NR 602 week 3 ihuman Performance Overview for Victoria Jupin on case Hailey Richardson

11 August 2024

Performance Overview for Victoria Jupin on case Hailey Richardson

The following table summarizes your performance on each section of the case, whether you completed that section or not.

  • Time spent: 3 hours, 37 minutes, 48 seconds
  • Status: Submitted

Case Section Performance:

  1. History
    • Status: Done
    • Score: 100%
    • Time spent: 16 minutes, 7 seconds
    • Performance Details: 44 questions asked, 35 correct, 0 missed relative to the case’s list.
  2. Physical Exams
    • Status: Done
    • Score: 96%
    • Time spent: 36 minutes, 5 seconds
    • Performance Details: 38 exams performed, 21 correct, 1 partially correct, 0 missed relative to the case’s list.
  3. Key Findings Organization
    • Status: Done
    • Time spent: 3 minutes, 30 seconds
    • Performance Details: 11 findings listed; 9 listed by the case.
  4. Problem Statement
    • Status: Done
    • Time spent: 8 minutes, 8 seconds
    • Performance Details: 81 words long; the case’s was 85 words.
  5. Differentials
    • Status: Done
    • Score: 100%
    • Time spent: 3 minutes, 15 seconds
    • Performance Details: 4 items in the DDx, 4 correct, 0 missed relative to the case’s list.
  6. Differentials Ranking
    • Status: Done
    • Score: 100% (lead/alt score) 100% (must not miss score)
    • Time spent: 0 seconds
  7. Tests
    • Status: Done
    • Score: 100%
    • Time spent: 5 minutes, 47 seconds
    • Performance Details: 4 correct tests ordered, 3 extraneous, 0 missed relative to the case’s list.
  8. Diagnosis
    • Status: Done
    • Score: 100%
    • Time spent: 4 seconds
  9. Management Plan
    • Status: Done
    • Time spent: 1 hour, 26 minutes, 40 seconds
    • Performance Details: 866 words long; the case’s was 46 words.
  10. Exercises
    • Status: Done
    • Score: 98% (of scored items only)
    • Time spent: 6 minutes, 27 seconds
    • Performance Details: 5 of 6 correct (of scored items only), 1 partially correct.

History Notecard by Victoria Jupin on case Hailey Richardson

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 Symptoms (Sx):
    • Sx =
    • Sx =
    • Sx =
    • Sx =
    • Sx =
    • Sx =

OnsetLocationDurationCharacteristicsAggravatingRelievingTiming / TreatmentsSeverity

Problem Statement by Victoria Jupin on case Hailey Richardson

  • H.R is a 65-year-old retired teacher with a chief complaint (CC) of insomnia, nervousness, fatigue, and palpitations progressively worsening over the past few months. She additionally notes an increase in soft bowel movements, heat intolerance, and unintentional weight loss despite increased appetite. Physical exam findings include tachycardia, a mildly enlarged (45g) soft, non-tender thyroid with a ropey isthmus, hyperreflexia, and coarse tremor on extension of hands. The patient is negative for abnormal heart sounds, abdominal discomfort, or pupil abnormalities. Family history is significant for a grandmother with a thyroid problem.

Management Plan by Victoria Jupin on case Hailey Richardson

  • Diagnosis: Hyperthyroidism, Graves' disease
  • Diagnostic Tests:
    • Free thyroxine (FT4): 2.8 ng/dL, Elevated level
    • Thyroid Scan: 131 Iodine scan shows 65% homogeneous uptake bilaterally, R slightly greater than L with prominent isthmus - Consistent with Graves' disease
    • Thyroid-stimulating hormone (TSH): 0.02, suppressed below normal level
    • Thyroid-stimulating immunoglobulin (TSI): >2.0, elevated levels of thyroid stimulating immunoglobulin are consistent with an autoimmune thyroid process.