Case # study for discussion CC: “My daughter has been coughing for the past 3 mo

Case # study for discussion
CC:
“My daughter has been coughing for the past 3 months. She cannot even play & run with her playmates.”
HPI: 3 1/2 year old Shelly has been seen several times in the office for colds, cough and wheezing. She has been on Orapred 3 times in the past year for this. No other meds have been given.
PMH: She was a term baby delivered without complication. No feeding, growth issues and is developmentally on target for age. Mom does report 3 years ago Shelly was very sick in the hospital with an infection in New Jersey. Immunizations are up to date.
Review of Systems: (obtained from mom)
General: “A normal 3 year old, she just coughs all the time, and when she has a cold it settles in her chest!”
HEENT: She sometimes has very dark circles under her eyes. I think it is from her not sleeping and coughing all night.
Chest/Resp: Coughing, sometimes to the point of not catching her breath. Maybe she is out of shape but she can’t play like her friends, she just coughs and has to stop. Coughs every day & night, especially in the winter. (FMH of both parent with Asthma)
Chest/Card: No color changes
GI/GU: Eats well, no issues
MSK/Extremities: Walks without an issue
PE:
She is wheezing bilaterally, is unable to really take in a good breath, afebrile, and VSS.
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Review the case study presented in this module and identify 2 differential diagnoses and your rationale to support these. Then discuss a treatment plan.
Please make sure you creat a treatment plan. Be specific on doses of meds and follow up.