I-HUMAN DDX SHEILA DAVIS VIRTUAL PATIENT CASE STUDY |
DIZZINESS | DIFFERENTIAL DIAGNOSIS & CLINICAL REASONING
| EXAM STUDY GUIDE | A+ NURSING REVIEW | 2026/2027 UPDATE
,SECTION 1: CASE OVERVIEW & PATIENT DEMOGRAPHICS
1.1 Introduction to the i-Human Virtual Patient Platform
The i-Human virtual patient platform, now part of Kaplan's educational offerings, provides
healthcare students and professionals with immersive, interactive clinical encounters
designed to sharpen diagnostic reasoning and clinical decision-making skills. Through
virtual patient encounters, students master cognitive-based concepts and clinical
assessment skills in a safe, repeatable environment. The platform employs a dynamic
differential diagnosis training system that simulates real-life clinical reasoning, allowing
learners to refine their diagnostic hypotheses through iterative modification and
refinement.
This case study presents a comprehensive analysis of Sheila Davis, a 68-year-old female
who presents with a chief complaint of dizziness. The case is designed to challenge
advanced practice nursing students and medical learners to systematically evaluate a
geriatric patient with a common yet diagnostically complex presenting symptom.
1.2 Patient Demographics and Identifying Data
Patient Information Details
Name Sheila Davis
Age 68 years
Sex Female
Ethnicity Caucasian
Reason for Encounter Dizziness
,Patient Information Details
Date of Encounter [Current date]
Setting Outpatient Clinic
1.3 Chief Complaint (CC)
Patient's own words: "I've been feeling dizzy and lightheaded for the past few days. It feels
like the room is spinning, and I'm afraid I might fall."
SECTION 2: HISTORY OF PRESENT ILLNESS (HPI)
2.1 Comprehensive HPI Using the OLD CARTS Framework
Onset
The patient reports that symptoms began approximately 4 days ago. She states that the
dizziness came on suddenly without any identifiable precipitating event. She denies any
recent illnesses, trauma, or medication changes prior to symptom onset.
Location
The patient describes the sensation as "room-spinning" vertigo, characterized as a true
rotational vertigo. She localizes the sensation to her head and reports feeling as though her
environment is moving around her. She denies any pain associated with the dizziness.
Duration
The episodes are episodic in nature, occurring 3–4 times per day. Individual episodes last
anywhere from 5 to 30 minutes, though she reports that some episodes have persisted
for several hours. The variability in episode duration is an important clinical clue that helps
distinguish between potential etiologies.
Characteristics
The patient describes the sensation as true rotational vertigo—a spinning sensation as
though the room is moving. She differentiates this from lightheadedness or presyncope,
stating clearly that the primary sensation is that of movement. This distinction is critical in
the differential diagnosis process, as true vertigo points toward vestibular pathology rather
than cardiovascular or metabolic causes.
, Aggravating Factors
The patient identifies several triggers that precipitate her symptoms:
• Turning her head, particularly to the right
• Rolling over in bed
• Looking upward
• Any rapid changes in head position
The positional nature of her symptoms is a hallmark finding that strongly suggests a
specific diagnosis.
Relieving Factors
The patient reports that symptoms typically resolve with:
• Maintaining a stationary head position
• Sitting or lying still
• Avoiding head movements
• Resting in a quiet environment
Timing
The episodes are intermittent and unpredictable. She reports that symptoms can occur
at any time of day but are most commonly triggered by specific movements. She denies
any circadian pattern to her symptoms.
Severity
On a 0–10 scale, the patient rates the severity of her vertigo episodes as 7–8/10 during
acute episodes. Between episodes, she rates her symptoms as 0–1/10. She reports that
the episodes are distressing and interfere with her ability to perform activities of daily living.
2.2 Associated Symptoms
The patient reports several symptoms that accompany her vertigo episodes:
Associated Symptom Description
Nausea Present during most episodes; mild to moderate intensity
DIZZINESS | DIFFERENTIAL DIAGNOSIS & CLINICAL REASONING
| EXAM STUDY GUIDE | A+ NURSING REVIEW | 2026/2027 UPDATE
,SECTION 1: CASE OVERVIEW & PATIENT DEMOGRAPHICS
1.1 Introduction to the i-Human Virtual Patient Platform
The i-Human virtual patient platform, now part of Kaplan's educational offerings, provides
healthcare students and professionals with immersive, interactive clinical encounters
designed to sharpen diagnostic reasoning and clinical decision-making skills. Through
virtual patient encounters, students master cognitive-based concepts and clinical
assessment skills in a safe, repeatable environment. The platform employs a dynamic
differential diagnosis training system that simulates real-life clinical reasoning, allowing
learners to refine their diagnostic hypotheses through iterative modification and
refinement.
This case study presents a comprehensive analysis of Sheila Davis, a 68-year-old female
who presents with a chief complaint of dizziness. The case is designed to challenge
advanced practice nursing students and medical learners to systematically evaluate a
geriatric patient with a common yet diagnostically complex presenting symptom.
1.2 Patient Demographics and Identifying Data
Patient Information Details
Name Sheila Davis
Age 68 years
Sex Female
Ethnicity Caucasian
Reason for Encounter Dizziness
,Patient Information Details
Date of Encounter [Current date]
Setting Outpatient Clinic
1.3 Chief Complaint (CC)
Patient's own words: "I've been feeling dizzy and lightheaded for the past few days. It feels
like the room is spinning, and I'm afraid I might fall."
SECTION 2: HISTORY OF PRESENT ILLNESS (HPI)
2.1 Comprehensive HPI Using the OLD CARTS Framework
Onset
The patient reports that symptoms began approximately 4 days ago. She states that the
dizziness came on suddenly without any identifiable precipitating event. She denies any
recent illnesses, trauma, or medication changes prior to symptom onset.
Location
The patient describes the sensation as "room-spinning" vertigo, characterized as a true
rotational vertigo. She localizes the sensation to her head and reports feeling as though her
environment is moving around her. She denies any pain associated with the dizziness.
Duration
The episodes are episodic in nature, occurring 3–4 times per day. Individual episodes last
anywhere from 5 to 30 minutes, though she reports that some episodes have persisted
for several hours. The variability in episode duration is an important clinical clue that helps
distinguish between potential etiologies.
Characteristics
The patient describes the sensation as true rotational vertigo—a spinning sensation as
though the room is moving. She differentiates this from lightheadedness or presyncope,
stating clearly that the primary sensation is that of movement. This distinction is critical in
the differential diagnosis process, as true vertigo points toward vestibular pathology rather
than cardiovascular or metabolic causes.
, Aggravating Factors
The patient identifies several triggers that precipitate her symptoms:
• Turning her head, particularly to the right
• Rolling over in bed
• Looking upward
• Any rapid changes in head position
The positional nature of her symptoms is a hallmark finding that strongly suggests a
specific diagnosis.
Relieving Factors
The patient reports that symptoms typically resolve with:
• Maintaining a stationary head position
• Sitting or lying still
• Avoiding head movements
• Resting in a quiet environment
Timing
The episodes are intermittent and unpredictable. She reports that symptoms can occur
at any time of day but are most commonly triggered by specific movements. She denies
any circadian pattern to her symptoms.
Severity
On a 0–10 scale, the patient rates the severity of her vertigo episodes as 7–8/10 during
acute episodes. Between episodes, she rates her symptoms as 0–1/10. She reports that
the episodes are distressing and interfere with her ability to perform activities of daily living.
2.2 Associated Symptoms
The patient reports several symptoms that accompany her vertigo episodes:
Associated Symptom Description
Nausea Present during most episodes; mild to moderate intensity
