IHUMAN CASE WEEK #9:65 YEAR-
OLD FEMALE REASON FOR
ENCOUNTER:TROUBLE SLEEPING
LOCATION:OUTPATIENT CLINIC
WITH X-RAY,ECG AND
LABORATORY CAPABILITIES(class
6531) LATEST 2024 100% guaranteed
pass!
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,Grading for the case is broken down as follows:
• HPI (History of Present Illness) statement: 10% of the grade.
• Plan covering all critical components of the patient's final
diagnosis: 40%.
• Overall I-Human percentage: 50%.
1. History of Present Illness (HPI):
• The HPI is critical for understanding the patient’s trouble
sleeping. You'll want to gather detailed information about the
onset, duration, frequency, and quality of her sleep issues.
o Questions you could ask:
▪ When did the trouble sleeping start? Has it been
worsening?
▪ How many hours of sleep is she getting?
▪ Does she have difficulty falling asleep, staying
asleep, or waking too early?
▪ Is there any pain, anxiety, or other symptoms
associated with her sleep problems?
▪ Does she take any medications or substances (e.g.,
caffeine, alcohol) that could be affecting her sleep?
• You'll also need to assess potential psychosocial stressors (e.g.,
depression, anxiety, life events) or medical conditions like sleep
apnea or restless leg syndrome.
2. Plan for Diagnosis and Management:
• Diagnostic tests: Consider ruling in or ruling out conditions that
could be causing sleep problems:
o Polysomnography (sleep study) to investigate sleep
disorders like apnea.
o Thyroid function tests or other labs (CBC, metabolic
panel) to rule out metabolic disorders.
o ECG to rule out cardiac issues, as this case takes place in a
clinic with ECG capabilities.
, o Mental health assessment: Depression or anxiety could
be contributors.
• Lifestyle recommendations:
o Sleep hygiene education: Encourage good sleep habits like
consistent sleep schedules, limiting caffeine, and creating a
restful sleep environment.
o Cognitive Behavioral Therapy for Insomnia (CBT-I): If
stress or anxiety is a factor, this may be helpful.
3. Differential Diagnosis:
For a patient with trouble sleeping, you'll need to consider a broad
differential diagnosis, including but not limited to:
• Primary insomnia: Difficulty sleeping without an underlying
medical condition.
• Sleep apnea: Disrupted sleep due to breathing problems.
• Restless Leg Syndrome: Discomfort in legs interfering with
sleep.
• Depression or anxiety disorders: Common causes of sleep
disturbances.
• Medication-induced insomnia: Certain drugs (e.g., beta-
blockers, antidepressants) can cause sleep problems.
4. Grading and Evaluation:
• Make sure your HPI captures the important details, as it
accounts for 10% of the grade.
• Your diagnostic plan and management of all the relevant
differential diagnoses will account for 40% of the grade.
• Finally, your overall score is affected by how efficiently and
accurately you work through the I-Human simulation (50%).
1. Expanded History of Present Illness (HPI)
You will need to gather precise details about her sleep difficulty:
Questions to ask:
1. Sleep Patterns:
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