1
Camilla Franklin I-Human Case Study – 48-
Year-Old with Fatigue and Irritability Actual
Exam 2026/2027 | Complete Exam-Style
Questions | Detailed Rationales – Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | History Taking and Chief Complaint | Q1 – Q13
Section 2 | Physical Examination and Findings | Q14 – Q25
Section 3 | Differential Diagnosis and Reasoning | Q26 – Q37
Section 4 | Diagnostic Testing and Management Plan | Q38 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: HISTORY TAKING AND CHIEF COMPLAINT Q1 – Q13
══════════════════════════════════════
Question 1 of 50
Camilla Franklin, a 48-year-old female, presents to the clinic complaining of progressive fatigue
and irritability over the last three months. She notes that her fatigue makes it difficult to get
through her workday. To better characterize the fatigue, which question should the provider ask
first?
A. Do you snore or wake up gasping for breath during the night?
B. How many hours of sleep do you typically get on a weeknight?
C. Does the fatigue improve with rest or does it persist regardless of sleep?
D. Have you experienced any changes in your weight or appetite recently?
,2
Correct Answer: C
Rationale: Determining if fatigue is systemic (unrelieved by rest) or related to sleep deprivation
helps differentiate between organic causes like anemia or hypothyroidism and lifestyle factors.
While sleep hygiene and snoring are important, understanding the nature of the fatigue is the
primary step in symptom characterization.
Question 2 of 50
During the review of systems, Camilla mentions that she has been experiencing heavy menstrual
bleeding for the past six months, requiring her to change sanitary products every hour for several
hours. She also reports passing clots the size of quarters. Which historical detail is most critical
to ask next to determine the etiology of her potential anemia?
A. Do you have a family history of thyroid disorders?
B. Have you noticed any blood in your stool or urine?
C. Are you taking any supplements like iron or multivitamins?
D. How old were you when you had your first menstrual period?
Correct Answer: B
Rationale: While menorrhagia is a likely cause of blood loss, ruling out gastrointestinal bleeding
is essential in a 48-year-old patient to ensure a more serious pathology like malignancy or an
ulcer is not missed. Family history and supplements are relevant but secondary to excluding
other acute sources of hemorrhage.
Question 3 of 50
Camilla states that in addition to feeling tired, she has been craving ice and has been chewing on
cups of ice constantly for the past month. What is the clinical significance of this specific finding
in her history?
A. It suggests she may be experiencing symptoms of anxiety or an oral fixation.
B. It is a classic sign of pica associated with iron deficiency anemia.
C. It indicates a possible vitamin B12 deficiency affecting oral sensation.
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D. It is a common side effect of drinking excessive amounts of caffeinated beverages.
Correct Answer: B
Rationale: Pagophagia, or the specific craving for ice, is a form of pica strongly associated with
iron deficiency anemia, though the exact mechanism is not fully understood. This symptom
provides a strong clinical clue to the underlying diagnosis before lab results are available.
Question 4 of 50
The provider asks Camilla about other constitutional symptoms. She denies fever or night sweats
but reports feeling cold when others are comfortable and noticing that her skin has become drier
recently. Which combination of symptoms is most consistent with hypothyroidism?
A. Heat intolerance, increased perspiration, and palpitations
B. Cold intolerance, dry skin, and constipation
C. Weight loss despite increased appetite, and insomnia
D. Polyuria, polydipsia, and blurred vision
Correct Answer: B
Rationale: Cold intolerance, dry skin, and constipation are classic symptoms of a hypothyroid
state resulting from a decrease in metabolic rate. Heat intolerance and weight loss are indicative
of hyperthyroidism, while polyuria and polydipsia suggest diabetes mellitus.
Question 5 of 50
Camilla denies any history of chronic illness but reports that she takes ibuprofen 400 mg three
times a day for knee pain. How might this medication history impact her current presentation?
