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Clinical Decision-Making in Action: 28-year-old Woman with History of Headache and Recent-Onset Fatigue

neuroscienceCME Medical Simulation

Premiere Date: Friday, November 15, 2013

This activity offers CE credit for:

  1. Physicians (CME)
  2. Nurses (CNE)
  3. Pharmacists (ACPE)
  4. Other

All other clinicians will receive a Certificate of Attendance stating this activity was certified for AMA PRA Category 1 Creditâ„¢

Credit Expiration Date:
Saturday, November 15, 2014
Note: Credit Is No Longer Available


David Rye, MD, PhDDavid Rye, MD, PhD 
Professor, Department of Neurology
Emory University School of Medicine
Atlanta, GA

Statement of Need

Enter Exam Room #1 and find Mrs. Brynne Monroe who presents to you, her general neurologist, for a six-month follow-up visit for migraines. At the visit, she reports new symptoms of fatigue. Your task is to navigate through this clinical encounter to perform history-taking, differential diagnosis, and work-up tasks and arrive at a working diagnosis, then to develop a management and follow-up plan.

The neuroscienceCME clinical simulation platform offers a safe learning environment where your choices determine your path and outcomes, and you can track your progress through the case. An expert faculty mentor provides content-specific commentary on your choices and helps guide you to the correct diagnosis and optimal treatment plan. Learning objectives and content on evidence-based, best practices for the correct diagnosis and treatment will be shared throughout the clinical simulation.

Learning Objectives

  • Conduct a focused history, physical exam, and work-up to evaluate a middle-aged woman with nonspecific complaints of fatigue and sleep problems and arrive at a differential diagnosis, then a working diagnosis.
  • Develop a treatment plan based on a working diagnosis and the patient's comorbid conditions.

  • Cook DA, Erwin PJ, Triola MM. Computerized virtual patients in health professions education: a systematic review and meta-analysis. Acad Med. 2010;85(10):1589-1602. PMID: 20703150.
    Benedict N. Virtual patients and problem-based learning in advanced therapeutics. Am J Pharm Educ. 2010;74(8):143. PMID: 21179254.

    Activity Goal

    This educational activity focuses on the CMEO Make-One-Change (M1C) Statement as the source for performance improvements attained in this medical simulation. The M1C is formulated by the faculty and Planning Committee from selected quality measures, clinical guidelines, or expert opinion and serves as a performance challenge to all participants. The M1C for this activity is: To implement evidence-based diagnostic and treatment strategies for patients with the diagnosed clinical condition in this medical simulation that align with current specialty society guideline recommendations.

    Financial Support

    Supported by an educational grant from UCB, Inc.

    Target Audience

    Neurologists, sleep specialists, physicians, physician assistants, nurse practitioners, pharmacists and nurses.

    Credit Information

    CME Credit (Physicians):
    CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

    CME Outfitters, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Creditâ„¢. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    CNE Credit (Nurses):
    Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.0 contact hours.

    CPE Credit (Pharmacists):
    ACPE CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hours (0.1 CEUs)
    Universal Activity Number: 0376-0000-13-024-H01-P (recorded programs)
    Activity Type: application-based

    Post-tests, credit request forms, and activity evaluations must be completed online at (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit

    Disclosure Declaration

    It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CME/CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

    Dr. Rye has disclosed that he serves as a consultant for Jazz Pharmaceuticals, Inc.; and UCB, Inc.

    Tony Graham, MD (peer reviewer) has nothing to disclose.

    Monique Johnson, MD, CCMEP (planning committee) has nothing to disclose.

    Catherine F. Murray (planning committee) has nothing to disclose.

    Joy Bartnett Leffler, MLA, NASW, CSE (planning committee) has nothing to disclose.

    Sandra Haas Binford, MAEd (planning committee) has nothing to disclose.

    Sharon Tordoff, CCMEP (planning committee) has nothing to disclose.

    CME Outfitters, LLC, the faculty, and UCB, Inc. do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.

    Questions about this activity? Call us at 877.CME.PROS (877.263.7767).


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