Cough and Shortness of breath
Attempt: 16-year-old female presents with cough nonproductive and SOB for 3 days. SOB when walking to class and worse at night and is unable to sleep due to coughing. The only child lives with parents and dad smoke in-home and is exposed to secondhand smoke. Inspiratory/expiratory wheezing, tachypnea, afebrile. History of coughing that resolved. No history of childhood asthma, no recent infections.
Attempt: KH is a 16-year-old female with a history of eczema and a recent URI who presents with a 3-week worsening dry cough, shortness of breath on exertion, chest tightness, and wheezing. Physical exam reveals bilateral expiratory wheezing, tachypnea, O2 sat of 94%, and labored breathing. KH reports cockroaches in her home. KH is UTD on all immunizations.
Attempt: KH is a 16-year-old female who presents with complaints of a cough and shortness of breath. Cough started 3 weeks ago with a runny nose and congestion which has subsided.
Cough is dry and no sputum noted. She reports increasing SOB with minimal exertion x3 days. On exam she is hypoxic at 94%, tachypneic, respirations are labored, expiratory wheezes are heard throughout, and subcostal retractions are present. Pertinent negatives include afebrile, lung fields resonant and not hyper-resonant, and no lymphadenopathy. Known exposure to cockroaches and secondhand smoke due to neighbors smoking inside the housing building. PMH of eczema well controlled.