.png){kind=logo}
Anxiety and depression are
the most common psychiatric problems you will encounter in your primary care
practice.
Review this case study
HPI: KB, 55 year old
Caucasian female who presents to office with complaints of fatigue. The fatigue has been
present for 6 months and seems worse in the morning, improving slightly through
the day. KB reports a lack
of energy and "loss of joy". States" I really don't feel like going anywhere or
doing anything" Reports she often has difficulty staying on task and completing
projects for work. She reports not feeling hungry and does not feel rested when she wakes up
in the morning. KB is a widow for 2 years, social events that are couples only can make
her symptoms worse. She tries to do at least one social activity a week but it
can be really exhausting. Her
husband died in their car while she was driving him to the hospital and
sometimes driving in that car makes all the memories come back. She recently
got a puppy, which she thought would help with the loneliness but the care of the puppy seems
overwhelming at times. Rest and exercise, specifically yoga and meditation seem to make her
feel better. At this time she does not want to do either. She has not tried any medications,
prescribed or otherwise. She reports drinking a lot of coffee, but that does not seem to help.
Current medications: Excedrin
PM about once a week when she can't sleep, seems to help a bit. NKDA.
PMH: no major illnesses.
Immunizations up to date.
SH: widowed, employed full
time as a manager. Drinks wine, 1 glass every night. No tobacco, no illicit
drugs. Previously married while living in France, reports an abusive
relationship. The French government gave custody of her son to the ex-husband.
She returned to US without her son 10 years ago. She sees her son two times a
year, they skype and text "all the time" but she misses him.
FH: Parents are alive and
well. Has one son, age 21, he is healthy but lives in France with his father.
ROS
CONSTITUTIONAL: reports weight loss of 2-3 pounds,
no fever, chills, or weakness reported
HEENT: Eyes: No visual loss,
blurred vision, double vision or yellow sclera. Ears, Nose, Throat: No hearing
loss, sneezing, congestion, runny nose or sore throat.
.png)