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Case 1 – Depression JS is a 20 yo female with a PMH of obesity. She presents to clinic today for her annual physical. Vitals BP: 128/74 Pulse: 87 bpm Temp: 98.2 F SpO2: 99% Weight: 187 lbs Height: 5’1″ PHQ-9: 13 Medications: MVI once daily Ortho-tricyclen Lo once daily Naproxen 220 mg po BID PRN cramps Ondansetron ODT 4 mg tabs BID PRN nausea Labs: Na 137 Ca 9.4 SCr 0.6 CO2 28 JS admits to feeling “dull” for the last 4 weeks. She tells you that she got “down” over the winter break when she was away from school and since returning, she has “not been able to shake it.” She reports to having sluggish thoughts in class, which caused her to run out of time on her first exam. She endorses sleeping 10-11 hours/night. Her normal sleep schedule was 7-8 hrs/night last semester. She also reports she has put on 10 pounds since returning to school. She states that she has been worrying incessantly about her grades even though she is doing fine in all of her classes. She also reports that she has become “snappy” with her roommate nearly every day, which has caused tension in
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