Description

A. C. is a 17-year-old high school student who presents to the clinic with increased fatigue for the last 2 months even after a good night’s sleep. Pt. reports feeling frustrated, and irritable, experiencing daily crying episodes. Tearful during the exam. Pt. reports a decline in school performance and a lack of interest in track. Pt. reports unintentional weight gain (25-30 lbs.) over the last year. Pt. reports eating pizza and French fries; skipping breakfast. Abd and buttocks striae, Acanthosis nigricans, mild comedonal acne on the forehead. No enlargement/tenderness of cervical, axillary, or inguinal canal bilaterally. Denies thoughts of hurting/killing herself. Admits to social alcohol use; past marijuana use with ex-BF. Denies sexual activity at this time. Family history of DM, HTN, and obesity.