LATEST EDITION 2026/2027 NINA ADAMS
IHUMAN CASE STUDY: FATIGUE AND ARM
WEAKNESS ANALYSIS WITH ALL
ANSWERS QUALIFIED 100% PASS!!!!!
,1. Patient Overview
• Name: Nina Adams
• Chief Complaint: “I feel very tired and my arm feels weak”
• Age range: often middle-aged adult (varies by simulation version)
• Symptom onset: acute or subacute fatigue with arm weakness
• Setting: outpatient or urgent care
2. History of Present Illness (HPI)
A structured OLDCARTS + neurologic focus approach is required.
Onset
• Sudden onset → concerning for stroke or TIA
• Gradual onset → metabolic, neuromuscular, or systemic illness
Location
• Unilateral arm weakness (right or left) is more concerning than generalized fatigue
Duration
• Minutes to hours → TIA
• Persistent weakness → stroke or structural neurologic disease
Character of Symptoms
• Weakness vs numbness vs heaviness must be clarified
• True weakness suggests neurologic or muscular pathology
Associated Symptoms (CRITICAL)
Students must assess for:
• Facial drooping
• Speech difficulty (aphasia or slurred speech)
, • Vision changes
• Headache
• Dizziness or confusion
• Chest pain or palpitations
• Shortness of breath
3. Risk Factor Assessment
Neurologic Risk Factors
• Hypertension (major stroke risk factor)
• Diabetes mellitus
• Smoking
• Hyperlipidemia
• Atrial fibrillation
• Obesity
• Sedentary lifestyle
Cardiac Risk Factors
• Coronary artery disease history
• Family history of MI or stroke
• Cardiac Risk Factors
• Cardiac risk factors are conditions, behaviors, or characteristics that increase a person’s
likelihood of developing cardiovascular disease (CVD). These include diseases such as
coronary artery disease, myocardial infarction (heart attack), heart failure, and stroke.
• In clinical practice and iHuman cases like Florence Blackman (chest pain) or other
cardiovascular scenarios, identifying risk factors is essential because they help determine
whether chest pain is likely to be cardiac (dangerous) or non-cardiac.
• 1. Non-Modifiable Cardiac Risk Factors
, • These are risk factors that cannot be changed, but they significantly increase baseline
risk.
• A. Age
• Risk increases with age
• Men >45 years
• Women >55 years (or post-menopausal)
In women, risk increases after menopause due to reduced estrogen protection.
• B. Sex (Gender)
• Men develop heart disease earlier than women
• Women often present later and with atypical symptoms (fatigue, nausea, jaw pain)
Important in iHuman cases because women may not show classic chest pain.
• C. Family History (Genetics)
• First-degree relative with:
• Heart attack
• Stroke
• Early cardiovascular disease
• Example:
• Father or brother <55 years with MI
• Mother or sister <65 years with MI
• Strong indicator of inherited risk.
• D. Ethnicity
• Some populations have higher risk due to genetic and social factors:
• African ancestry (higher hypertension risk)
IHUMAN CASE STUDY: FATIGUE AND ARM
WEAKNESS ANALYSIS WITH ALL
ANSWERS QUALIFIED 100% PASS!!!!!
,1. Patient Overview
• Name: Nina Adams
• Chief Complaint: “I feel very tired and my arm feels weak”
• Age range: often middle-aged adult (varies by simulation version)
• Symptom onset: acute or subacute fatigue with arm weakness
• Setting: outpatient or urgent care
2. History of Present Illness (HPI)
A structured OLDCARTS + neurologic focus approach is required.
Onset
• Sudden onset → concerning for stroke or TIA
• Gradual onset → metabolic, neuromuscular, or systemic illness
Location
• Unilateral arm weakness (right or left) is more concerning than generalized fatigue
Duration
• Minutes to hours → TIA
• Persistent weakness → stroke or structural neurologic disease
Character of Symptoms
• Weakness vs numbness vs heaviness must be clarified
• True weakness suggests neurologic or muscular pathology
Associated Symptoms (CRITICAL)
Students must assess for:
• Facial drooping
• Speech difficulty (aphasia or slurred speech)
, • Vision changes
• Headache
• Dizziness or confusion
• Chest pain or palpitations
• Shortness of breath
3. Risk Factor Assessment
Neurologic Risk Factors
• Hypertension (major stroke risk factor)
• Diabetes mellitus
• Smoking
• Hyperlipidemia
• Atrial fibrillation
• Obesity
• Sedentary lifestyle
Cardiac Risk Factors
• Coronary artery disease history
• Family history of MI or stroke
• Cardiac Risk Factors
• Cardiac risk factors are conditions, behaviors, or characteristics that increase a person’s
likelihood of developing cardiovascular disease (CVD). These include diseases such as
coronary artery disease, myocardial infarction (heart attack), heart failure, and stroke.
• In clinical practice and iHuman cases like Florence Blackman (chest pain) or other
cardiovascular scenarios, identifying risk factors is essential because they help determine
whether chest pain is likely to be cardiac (dangerous) or non-cardiac.
• 1. Non-Modifiable Cardiac Risk Factors
, • These are risk factors that cannot be changed, but they significantly increase baseline
risk.
• A. Age
• Risk increases with age
• Men >45 years
• Women >55 years (or post-menopausal)
In women, risk increases after menopause due to reduced estrogen protection.
• B. Sex (Gender)
• Men develop heart disease earlier than women
• Women often present later and with atypical symptoms (fatigue, nausea, jaw pain)
Important in iHuman cases because women may not show classic chest pain.
• C. Family History (Genetics)
• First-degree relative with:
• Heart attack
• Stroke
• Early cardiovascular disease
• Example:
• Father or brother <55 years with MI
• Mother or sister <65 years with MI
• Strong indicator of inherited risk.
• D. Ethnicity
• Some populations have higher risk due to genetic and social factors:
• African ancestry (higher hypertension risk)
