I HUMAN CASE STUDY COMPREHENSIVE
#WEEK 9 54 YEAR OLD REASON FOR
ENCOUNTER BACK PAIN [6512] REAL !!
LATEST 2025
,HISTORY
Patient Name: Not specified
Age: 54 years old
Gender: Female
Reason for Encounter: Back Pain
Chief Complaint:
“I've been having lower back pain for the past few days. It's getting worse.”
History of Present Illness (HPI):
The patient states she has had lower back pain for four days. The pain has been
getting worse since she lifted a heavy box at work. She describes it as dull and
aching, rating it a 7 out of 10 at its worst. The pain is focused in the lower lumbar
, area and does not spread to other areas. She has not experienced any recent
trauma, falls, or accidents.
The pain worsens with movement, especially when bending or twisting, but it
improves slightly when she rests. She has taken 400 mg of ibuprofen, which
gives her temporary relief. She does not report any numbness, tingling,
weakness, or issues with bowel or bladder control.
Past Medical History (PMH):
- Hypertension
- Hyperlipidemia
- No previous back problems reported
Past Surgical History (PSH):
- Cesarean section (x2)
Medications:
- Lisinopril 10 mg daily
- Atorvastatin 20 mg daily
- Occasional ibuprofen for pain
Allergies:
NKDA (No known drug allergies)
#WEEK 9 54 YEAR OLD REASON FOR
ENCOUNTER BACK PAIN [6512] REAL !!
LATEST 2025
,HISTORY
Patient Name: Not specified
Age: 54 years old
Gender: Female
Reason for Encounter: Back Pain
Chief Complaint:
“I've been having lower back pain for the past few days. It's getting worse.”
History of Present Illness (HPI):
The patient states she has had lower back pain for four days. The pain has been
getting worse since she lifted a heavy box at work. She describes it as dull and
aching, rating it a 7 out of 10 at its worst. The pain is focused in the lower lumbar
, area and does not spread to other areas. She has not experienced any recent
trauma, falls, or accidents.
The pain worsens with movement, especially when bending or twisting, but it
improves slightly when she rests. She has taken 400 mg of ibuprofen, which
gives her temporary relief. She does not report any numbness, tingling,
weakness, or issues with bowel or bladder control.
Past Medical History (PMH):
- Hypertension
- Hyperlipidemia
- No previous back problems reported
Past Surgical History (PSH):
- Cesarean section (x2)
Medications:
- Lisinopril 10 mg daily
- Atorvastatin 20 mg daily
- Occasional ibuprofen for pain
Allergies:
NKDA (No known drug allergies)
