I-HUMAN WEEK 7 COMPLETE CASE ANALYSIS:
NAUSEA AND FATIGUE IN A 65-YEAR-OLD
ADULT | DIAGNOSIS, LABS, TREATMENT PLAN &
FOLLOW-UP (2026 UPDATE)
,iHuman Case Simulation: Week 7 Encounter
Scenario: You are the clinician. The patient, James Wilson, is a
65-year-old male who has checked in with the chief complaint of
nausea and fatigue.
PART 1: SUBJECTIVE DATA - THE INTERVIEW
(You enter the virtual exam room.)
Clinician: "Hello, Mr. Wilson? I'm [Your Name]. What brings you in
today?"
Patient (CC): "Doc, I just feel awful. Sick to my stomach and so
tired I can barely get off the couch."
History of Present Illness (HPI) - Questioning Path:
Clinician: "I'm sorry to hear that. Let's start with the nausea.
When did it first begin?"
Patient: "About a week ago, I guess."
Clinician: "Can you describe the feeling for me? Is it a queasy
feeling, or more like you need to vomit?"
Patient: "Both. Just a constant sick feeling. I've dry heaved a few
times in the morning, but haven't actually thrown up."
Clinician: "On a scale of 0 to 10, with 10 being the worst, how bad
, is the nausea?"
Patient: "Maybe a 6 or 7."
Clinician: "Is it there all the time, or does it come and go? Is it
worse before or after eating?"
Patient: "It's pretty much there all the time. Eating doesn't seem
to make it better or worse, to be honest. My appetite is gone."
Clinician: "And the fatigue. Is this a new kind of tiredness for
you?"
Patient: "Completely new. I'm usually pretty active. Now, I have to
take a nap in the afternoon just to make it through the day."
Clinician: "Have you had any fever, chills, or sweats?"
Patient: "No, nothing like that."
Clinician: "Any abdominal pain, diarrhea, or constipation?"
Patient: "No pain, no. My bowels seem normal."
Clinician: "Have you noticed any changes in your weight
recently?"
Patient: "I haven't weighed myself, but my pants feel a little loose.
Maybe a few pounds."
(At this point, a skilled clinician would start to think about
systemic causes. The combination of nausea, fatigue, and
possible weight loss in a 65-year-old triggers a broad
differential, including metabolic, cardiac, or infectious
causes.)
Past Medical History (PMH), Medications, Allergies:
Clinician: "To help me understand your overall health, do you
have any chronic medical conditions, like high blood pressure,
diabetes, or heart problems?"
NAUSEA AND FATIGUE IN A 65-YEAR-OLD
ADULT | DIAGNOSIS, LABS, TREATMENT PLAN &
FOLLOW-UP (2026 UPDATE)
,iHuman Case Simulation: Week 7 Encounter
Scenario: You are the clinician. The patient, James Wilson, is a
65-year-old male who has checked in with the chief complaint of
nausea and fatigue.
PART 1: SUBJECTIVE DATA - THE INTERVIEW
(You enter the virtual exam room.)
Clinician: "Hello, Mr. Wilson? I'm [Your Name]. What brings you in
today?"
Patient (CC): "Doc, I just feel awful. Sick to my stomach and so
tired I can barely get off the couch."
History of Present Illness (HPI) - Questioning Path:
Clinician: "I'm sorry to hear that. Let's start with the nausea.
When did it first begin?"
Patient: "About a week ago, I guess."
Clinician: "Can you describe the feeling for me? Is it a queasy
feeling, or more like you need to vomit?"
Patient: "Both. Just a constant sick feeling. I've dry heaved a few
times in the morning, but haven't actually thrown up."
Clinician: "On a scale of 0 to 10, with 10 being the worst, how bad
, is the nausea?"
Patient: "Maybe a 6 or 7."
Clinician: "Is it there all the time, or does it come and go? Is it
worse before or after eating?"
Patient: "It's pretty much there all the time. Eating doesn't seem
to make it better or worse, to be honest. My appetite is gone."
Clinician: "And the fatigue. Is this a new kind of tiredness for
you?"
Patient: "Completely new. I'm usually pretty active. Now, I have to
take a nap in the afternoon just to make it through the day."
Clinician: "Have you had any fever, chills, or sweats?"
Patient: "No, nothing like that."
Clinician: "Any abdominal pain, diarrhea, or constipation?"
Patient: "No pain, no. My bowels seem normal."
Clinician: "Have you noticed any changes in your weight
recently?"
Patient: "I haven't weighed myself, but my pants feel a little loose.
Maybe a few pounds."
(At this point, a skilled clinician would start to think about
systemic causes. The combination of nausea, fatigue, and
possible weight loss in a 65-year-old triggers a broad
differential, including metabolic, cardiac, or infectious
causes.)
Past Medical History (PMH), Medications, Allergies:
Clinician: "To help me understand your overall health, do you
have any chronic medical conditions, like high blood pressure,
diabetes, or heart problems?"
