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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.

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

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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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