Convert this clinical note into a concise study guide designed to prepare a student to be quizzed on topics related to this case.

Output Structure
CASE PRESENTATION [Rewrite the case in standard presentation format: Demographics (age/gender only), Chief Complaint, HPI, Pertinent Physical Exam, Assessment and Plan]
LEARNING OBJECTIVES
1.	[Specific, measurable objective related to diagnosis]
2.	[Specific, measurable objective related to management]
3.	[Specific, measurable objective related to clinical reasoning]
DISCUSSION QUESTIONS
1.	[Open-ended question about differential diagnosis]
	- Answer
2.	[Question about diagnostic approach or testing]
	- Answer
3.	[Question about management decisions]
	- Answer
4.	[Question about when to escalate or refer]
	- Answer
KEY TEACHING POINTS
·	[Clinical pearl #1]
·	[Clinical pearl #2]
·	[Clinical pearl #3]

Few-Shot Examples
Input: 5yo male, fever 102.5 x 2 days, sore throat, + strep test, started amoxicillin
Output:
CASE PRESENTATION A preschool-age male presented with 2 days of fever (max 102.5°F) and sore throat. Physical exam revealed tonsillar exudates and anterior cervical lymphadenopathy. Rapid strep test was positive. The patient was started on amoxicillin 50mg/kg/day divided BID for 10 days.
LEARNING OBJECTIVES
1.	Apply Centor criteria to determine when strep testing is indicated in pediatric pharyngitis
2.	Prescribe appropriate antibiotic therapy for group A streptococcal pharyngitis
3.	Counsel families on complications of untreated strep throat
DISCUSSION QUESTIONS
1.	What clinical features increase the likelihood of bacterial vs viral pharyngitis in children?
	- Exudate on exam and lack of coughing
2.	When is empiric antibiotic therapy appropriate without testing?
	- Amoxicillin is first line
3.	How would management change if the patient had a penicillin allergy?
	- Keflex if not anaphylactic, azithromycin if it was anaphylactic
4.	What are the potential complications of untreated streptococcal pharyngitis?
	- Rhuematic fever is the major concern, also Post-streptococcal glomerulonephritis (PSGN) is the one that treatment doesn't change the risk 
KEY TEACHING POINTS
·	Centor criteria have limited utility in children under age 3
·	Amoxicillin remains first-line therapy due to narrow spectrum and efficacy
·	Symptoms improve within 48-72 hours but full 10-day course prevents complications

Input: 16yo female with worsening asthma, using albuterol 5-6x/day, nighttime cough, exam with mild expiratory wheeze, not on controller, started Flovent 88mcg BID
Output:
CASE PRESENTATION An adolescent female with known asthma presented with worsening symptoms over the past 2 weeks. She reported using her albuterol rescue inhaler 5-6 times daily and experiencing nighttime cough 3-4 times per week. She was not on controller medication. Physical exam revealed mild expiratory wheezing bilaterally. She was started on fluticasone 88mcg 2 puffs twice daily with spacer and counseled on proper inhaler technique.
LEARNING OBJECTIVES
1.	Classify asthma severity using NHLBI guidelines
2.	Recognize indications for initiating controller therapy in asthma
3.	Prescribe appropriate step therapy for persistent asthma
DISCUSSION QUESTIONS
1.	How do you differentiate mild intermittent from mild persistent asthma?
- For mild persistent asthma symptoms occur more than twice a week but less than once a day; Nighttime symptoms more than twice a month but less than once a week
2.	What factors indicate the need for controller medication vs rescue therapy alone?
	- Number and severity of exacerbations
3.	What would prompt escalation to Step 3 or 4 therapy?
	- Number and severity of exacerbations
4.	How would you counsel this patient on proper inhaler technique and adherence?
	- Using a spacer is key
KEY TEACHING POINTS
·	Rescue inhaler use >2 days/week indicates inadequate control and need for controller
·	Nighttime symptoms are a key marker of persistent asthma
·	Spacers improve medication delivery and reduce oral thrush risk with ICS

Quality Checks
Before outputting, verify: 1. Clinical accuracy preserved 2. 3 learning objectives that are specific and measurable 3. 4 discussion questions that promote critical thinking with answers  4. teaching points that are concise and actionable 5. Case written in standard presentation format