How to Answer Mellissa Rodrigues Year Questions (Complete Guide)
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Original Question
Mellissa Rodrigues, a 46-year-old female with past medical history (PMH) of obesity (BMI 35), HTN, hyperlipidemia, frequent Candidiasis, and depression, has ongoing fatigue, weight loss, blurry vision, and nocturia. Patient states: “I guess it’s no big deal that I have to urinate 5- 6 times at night because I already have insomnia. I can’t sleep at all. Actually, I have to pee all the time. I don’t understand why I have leaky bladder, I never had children”. Ms. Rodrigues is unmarried, lives alone, has no children, is not pregnant, and has a desk job. Per patient, she is not physically active, and the lifestyle changes recommended by her previous PCP never worked for her. Family history is significant for HTN and diabetes in both parents, breast cancer and thyroid cancer in mother (deceased at age 62 from metastasis to lung), MI in father at 54, and sister Cushing’s Disease. Patient reports visiting her OBGYN for refill of Diflucan at least every other month or more often. Patient also reports on and off rash for many years (worse when the weather is warm) in her bilateral axillas, below her breast tissue, and panniculus, which seems to never heal. Denies recent fever, chills, anorexia, nausea, vomiting, change in bowel habits, hematuria, hematochezia, edema, easy bruising, and use of blood thinners. PHYSICAL EXAM: • VS: T = 37.2, HR = 78, RR = 15 and unlabored, BP = 162/98 right arm (sitting), weight 98 kg • Obese female in no acute distress
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