IHUMAN CASE BETTY BURNS PERFORMANCE OVERVIEW

IHUMAN CASE BETTY BURNS PERFORMANCE OVERVIEW The following table summarizes your performance on each section of the case, whether you completed that section or not. Status: Submitted Case Section Status Your Score ...

IHUMAN CASE BETTY BURNS PERFORMANCE OVERVIEW The following table summarizes your performance on each section of the case, whether you completed that section or not. Status: Submitted Case Section Status Your Score Time spent Performance Details History Done 100% 58min 42sec 50 questions asked, 33 correct, 0 missed relative to the case's list Physical exams Done 91% 1hr 46min 3sec 38 exams performed, 17 correct, 1 partially correct, 0 missed relative to the case's list Key findings organization Done 3min 17sec 11 findings listed; 11 listed by the case Problem statement Done 8min 9sec 83 words long; the case's was 67 words Differentials Done 50% 1hr 3min 7sec 6 items in the DDx, 3 correct, 3 missed relative to the case's list Differentials ranking Done 100% (lead/alt score) 83% (must not miss score) 8min 13sec Tests Done 100% 29min 6sec 10 tests ordered, 6 correct, 0 missed relative to the case's list Diagnosis Done 100% 12sec Management plan Done 3hr 33min 18sec 600 words long; the case's was 88 words Exercises Done 81% (of scored items only) 4hr 24min 25sec 1 of 3 correct (of scored items only) 2 partially correct - Report generated on 4/29/2023, 6:17:28 PM America/Denver History Notecard by - on case Betty Burns Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = back pain Sx = Sx = Sx = Sx = Sx = Onset Location lower back Duration Characteristics sharp, stabbing, gnawing Aggravating Relieving Timing / Treatments Severity 10/10 - Report generated on 4/29/2023, 6:17:28 PM America/Denver Problem Statement by - on case Betty Burns The patient is a 53-year-old female with an acute onset of radiating severe lower back pain 10/10 complaint that started 3 days ago. History is significant for left breast cancer 5 years ago; status-post unilateral mastectomy, chemotherapy, and breast reconstruction, and a 20 pound unintentional weight loss in the last 6 months. Physical exam reveals elevated BP 142/80, right lower extremity motor deficit, sensory deficit, patellar hyperreflexia, abnormal straight leg raise on the right, and right upper quadrant pain with associated with hepatomegaly. - Report generated on 4/29/2023, 6:17:28 PM America/Denver Management Plan by - on case Betty Burns Primary Diagnosis: Metastatic Cancer Status/Condition: Stable Code Status: Full Allergies: NKA Admit to Unit: Telemetry Unit Activity Level: Up as tolerated with assistance from staff. Diet: Balanced Critical Drips: Respiratory: 100% O2 Medications: - Hydrochlorothiazide - Fluticasone/Salmeterol - Prednisone PRN severe asthma attacks - Cyclobenzaprine (Flexeril) 10mg PO tid PRN for ain/back spasms - Tramadol (Ultran) 50mg PO q 4-6 hours PRN pain Nursing Orders: - Initiate short-acting opioids in patients who have never taken them: 2 mg IV morphine sulfate. - Reassess the effect after 15 minutes. - Following evaluation, if the pain score stays the same or increases, administer 50% to 100% of the previous opioid rescue dose. - Every 15 minutes, a reassessment should be done, and the same opioid dose repeated if the pain score drops to 4 to 6.