A. It is likely the cause of her irritability due to central nervous system stimulation.
B. Chronic NSAID use can lead to gastrointestinal blood loss, contributing to anemia.
C. It interferes with thyroid hormone synthesis, potentially causing hypothyroidism.
Camilla Franklin I-Human Case Study – 48-
Year-Old with Fatigue and Irritability Actual
Exam 2026/2027 | Complete Exam-Style
Questions | Detailed Rationales – Pass
Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | History Taking and Chief Complaint | Q1 – Q13
Section 2 | Physical Examination and Findings | Q14 – Q25
Section 3 | Differential Diagnosis and Reasoning | Q26 – Q37
Section 4 | Diagnostic Testing and Management Plan | Q38 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: HISTORY TAKING AND CHIEF COMPLAINT Q1 – Q13
══════════════════════════════════════
Question 1 of 50
Camilla Franklin, a 48-year-old female, presents to the clinic complaining of progressive fatigue
and irritability over the last three months. She notes that her fatigue makes it difficult to get
through her workday. To better characterize the fatigue, which question should the provider ask
first?
A. Do you snore or wake up gasping for breath during the night?
B. How many hours of sleep do you typically get on a weeknight?
C. Does the fatigue improve with rest or does it persist regardless of sleep?
D. Have you experienced any changes in your weight or appetite recently?
,2
Correct Answer: C
Rationale: Determining if fatigue is systemic (unrelieved by rest) or related to sleep deprivation
helps differentiate between organic causes like anemia or hypothyroidism and lifestyle factors.
While sleep hygiene and snoring are important, understanding the nature of the fatigue is the
primary step in symptom characterization.
Question 2 of 50
During the review of systems, Camilla mentions that she has been experiencing heavy menstrual
bleeding for the past six months, requiring her to change sanitary products every hour for several
hours. She also reports passing clots the size of quarters. Which historical detail is most critical
to ask next to determine the etiology of her potential anemia?
A. Do you have a family history of thyroid disorders?
B. Have you noticed any blood in your stool or urine?
C. Are you taking any supplements like iron or multivitamins?
D. How old were you when you had your first menstrual period?
Correct Answer: B
Rationale: While menorrhagia is a likely cause of blood loss, ruling out gastrointestinal bleeding
is essential in a 48-year-old patient to ensure a more serious pathology like malignancy or an
ulcer is not missed. Family history and supplements are relevant but secondary to excluding
other acute sources of hemorrhage.
Question 3 of 50
Camilla states that in addition to feeling tired, she has been craving ice and has been chewing on
cups of ice constantly for the past month. What is the clinical significance of this specific finding
in her history?
A. It suggests she may be experiencing symptoms of anxiety or an oral fixation.
B. It is a classic sign of pica associated with iron deficiency anemia.
C. It indicates a possible vitamin B12 deficiency affecting oral sensation.
, 3
D. It is a common side effect of drinking excessive amounts of caffeinated beverages.
Correct Answer: B
Rationale: Pagophagia, or the specific craving for ice, is a form of pica strongly associated with
iron deficiency anemia, though the exact mechanism is not fully understood. This symptom
provides a strong clinical clue to the underlying diagnosis before lab results are available.
Question 4 of 50
The provider asks Camilla about other constitutional symptoms. She denies fever or night sweats
but reports feeling cold when others are comfortable and noticing that her skin has become drier
recently. Which combination of symptoms is most consistent with hypothyroidism?
A. Heat intolerance, increased perspiration, and palpitations
B. Cold intolerance, dry skin, and constipation
C. Weight loss despite increased appetite, and insomnia
D. Polyuria, polydipsia, and blurred vision
Correct Answer: B
Rationale: Cold intolerance, dry skin, and constipation are classic symptoms of a hypothyroid
state resulting from a decrease in metabolic rate. Heat intolerance and weight loss are indicative
of hyperthyroidism, while polyuria and polydipsia suggest diabetes mellitus.
Question 5 of 50
Camilla denies any history of chronic illness but reports that she takes ibuprofen 400 mg three
times a day for knee pain. How might this medication history impact her current presentation?
A. It is likely the cause of her irritability due to central nervous system stimulation.
B. Chronic NSAID use can lead to gastrointestinal blood loss, contributing to anemia.
C. It interferes with thyroid hormone synthesis, potentially causing hypothyroidism.
