IHUMAN CASE STUDY: CONSTANCE BARN 70YRS OLD FEMALE CC:
(CHRONIC DYSPNEA) SHORTNESS OF BREATH.Questions – 100 %
1 How can I help you
... [Show More] today?
2 Are there any other symptoms or concerns we should discuss?
3 When did your difficulty breathing start?
4 Does anything make your difficulty breathing better or worse?
5 Are you short of breath when lying down?
6 Are you short of breath at rest?
7 Do you sleep with pillows to help you breathe?
8 Do you have any pain or symptoms associated with your difficulty breathing?
9 How severe is your difficulty breathing?
10 Do you wheeze?
11 Do you become short of breath with exertion?
12 Do you awaken at night short of breath?
13 Does anyone in your family have difficulty breathing?
14 Do you feel faint or like you might faint?
15 Do you have a problem with fatigue/tiredness?
16 Have you been having fevers?
17 Have you noticed any swelling in any part of your body?
18 Do you have a problem with generalized weakness?
19 Do you have a cough?
20 Do you have unusual heartbeats?
21 Do you have a sensation of a “pounding heart” in your chest?
22 Do you have any pain in your chest?
23 Does your chest feel tight or heavy?
24 Can you tell me about any current or past medical problems you have had?
25 Do you have high cholesterol?
26 Do you have heart disease and/or have you ever had a heart attack?
27 Do you have a history of heart failure?
28 Have you ever been told that you have a murmur or valve problems?
29 Do you have asthma?
30 Do you have a history of lung disease?
31 Do you now or have you ever had cancer?
32 Any previous medical, surgical, or dental procedures?
33 Have you ever been hospitalized?
34 Do you have any allergies?
35 Are you taking any over the counter or herbal medications?
36 Are there any disease that run in your family?
37 Are you taking any prescription medications?
38 Do you drink alcohol? If so, what do you drink and how many drinks per day?
39 Do you now or have you ever smoked or chewed tobacco?
40 Do you have diabetes?
41 Have you ever fainted?
42 Were you short of breath just before you fainted?
43 Have you had tuberculosis?
44 Do you have a family history of blood clots in your legs or lungs?
45 Do you have a history of deep vein thrombosis or pulmonary embolism?
46 Have you ever been diagnosed with thyroid problems?
47 Have you recently traveled? Where?
48 Have you ever been diagnosed with a bleeding disorder?
lOMoARcPSD|5734770
49 Do you have chills?
50 Have you had chicken pox, Measles, or Rheumatic fever?
51 Are you eating a lot of salty foods?
52 Do you have muscle pain or cramping?
53 Do you have problems with movement?
54 Do you have any difficulty performing activities of daily living?
55 Do you have a problem with swallowing?
56 Do you have a family history of heart disease?
57 Do you have arthritis?
58 Do you have difficulty chewing?
59 Do you feel your muscles are tense?
60 Did you have strep throat as a child?
61 Have you eaten anything out of the ordinary lately?
62 Have you noticed any trouble with your speech?
63 Did you ever have involuntary strange dance like movements?
64 Is your voice hoarse?
Physical Exams – 93%
31 of these are correct (3 were performed incorrectly somehow *probably something with taking the blood pressure because iHuman is stupid*, so this section should score 100% if you do everything right) unsure which of the 31 are correct, so if you choose to eliminate exams, it cannot be guaranteed that you will earn full credit.
1 Cognitive status
2 Blood pressure, R&L arms (normal)
3 Blood pressure R&L arms (orthostatic)
4 RR
5 Pulse
6 Temperature
7 SpO2
8 Ask patient to swallow
9Inspect skin overall
10Capillary refill
11Inspect face
12Inspect/palpate head
13Palpate neck
14Inspect neck
15Inspect nails
16Look up nostrils
17Inspect mouth/pharynx
18Inspect nose
19Inspect eyes
20Examine pupils
21Ophthalmoscope
22eTCO2
23Auscultate carotid arteries
24JVP
25PMI
26Auscultate Lungs
27Inspect ears
lOMoARcPSD|5734770
28 Otoscope
29 Auscultate heart
30 Dynamic auscultation
31 Palpate AP chest
32 Quincke’s Test
33 Percuss AP chest
34 Dix-Hallpike Maneuver
35 Breast Exam
36 Visual inspection AP chest
37 Visual inspection abdomen
38 Ocular motor test
39 Evaluate mandible muscles and mastication
40 Auscultate abdomen
41 Femoral arteries
42 Percuss abdomen
43 Palpate abdomen
44 Palpate back and spine
45 Eyelid icepack test
46 Visual inspection of the spine
47 Inspect for muscle bulk and tone
48 Test strength
49 Test stability
50 Palpate extremities
51 Assess pharynx movement and phonation
52 Visual inspection of extremities
53 Range of motion
54 Balance test
55 MMSE
56 Romberg and pronator drift test
57 Assess gait and stance
58 Palpate all lymph nodes
59 Look for involuntary movements
60 Ankle brachial pressure index
61 DTR’s
62 Assess head rotation against resistance/shoulder elevation
63 Gross pain stimulus
64 Facial strength/expression
65 Rapid alternating movements – hands
66 Rapid alternating movements – fingers
MSAP – Not graded
1 Dyspnea
2 Fatigue
3 Ankle swelling
4 Vasovagal 2 months prior
51+ BL pretibial edema
6Abnormal carotids
7Abnormal abdominal/femoral arteries
8Murmur
lOMoARcPSD|5734770
9 26-year PPD smoker
10 Hyperactive bowel sounds [Show Less]