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Camilla Franklin I-Human Case Study Week 10
Fatigue Irritability 48-Year-Old Primary Care Actual
Exam 2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
History Taking & Differential Diagnosis
Q1: Camilla Franklin presents to your clinic stating, "I just feel tired all the time, and I'm
snapping at everyone at work and home." To best characterize her fatigue, which is the most
appropriate initial question to ask?
A. Do you think you might have anemia or a thyroid problem?
B. Is your fatigue constant throughout the day, or does it tend to be worse in the morning or
evening?
C. Have you been taking any over-the-counter medications like vitamins or supplements?
D. How many hours of sleep do you usually get on a typical night?
Correct Answer: B
Rationale: The best answer is B because clarifying the timing and pattern of fatigue helps
differentiate between organic causes like hypothyroidism (often worse in the morning or
constant) and sleep disorders or depression.
Q2: During the review of systems, Camilla mentions she has been having trouble with
constipation over the last two months. In the context of fatigue, which associated symptom
would most strongly point you toward a thyroid etiology rather than a gastrointestinal origin?
A. Abdominal cramping and bloating
B. Blood in the stool
C. Intolerance to cold weather
D. Nausea after eating
Correct Answer: C
,2
Rationale: This choice is correct because cold intolerance, when clustered with fatigue and
constipation, is a classic triad for hypothyroidism, whereas the other options are more specific to
primary GI disorders.
Q3: You ask Camilla about her menstrual history. She reports that her periods have become
irregular over the past six months, sometimes skipping a month, and flow has been lighter. At 48
years old, what is the most clinically relevant reason for asking about vasomotor symptoms like
hot flashes?
A. To confirm if she is in perimenopause, which could explain both irregular periods and fatigue
B. To determine if she needs a referral to gynecology for endometrial ablation
C. To rule out pregnancy as the cause of her fatigue
D. To see if she is a candidate for oral contraceptives to regulate her cycle
Correct Answer: A
Rationale: This choice is correct because perimenopause is a primary differential diagnosis for
fatigue and irritability in a 48-year-old, and the presence of hot flashes would support this
diagnosis alongside her menstrual irregularities.
Q4: Camilla reports that her hair texture has changed, becoming dry and brittle, and she notices
more hair falling out in the shower drain. Which focused question helps differentiate
hypothyroidism from iron deficiency anemia as the cause of these changes?
A. Do you have heavy menstrual bleeding or blood in your stool?
B. Do you feel unusually cold when others are comfortable?
C. Have you had any recent unexplained weight loss?
D. Are you experiencing any palpitations or rapid heartbeat?
Correct Answer: A
Rationale: The best answer is A because iron deficiency anemia is often caused by blood loss;
asking about heavy periods or GI bleeding identifies the source, whereas cold intolerance (B) is
non-specific to the hair loss cause.
Q5: When screening for depression, which is a "red flag" symptom that requires immediate
safety planning and evaluation rather than just routine outpatient workup?
, 3
A. Loss of interest in hobbies
B. Feelings of guilt or worthlessness
C. Passive thoughts that "life isn't worth living"
D. Specific plan and intent to harm herself
Correct Answer: D
Rationale: This choice is correct because active suicidal ideation with a specific plan and intent is
a psychiatric emergency requiring immediate intervention, whereas the other symptoms, while
serious, can be managed in an outpatient setting initially.
Q6: Camilla's past medical history is significant for "controlled hypertension." Which class of
antihypertensive medication is known to potentially cause fatigue and depressive symptoms as
side effects?
A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Thiazide diuretics
Correct Answer: B
Rationale: This choice is correct because beta-blockers are associated with side effects of fatigue,
lethargy, and sometimes depressive symptoms due to their central nervous system effects.
Q7: In gathering Camilla's social history, she admits to drinking "a glass or two of wine every
night to help me unwind." How does this information impact your differential diagnosis for her
fatigue?
