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Chief Complaint

“I can’t stop coughing.”

History of Present Illness

MT is a 35-year-old female who presents to her primary care physician with cough for the last 10 days. She explains that her 6-year-old son had fever, runny nose, and cough about 2 weeks ago but got better after a few days. She explains that she got sick shortly after him and developed nasal congestion, sore throat, and a productive cough. While her congestion has improved, she continues to cough and is concerned that her symptoms still persist. She denies any fever, chills, dyspnea, or hemoptysis.

Past Medical History

Hypothyroidism, insomnia

Surgical History


Family History

Father has HTN and hyperlipidemia, mother has history of breast cancer and is in remission. One younger sister (age 30), who is alive and well.

Social History

Married with two children (ages 6 and 8), works as a dental hygienist, denies smoking and illicit drug use



Home Medications

Levothyroxine 50 mcg orally once daily

Alprazolam 0.25 mg orally nightly as needed for insomnia

Physical Examination

Vital Signs

Temp 98.8°F, P 68, RR 16, BP 115/73 mm Hg, O2 saturation 98%, Ht 5′9″, Wt 63 kg


Well-developed female in NAD


PERRLA, EOMI, TMs intact, moist mucous membranes, mild pharyngeal erythema present

Neck/Lymph Nodes

Supple, no lymphadenopathy


CTA, no crackles/wheezing, cough present


NSR, no m/r/g


Soft, non-tender, non-distended, bowel sounds present




A&O ×3, CN intact



Laboratory Findings

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Na = 136 mEq/L

Hgb = 14 g/dL

K = 3.9 mEq/L

Hct = 40%

Cl = 100 mEq/L

Plt = 201 × 103/mm3

CO2 = 22 mEq/L

WBC = 9 × 103/mm3

BUN = 12 mg/dL

Scr = 0.8 mg/dL

Glu = 98 mg/dL

Rapid Influenza Test



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