I-HUMAN PATIENTS PRACTICE CASE Marvin Webster Answers
I-HUMAN PATIENTS PRACTICE CASE
Marvin Webster
18 y/o
6′ 0″ (183 cm)
185.0 lb (84.1 kg)
Reason for encounter
Fatigue and cough
Case Problem Statement
This is an 18-year-old male college student with a history of childhood asthma who presents with acute onset of nonproductive cough, sore throat, fatigue, myalgias, and headache x 4 days. He reports a sick contact, and has not had annual flu vaccine or COVID booster. Physical examination reveals a temperature of 101°F, tachycardia, erythematous pharynx, and anterior cervical lymphadenopathy, but is negative for adventitious breath sounds and hepatosplenomegaly.
History & Physical Exam – Marvin Webster Jr i-Human Patients Case Study
All History Questions
How can I help you today?
How does this affect your life?
When did your cough start?
Are you coughing up any sputum?
Have you had any other contact with other sick people?
Has anyone else you know developed these symptoms?
Do you have any allergies?
Have you had a flu shot this year?
Do you have a sore throat?
When did your sore throat start?
does anything make your sore throat better or worse?
what treatments have you had for your sore throat?
How severe is your sore throat?
When did your headache start?
Does anything make your headache better or worse?
How severe (1-10 scale) is your headache?
What treatments have you had for your headache?
Does your headache come and go?
Do you have any pain in your chest?
Do you have any other symptoms or concerns that we should discuss?
Have you had any contact with other sick people?
Is your fatigue unrelated to physical effort?
How severe is your fatigue/ tiredness?
Does your fatigue/ tiredness improve after a good night’s rest?
Do you feel unwell, not normal or just “not yourself” (malaise) lately?
Do you wheeze?
Are you short of breath?
Do you have new headaches that you have not experienced previously?
What are the events surrounding the start of your headache?
Do you have a runny nose/ nasal congestion?
Does your sore throat come and go?
What are the events surrounding the start of your sore throat?
Do you have a problem swallowing?
Do you have pain in your chest?
Are your immunizations up to date?
Do you have chills?
Does your chest feel tight or heavy?
Are you short of breath?
Do you have muscle pain or cramping?
What symptom is the most distressing for you?
What is your name?
Are you taking any over-the-counter or herbal medications?
Are you taking any prescription medications?
Is there anything I can do for you right now?
Can you tell me about any current or past medical problems you have had?
Marvin Webster Jr i-Human Patients Case Study
All physical exams
Temperature
Vitals: Pulse
Vitals: blood pressure
Vitals: respiration
Abdomen: Palpate abdomen
Heart: Auscultate heart
HEENT: Inspect mouth/Pharynx
Neck: Evaluate neck range of motion
Neck: Palpate Neck
Marvin Webster Jr i-Human Patients Case Study
Case: Key Findings
Key Finding
Temperature 101°F
Tachycardia
Dry cough
Myalgias
Sore throat, erythematous pharynx
Headache
Cervical lymphadenopathy
Fatigue
Case: Key Findings Feedback – Marvin Webster Jr i-Human Patients Case Study
Temperature 101°F: In most cases, this is indicative of immunologic response. However, fever can also be induced by a defective heat loss mechanism that cannot accommodate normal heat loads (ie heat stroke) or in scenarios where heat production exceeds heat loss (i.e. hyperthyroidism)
Tachycardia: Increased heart rate is frequently a concomitant of fever.
Dry cough: There are three main mechanisms responsible for a cough. In this case, the cough receptors are being stimulated by mechanical stimuli like upper respiratory tract secretions. Cough can also be triggered by pulmonary C-fibers reacting to a chemical or when the cough receptors are activated by smooth muscle contraction and gastric acid
Myalgias. The acuity of sore muscles typically aids the practitioner in determining the source of its pathology For the acute onset of myalgia, common causes include viral or bacterial infections, injury, and vitamin/mineral deficiencies. For chronic myalgias, clinicians should consider musculoskeletal, autoimmune, or mental health conditions
Sore throat, erythematous pharynx: Inflammation of the mucosa of the oropharynx is the most familiar culprit of throat pain, secondary to an infectious cause Marvin Webster Jr i-Human Patients Case Study
Headache: Headaches can be classified as primary or secondary. Primary headaches account for approximately 90% of all headaches and are not attributed to structural pathology or systemic disease. Secondary headaches are attributed to underlying disorders. Abrupt onset suggests a secondary headache and severity and location of pain extend guidance toward pathology and precariousness
Cervical lymphadenopathy: Inflammation of the pharynx and its associated lymph fluid drain to the upper cervical nodes in front of the sternocleidomastoid muscle. Adenopathy in other cervical and axillary lymph nodes in the presence of sore throat demonstrates a higher likelihood ratio for infectious mononucleosis Marvin Webster Jr i-Human Patients Case Study
Fatigue Acute onset fatigue (defined as less than 6 months) frequently occurs as a prodrome of bactena! and viral illnesses.
Get FREE Marvin Webster i-Human Case Answers
Click here to get the History Questions to ask for this iHuman Case. No payment upfront, only pay after you are satisfied with your grade.
Marvin Webster Plan
Pharmacologic Care:
Acetaminophen OTC 325 mg 1-2 tabs PO q 4-6 hours; maximum dose 10 tablets per day prn fever, headache, myalgias
Dextromethorphan HBr + guaifenesin 20mg/400 mg 20 mL PO q 4 hrs; maximum dose 6 doses daily prn cough
Supportive Care:
Increase fluid intake
Rest – no class attendance – school note provided for 48 hours
Patient Education:
Offered education on the diagnosis and treatments provided
Educated patient that oseltamivir is not indicated given timeline since symptom onset
Follow-Up/Disposition:
Follow up in the student health center if not improving within 48 hours or headache worsens or if shortness of breath develops
At future visit, address vaccination status – encourage flu vaccine and COVID booster
Marvin Webster Jr i-Human Patients Case Study
To prepare:
Be sure that you have thoroughly reviewed the i-Human Patients Case Player Student Manualin the Week 2 Learning Resources.
Access the required i-Human Patients Marvin Webster, Jr.practice case study from the Week 2 Learning Resources.
Assignment
As you interact with the Marvin Webster, Jr. i-Human Patients practice case, complete the assigned case study. Upload your PDF from i-Human Patients to this Assignment.