,Patient Information
Name: Michael Reynolds
Age: 45 years old
Gender: Male
Chief Complaint: Arm weakness
Informant: Patient (Michael Reynolds)
Case Overview
Michael Reynolds, a 45-year-old male, presents to the primary care clinic with a one-week history of
weakness in his right arm. The i-Human simulation for NRNP 6512 (Week 4) challenges learners to
perform a thorough health assessment, including a detailed history, a focused neurological and
musculoskeletal physical exam, a differential diagnosis for arm weakness, targeted diagnostic tests, and
an evidence-based, patient-centered management plan. The case emphasizes clinical reasoning,
distinguishing neurological from musculoskeletal causes, patient communication, and integration of
2025 healthcare technologies (e.g., AI-driven neurological assessment tools, telehealth) to optimize
care. The goal is to identify the underlying cause of arm weakness while addressing potential serious
conditions.
Step 1: History of Present Illness (HPI)Chief Complaint: “My right arm has been feeling weak for about a
week, and it’s hard to lift things.”History-Taking (i-Human Interface Description):
Screenshot Description: The i-Human history-taking interface displays a virtual patient (Michael
Reynolds) in a clinic room, with a text input field for asking questions. The learner selects from a
dropdown menu of question categories (e.g., OLDCARTS, Associated Symptoms, Past Medical
History) or types free-text questions. Responses appear in a dialogue box, with a progress bar
tracking history completeness (e.g., “History 85% complete”).
Process: The learner uses the OLDCARTS framework (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Related symptoms, Treatment, Severity) to gather a
comprehensive history. Open-ended questions (e.g., “Can you describe the weakness in your
arm?”) are combined with targeted questions (e.g., “Have you had any numbness or tingling?”)
, to elicit details. The interface highlights key symptoms in red (e.g., “weakness,” “numbness”) to
guide differential diagnosis development.
HPI Details:
Onset: Weakness began 7 days ago, noticed after lifting heavy boxes at work. Gradual onset, not
sudden.
Location: Right arm, primarily affecting the proximal muscles (shoulder, upper arm); weakness
extends to grip strength but is less severe distally.
Duration: Persistent for 7 days, with slight worsening over time; no complete resolution.
Characteristics:
Weakness described as “heaviness” and difficulty lifting objects (e.g., unable to lift a 10-
lb box overhead).
Mild numbness and tingling in the right forearm and hand, intermittent, rated 3/10.
No complete paralysis or loss of sensation.
No pain in the arm, but mild stiffness in the right shoulder.
Aggravating Factors: Weakness worsens with repetitive arm movements (e.g., lifting, typing) or
prolonged use.
Alleviating Factors: Resting the arm reduces the sense of heaviness; no significant relief from
over-the-counter remedies.
Related Symptoms:
Occasional mild headache, non-specific, rated 2/10, no visual changes or nausea.
No speech difficulties, facial drooping, or leg weakness.
No chest pain, shortness of breath, or palpitations.
No fever, weight loss, night sweats, or systemic symptoms.
Treatment:
Name: Michael Reynolds
Age: 45 years old
Gender: Male
Chief Complaint: Arm weakness
Informant: Patient (Michael Reynolds)
Case Overview
Michael Reynolds, a 45-year-old male, presents to the primary care clinic with a one-week history of
weakness in his right arm. The i-Human simulation for NRNP 6512 (Week 4) challenges learners to
perform a thorough health assessment, including a detailed history, a focused neurological and
musculoskeletal physical exam, a differential diagnosis for arm weakness, targeted diagnostic tests, and
an evidence-based, patient-centered management plan. The case emphasizes clinical reasoning,
distinguishing neurological from musculoskeletal causes, patient communication, and integration of
2025 healthcare technologies (e.g., AI-driven neurological assessment tools, telehealth) to optimize
care. The goal is to identify the underlying cause of arm weakness while addressing potential serious
conditions.
Step 1: History of Present Illness (HPI)Chief Complaint: “My right arm has been feeling weak for about a
week, and it’s hard to lift things.”History-Taking (i-Human Interface Description):
Screenshot Description: The i-Human history-taking interface displays a virtual patient (Michael
Reynolds) in a clinic room, with a text input field for asking questions. The learner selects from a
dropdown menu of question categories (e.g., OLDCARTS, Associated Symptoms, Past Medical
History) or types free-text questions. Responses appear in a dialogue box, with a progress bar
tracking history completeness (e.g., “History 85% complete”).
Process: The learner uses the OLDCARTS framework (Onset, Location, Duration, Characteristics,
Aggravating/Alleviating factors, Related symptoms, Treatment, Severity) to gather a
comprehensive history. Open-ended questions (e.g., “Can you describe the weakness in your
arm?”) are combined with targeted questions (e.g., “Have you had any numbness or tingling?”)
, to elicit details. The interface highlights key symptoms in red (e.g., “weakness,” “numbness”) to
guide differential diagnosis development.
HPI Details:
Onset: Weakness began 7 days ago, noticed after lifting heavy boxes at work. Gradual onset, not
sudden.
Location: Right arm, primarily affecting the proximal muscles (shoulder, upper arm); weakness
extends to grip strength but is less severe distally.
Duration: Persistent for 7 days, with slight worsening over time; no complete resolution.
Characteristics:
Weakness described as “heaviness” and difficulty lifting objects (e.g., unable to lift a 10-
lb box overhead).
Mild numbness and tingling in the right forearm and hand, intermittent, rated 3/10.
No complete paralysis or loss of sensation.
No pain in the arm, but mild stiffness in the right shoulder.
Aggravating Factors: Weakness worsens with repetitive arm movements (e.g., lifting, typing) or
prolonged use.
Alleviating Factors: Resting the arm reduces the sense of heaviness; no significant relief from
over-the-counter remedies.
Related Symptoms:
Occasional mild headache, non-specific, rated 2/10, no visual changes or nausea.
No speech difficulties, facial drooping, or leg weakness.
No chest pain, shortness of breath, or palpitations.
No fever, weight loss, night sweats, or systemic symptoms.
Treatment:
