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Miranda O. is an 11-year-old patient with asthma who has poor academic performance in her fifth-grade class.

Miranda O. is an 11-year-old patient with asthma who has poor academic performance in her fifth-grade class. This was brought to the mother’s attention by her teacher. She is disruptive in class and has difficulty paying attention. Her asthma is well controlled.

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What is your differential diagnoses (3-4) with this patient and your presumptive diagnosis? What diagnostic tools might you do to confirm this?

Medications:

Advair inhaler 100/50 1 puff  INH BID

Proventil inhaler 2 puffs INH prn

Singulair 5 mg qHS

Physical Examination and labs: WNL

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