NR511 Week 2 iHuman Case: Nora Higgins

NR511 Week 2 iHuman: Nora Higgins — **NR511 Week 2 iHuman Case: Nora Higgins**

History Feedback

Ask relevant problem-focused questions to create an accurate initial differential diagnosis list. Various questions may yield the same information. Examples of high-yield questions for this case include:

• Performed x Missed

HPI	How can I help you today? (patient)	I have this itchy rash on my hands that won’t go away.
HPI	Do you have any other symptoms or concerns we should discuss? (patient)	Not really, just my ongoing skin issues.
PMH	Do you have any allergies? (patient)	Yes, I’m allergic to dust mites and pollen. I don’t have any medication allergies.
PMH	What is your allergic reaction? (patient)	The dust mites and pollen make me congested and my throat a little sore.

Physical Exam Feedback

• Performed Correctly Not Required, Not Inappropriate

& Partially Correct

Preferred Exams	My Exams	Feedback个司
• cognitive status O	* cognitive status	+ Not Required, Not Inappropriate
• height	® height	+ Not Required, Not Inappropriate
• weight	* weight	+ Not Required, Not Inappropriate
• blood pressure	• blood pressure	• Performed Correctly
• pulse	• pulse	• Performed Correctly
• respiration	• respiration	• Performed Correctly

Your Findings	Case Findings
• Itchy rash for 2 weeks	• 13-year-old patient
• Dorsal hands erythematous and flaky	Progressively worsening itchy hands for 2 weeks
• Lichenification of antecubital fossae	• Chronic dry skin for 7 months, worsens in the winter
• Dry skin for 7 months	• History of environmental allergies and asthma
• Negative Auspitz sign	Use of scented lotion, new stacker rings
• Environmental allergies	Denies exposures to environmental/plant-based irritants
• Use of scented lotion and stacker rings	• Denies new lotions, soaps, or detergents
• 13 year old patient	• Dorsal aspects of the hands erythematous, flaky, and
• PMH of asthma	dry, with poorly demarcated borders
	• Thickened, leathery skin on bilateral antecubital fossae

Plan Feedback

Pharmacologic Care:

Continue with prior medications as prescribed
Prescribe triamcinolone acetonide 0.025% topical cream. Apply to the affected area(s) once daily for 2 weeks.
Recommend switching to an over-the-counter fragrance-free emollient lotion. Apply to the affected area(s) at least once daily and as needed for dry skin………………………………purchase this entire case at $30 only