A. It is likely the primary cause of her fatigue due to hangovers.
B. Alcohol can disrupt sleep architecture, leading to non-restorative sleep and daytime fatigue.
C. It rules out any medical causes, pointing purely to stress.
D. It indicates she has an alcohol use disorder requiring inpatient rehab.
Correct Answer: B
Camilla Franklin I-Human Case Study Week 10
Fatigue Irritability 48-Year-Old Primary Care Actual
Exam 2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
History Taking & Differential Diagnosis
Q1: Camilla Franklin presents to your clinic stating, "I just feel tired all the time, and I'm
snapping at everyone at work and home." To best characterize her fatigue, which is the most
appropriate initial question to ask?
A. Do you think you might have anemia or a thyroid problem?
B. Is your fatigue constant throughout the day, or does it tend to be worse in the morning or
evening?
C. Have you been taking any over-the-counter medications like vitamins or supplements?
D. How many hours of sleep do you usually get on a typical night?
Correct Answer: B
Rationale: The best answer is B because clarifying the timing and pattern of fatigue helps
differentiate between organic causes like hypothyroidism (often worse in the morning or
constant) and sleep disorders or depression.
Q2: During the review of systems, Camilla mentions she has been having trouble with
constipation over the last two months. In the context of fatigue, which associated symptom
would most strongly point you toward a thyroid etiology rather than a gastrointestinal origin?
A. Abdominal cramping and bloating
B. Blood in the stool
C. Intolerance to cold weather
D. Nausea after eating
Correct Answer: C
,2
Rationale: This choice is correct because cold intolerance, when clustered with fatigue and
constipation, is a classic triad for hypothyroidism, whereas the other options are more specific to
primary GI disorders.
Q3: You ask Camilla about her menstrual history. She reports that her periods have become
irregular over the past six months, sometimes skipping a month, and flow has been lighter. At 48
years old, what is the most clinically relevant reason for asking about vasomotor symptoms like
hot flashes?
A. To confirm if she is in perimenopause, which could explain both irregular periods and fatigue
B. To determine if she needs a referral to gynecology for endometrial ablation
C. To rule out pregnancy as the cause of her fatigue
D. To see if she is a candidate for oral contraceptives to regulate her cycle
Correct Answer: A
Rationale: This choice is correct because perimenopause is a primary differential diagnosis for
fatigue and irritability in a 48-year-old, and the presence of hot flashes would support this
diagnosis alongside her menstrual irregularities.
Q4: Camilla reports that her hair texture has changed, becoming dry and brittle, and she notices
more hair falling out in the shower drain. Which focused question helps differentiate
hypothyroidism from iron deficiency anemia as the cause of these changes?
A. Do you have heavy menstrual bleeding or blood in your stool?
B. Do you feel unusually cold when others are comfortable?
C. Have you had any recent unexplained weight loss?
D. Are you experiencing any palpitations or rapid heartbeat?
Correct Answer: A
Rationale: The best answer is A because iron deficiency anemia is often caused by blood loss;
asking about heavy periods or GI bleeding identifies the source, whereas cold intolerance (B) is
non-specific to the hair loss cause.
Q5: When screening for depression, which is a "red flag" symptom that requires immediate
safety planning and evaluation rather than just routine outpatient workup?
, 3
A. Loss of interest in hobbies
B. Feelings of guilt or worthlessness
C. Passive thoughts that "life isn't worth living"
D. Specific plan and intent to harm herself
Correct Answer: D
Rationale: This choice is correct because active suicidal ideation with a specific plan and intent is
a psychiatric emergency requiring immediate intervention, whereas the other symptoms, while
serious, can be managed in an outpatient setting initially.
Q6: Camilla's past medical history is significant for "controlled hypertension." Which class of
antihypertensive medication is known to potentially cause fatigue and depressive symptoms as
side effects?
A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Thiazide diuretics
Correct Answer: B
Rationale: This choice is correct because beta-blockers are associated with side effects of fatigue,
lethargy, and sometimes depressive symptoms due to their central nervous system effects.
Q7: In gathering Camilla's social history, she admits to drinking "a glass or two of wine every
night to help me unwind." How does this information impact your differential diagnosis for her
fatigue?
A. It is likely the primary cause of her fatigue due to hangovers.
B. Alcohol can disrupt sleep architecture, leading to non-restorative sleep and daytime fatigue.
C. It rules out any medical causes, pointing purely to stress.
D. It indicates she has an alcohol use disorder requiring inpatient rehab.
Correct Answer: B
