Child and Adolescent Asthma video transcripts
- Assess the case study
- Answer the questions within the case study(1-What preliminary diagnosis are you considering at this time? 2- What areas of physical examination are important for this patient?, 3- What are your 3 diagnostics considerations in order of priority?, 4- List 3 next steps in your diagnostic workup)
- Case study transcripts attached below
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BATES’ VISUAL GUIDE TO PHYSICAL EXAMINATION
OSCE 12: Child and Adolescent Asthma
This video is designed to help prepare you for objective structured clinical examinations, or
OSCEs.
You are seeing a 14-year-old boy and his mother in an urgent care setting. The boy’s chief
complaint is difficulty breathing. As you watch this encounter, you will be asked to answer
questions while the image on the screen freezes. These questions will engage you in practicing
the skills of focused history taking, physical examination, and clinical reasoning as you develop
your preliminary differential diagnosis, based on the guidelines designated in the USMLE Step 2
Clinical Skills Examination.
Note also that you will be performing the history and the physical examination with the mother
in the room. Some of your history will be obtained from the patient himself, with additional
information obtained from his mother.
You are expected to develop three diagnoses with supporting history and physical exam
findings and list the diagnostic workup studies you would order.
You will have time to record your findings and receive feedback.
Health History
Good morning, Devan and Mrs. Williams. Tell me what brings you in today.
I’m having trouble breathing, and I can’t stop coughing.
You see, Devan has been coughing for 3 to 4 days now. But last night, he couldn’t stop. And I
noticed he was having difficulty catching his breath. I almost brought him to the emergency
room, but we were able to get him through the night.
I am sorry to hear that. And I’m glad you brought him in now.
What preliminary diagnoses are you considering at this time?
Press pause and list your answers. Resume when you are ready to receive feedback.
Asthma.
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Pneumonia.
Viral upper respiratory infection.
Devan, can you or your mom tell me more about this? Please start when you first got sick.
I think my mom better tell you.
[patient coughs]. I can’t remember.
He started about 4 days ago. I didn’t think anything of it….you know, it was just a runny nose
and a mild cough. But last night, he was coughing non-stop.
Does it feel like anything is coming up when you cough? Like from your chest up into your
throat?
Nope. I don’t cough anything up.
Tell me about your breathing.
It feels like I can’t catch my breath. Kind of like when I run too much.
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