Shadow Health Depression Test Questions and Answers Rated A
Chief Complaint - -Ms. Abigail Harris is an Family History - -No family history of
86-year-old African American woman who mental illness.
presented in the ED with weakness and fatigue.
Social History - -Occupations: Retired high
History of Present Illness - -Reports school English teacher.
weakness and fatigue for last month, increasing Marital Status: Widowed; husband died six years
over last 7 days. Ms. Harris is occasionally ago.
unable to get out of bed in the morning. The Substance Use: Never used tobacco. Drinks one
timing of fatigue is every morning. Reports that alcoholic beverage less than once a month.
her fatigue is somewhat alleviated by lying down, Religion: Christian (Non-denominational).
and that she has slightly more energy in the Her son is her primary caregiver and helps her
afternoon. No known triggers. Reports feeling manage medications, including refilling and
guilty about appearance and lack of social picking up prescriptions and ensuring she is
interaction last two weeks. complaint. Ms. Harris reports that her depression
Reports not leaving her house much. She reports started after the loss of her husband. Since then,
a depression diagnosis, and her current she has moved in with her son and his family.
depression screening shows her positive for Previously had organized a knitting group at her
moderate depressive symptoms. church and attended weekly, and walked most
evenings for her dog and for exercise and stress
management.
Allergies - -NKA/NKDA
Review of Relevant Systems - -GENERAL:
Past Medical History - -Hypothyroidism Lost 9 pounds over the last month. Has some
age 50 trouble falling asleep and staying asleep.
DM Type II age 50 Daytime fatigue, worst in morning, like a
Depression age 81 "hangover."
Previous hospitalization (36 years ago) for HEENT: Dizzy in the morning. Mild presbycusia
fatigue and weight loss related to DM II and and presbyopia (corrected with glasses)
hypothyroidism RESPIRATORY: Reports shortness of breath
walking around the house (ex. to the bathroom).
Mostly lays in bed at home lately.
Past Surgical History - -No previous GASTROINTESTINAL: Positive for anorexia: less
surgeries. desire to eat until later in the day. Still takes
regular insulin "TID" (mealtimes). Positive for mild
nausea and constipation. Negative for abdominal
tenderness.
Medication History - -Insulin aspart: 16
MUSCULOSKELETAL: Negative for joint pain,
units, SC, TID mealtimes
swelling.
Insulin glargine: 45 units, SC, daily
NEUROLOGICAL: Weak, nearly fell twice last
Levothyroxine: 50 mcg, P.O., daily
week.
Venlafaxine extended-release (Effexor XR): 150
PSYCHOLOGICAL: History of depression and
mg P.O. daily
has a prescribed antidepressant medication.
Zolpidem: 5 mg, P.O., PRN at bedtime
Does not endorse sad mood. Lost interest and
pleasure associated with church and social
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Chief Complaint - -Ms. Abigail Harris is an Family History - -No family history of
86-year-old African American woman who mental illness.
presented in the ED with weakness and fatigue.
Social History - -Occupations: Retired high
History of Present Illness - -Reports school English teacher.
weakness and fatigue for last month, increasing Marital Status: Widowed; husband died six years
over last 7 days. Ms. Harris is occasionally ago.
unable to get out of bed in the morning. The Substance Use: Never used tobacco. Drinks one
timing of fatigue is every morning. Reports that alcoholic beverage less than once a month.
her fatigue is somewhat alleviated by lying down, Religion: Christian (Non-denominational).
and that she has slightly more energy in the Her son is her primary caregiver and helps her
afternoon. No known triggers. Reports feeling manage medications, including refilling and
guilty about appearance and lack of social picking up prescriptions and ensuring she is
interaction last two weeks. complaint. Ms. Harris reports that her depression
Reports not leaving her house much. She reports started after the loss of her husband. Since then,
a depression diagnosis, and her current she has moved in with her son and his family.
depression screening shows her positive for Previously had organized a knitting group at her
moderate depressive symptoms. church and attended weekly, and walked most
evenings for her dog and for exercise and stress
management.
Allergies - -NKA/NKDA
Review of Relevant Systems - -GENERAL:
Past Medical History - -Hypothyroidism Lost 9 pounds over the last month. Has some
age 50 trouble falling asleep and staying asleep.
DM Type II age 50 Daytime fatigue, worst in morning, like a
Depression age 81 "hangover."
Previous hospitalization (36 years ago) for HEENT: Dizzy in the morning. Mild presbycusia
fatigue and weight loss related to DM II and and presbyopia (corrected with glasses)
hypothyroidism RESPIRATORY: Reports shortness of breath
walking around the house (ex. to the bathroom).
Mostly lays in bed at home lately.
Past Surgical History - -No previous GASTROINTESTINAL: Positive for anorexia: less
surgeries. desire to eat until later in the day. Still takes
regular insulin "TID" (mealtimes). Positive for mild
nausea and constipation. Negative for abdominal
tenderness.
Medication History - -Insulin aspart: 16
MUSCULOSKELETAL: Negative for joint pain,
units, SC, TID mealtimes
swelling.
Insulin glargine: 45 units, SC, daily
NEUROLOGICAL: Weak, nearly fell twice last
Levothyroxine: 50 mcg, P.O., daily
week.
Venlafaxine extended-release (Effexor XR): 150
PSYCHOLOGICAL: History of depression and
mg P.O. daily
has a prescribed antidepressant medication.
Zolpidem: 5 mg, P.O., PRN at bedtime
Does not endorse sad mood. Lost interest and
pleasure associated with church and social
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