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Kathleen Parks iHuman Case Study on Severe
Headaches: Complete 2026/2027 Guide to Ace Your
Exam and Avoid Resits
Case Overview: Kathleen Parks
• Patient: Kathleen Parks, 26-year-old female.
• Occupation: Graphic designer.
• Chief Complaint: "More frequent severe headaches" / "I've been
having these really bad headaches over the last few months."
This guide is organized into the key sections you will encounter in the
iHuman simulator. Follow these steps in order for a systematic and high-
scoring approach.
Part 1: History Taking (Subjective)
This is the most critical part of the case. A thorough history will point
you toward the correct diagnosis and away from dangerous alternatives.
History of Present Illness (HPI) - Use OLD CARTS
• Onset: Headaches began approximately 3 months ago, but have
significantly worsened in frequency over the last few weeks. She
has a history of headaches for about 10 years, occurring every 1-2
months.
• Location: Primarily unilateral, located on one side of the head,
often in the frontal or temporal regions (e.g., "left side behind the
eye").
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• Duration: Each episode lasts several hours, typically 4-6 hours,
but can last up to 15 hours, affecting her for an entire day.
• Characteristic: Throbbing, pulsating quality. The pain is severe,
rated 8/10 on the pain scale.
• Aggravating Factors: Stress from work, prolonged computer use,
lack of sleep (averaging 5-6 hours/night), skipping meals, and
menstruation. During the headache, light (photophobia) and noise
(phonophobia) worsen the pain.
• Relieving Factors: Lying down in a dark, quiet room and sleeping
it off provides temporary relief. Over-the-counter ibuprofen or
acetaminophen provides only partial, limited relief.
• Timing: Currently occurs 4-5 times per week. This is a significant
increase from her baseline.
• Severity: 8/10, debilitating. It negatively impacts her ability to
perform her job as a graphic designer and her overall quality of
life.
Associated Symptoms (Pertinent Positives & Negatives)
This is where you prove you can distinguish a migraine from other
conditions.
• Pertinent Positives:
o Nausea: Frequently present during headaches.
o Vomiting: Occasionally present with severe episodes.
o Photophobia (sensitivity to light): A classic migraine
feature.
o Phonophobia (sensitivity to sound): Another classic
feature.
o Aura (Visual): Reports occasional visual
disturbances before the headache, such as flashes of light,
zig-zag lines, or blind spots (scintillating scotoma). This is a
key finding for migraine with aura.
• Pertinent Negatives (Crucial for Ruling Out Danger):
o Denies any vision loss.
Kathleen Parks iHuman Case Study on Severe
Headaches: Complete 2026/2027 Guide to Ace Your
Exam and Avoid Resits
Case Overview: Kathleen Parks
• Patient: Kathleen Parks, 26-year-old female.
• Occupation: Graphic designer.
• Chief Complaint: "More frequent severe headaches" / "I've been
having these really bad headaches over the last few months."
This guide is organized into the key sections you will encounter in the
iHuman simulator. Follow these steps in order for a systematic and high-
scoring approach.
Part 1: History Taking (Subjective)
This is the most critical part of the case. A thorough history will point
you toward the correct diagnosis and away from dangerous alternatives.
History of Present Illness (HPI) - Use OLD CARTS
• Onset: Headaches began approximately 3 months ago, but have
significantly worsened in frequency over the last few weeks. She
has a history of headaches for about 10 years, occurring every 1-2
months.
• Location: Primarily unilateral, located on one side of the head,
often in the frontal or temporal regions (e.g., "left side behind the
eye").
, 2|Page
• Duration: Each episode lasts several hours, typically 4-6 hours,
but can last up to 15 hours, affecting her for an entire day.
• Characteristic: Throbbing, pulsating quality. The pain is severe,
rated 8/10 on the pain scale.
• Aggravating Factors: Stress from work, prolonged computer use,
lack of sleep (averaging 5-6 hours/night), skipping meals, and
menstruation. During the headache, light (photophobia) and noise
(phonophobia) worsen the pain.
• Relieving Factors: Lying down in a dark, quiet room and sleeping
it off provides temporary relief. Over-the-counter ibuprofen or
acetaminophen provides only partial, limited relief.
• Timing: Currently occurs 4-5 times per week. This is a significant
increase from her baseline.
• Severity: 8/10, debilitating. It negatively impacts her ability to
perform her job as a graphic designer and her overall quality of
life.
Associated Symptoms (Pertinent Positives & Negatives)
This is where you prove you can distinguish a migraine from other
conditions.
• Pertinent Positives:
o Nausea: Frequently present during headaches.
o Vomiting: Occasionally present with severe episodes.
o Photophobia (sensitivity to light): A classic migraine
feature.
o Phonophobia (sensitivity to sound): Another classic
feature.
o Aura (Visual): Reports occasional visual
disturbances before the headache, such as flashes of light,
zig-zag lines, or blind spots (scintillating scotoma). This is a
key finding for migraine with aura.
• Pertinent Negatives (Crucial for Ruling Out Danger):
o Denies any vision loss.
