{"id":117764,"date":"2023-09-01T09:34:35","date_gmt":"2023-09-01T09:34:35","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=117764"},"modified":"2023-09-01T09:34:36","modified_gmt":"2023-09-01T09:34:36","slug":"florence-blackman-66-year-old-female-chest-pain-2-different-versions-of-the-answer-expert-feedback-solutions","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/09\/01\/florence-blackman-66-year-old-female-chest-pain-2-different-versions-of-the-answer-expert-feedback-solutions\/","title":{"rendered":"Florence Blackman 66 Year-old Female \u2013 Chest Pain 2 DIFFERENT VERSIONS OF THE ANSWER EXPERT FEEDBACK (SOLUTIONS)"},"content":{"rendered":"\n<p>Florence Blackman 66 Year-old Female \u2013 Chest Pain 2<br>DIFFERENT VERSIONS OF THE ANSWER EXPERT FEEDBACK<br>(SOLUTIONS)<br>CONTENTS : ALL QUESTIONS, OLD-CARTS for the HPI,(PMH,FH,SH as<br>Needed),PHSICAL EXAM,EXAMS FEEDBACK,CASE<br>FINDINGS,FEEDBACK,DIFFERENTIAL RANKING ,DIAGNOSIS,CASE PLAN<\/p>\n\n\n\n<p>1<br>This study source was downloaded by 100000853504600 from CourseHero.com on 01-14-2023 14:03:38 GMT -06:00<br>https:\/\/www.coursehero.com\/file\/67771889\/Oral-Comprehensivedocx\/<br>VERSION 1<br>Florence Blackman (66 y\/o female) \u2013 Chest Pain<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>CC: Intermittentsqueezing chest pain<\/li>\n\n\n\n<li>MSAP: Exertional \u201csqueezing\u201d mid-chest pain radiating to left arm, relieved by rest,<br>worse with cold<\/li>\n\n\n\n<li>Associated dyspnea on exertion<\/li>\n\n\n\n<li>History: HLD, HTN, previous smoker, family hx of heart disease<\/li>\n\n\n\n<li>Stressful work<br>History Questions:<\/li>\n\n\n\n<li>How can I help you today?<\/li>\n\n\n\n<li>Any othersymptoms we should discuss?<\/li>\n\n\n\n<li>Do you have any allergies?<\/li>\n\n\n\n<li>Are you taking any OTC or herbal medications?<\/li>\n\n\n\n<li>Any new or recent changes in medications?<\/li>\n\n\n\n<li>What doesthe pain \/ discomfort in your chest feel like? (squeezing, pressure, crushing,<br>burning, stabbing, aching, tingling, suffocating)<\/li>\n\n\n\n<li>How severe (scale 1-10) is the pain in your chest?<\/li>\n\n\n\n<li>Does anything make the pain in your chest better or worse?<\/li>\n\n\n\n<li>What are the events surrounding the start of your chest pain?<\/li>\n\n\n\n<li>Is there a pattern to your chest pain?<\/li>\n\n\n\n<li>Have you had any trauma to your chest?<\/li>\n\n\n\n<li>Doesthe pain in your chest radiate someplace else? Where?<\/li>\n\n\n\n<li>Do you have unusual heartbeats(palpitations)?<\/li>\n\n\n\n<li>Doesthe pain get worse with breathing?<\/li>\n\n\n\n<li>Does your pain awaken you from yoursleep?<\/li>\n\n\n\n<li>Is your pain affected by what, when, or how much you eat?<\/li>\n\n\n\n<li>Do you presently have heartburn, a food or acid taste in your mouth?<\/li>\n\n\n\n<li>Do you drink alcohol? If so, what do you drink and how many drinks per day?<\/li>\n\n\n\n<li>Do you have any of the following problems: fatigue, difficulty sleeping, unintentional<br>weight loss or gain, fevers, night sweats?<\/li>\n\n\n\n<li>Do you experience: SOB, wheezing, difficulty catching breath, chronic cough,sputum<br>production?<\/li>\n\n\n\n<li>Does anything make yourshortness of breath better or worse?<\/li>\n\n\n\n<li>How long does your SOB last?<\/li>\n\n\n\n<li>Do you have any of the following: heat or cold intolerance, increased thirst, increased<br>sweating, frequent urination, change in appetite?<\/li>\n\n\n\n<li>Do you have any of the following: dizziness, fainting, spinning room, seizures, weakness,<br>numbness, tingling, tremor?<\/li>\n<\/ul>\n\n\n\n<p>2<br><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Do you have problems with: N\/V, constipation, diarrhea, coffee groundsin your vomit,<br>dark tarry stool, bright red blood in your BM, early satiety, bloating?<\/li>\n\n\n\n<li>How is your overall health?<\/li>\n\n\n\n<li>Tell me about your work.<\/li>\n\n\n\n<li>Tell me about daily exercise or sportsthat you play.<br>Physical Exam:<\/li>\n\n\n\n<li>Vitals: pulse, BP, respirations<\/li>\n\n\n\n<li>Examine skin<\/li>\n\n\n\n<li>Neck: measure JVP (jugular venous pressure)<\/li>\n\n\n\n<li>Neck: auscultate carotid arteries<\/li>\n\n\n\n<li>Chest wall &amp; lungs:<br>o Visual inspection of anterior &amp; posterior chest<br>o Palpate anterior &amp;posterior chest<br>o Auscultate lungs<\/li>\n\n\n\n<li>Heart:<br>o Palpate for PMI (Point of Maximal Impact)<br>o Auscultate heart<\/li>\n\n\n\n<li>Abdomen:<br>o Auscultate abdominal\/femoral arteries<br>o Palpate abdomen<\/li>\n\n\n\n<li>Extremities: Visual inspection of extremities<br>Assessment note:<\/li>\n\n\n\n<li>F.B. is a 66 y\/o Caucasian female presenting with 2-week h\/o new onset, intermittent,<br>stable chest pain which radiates to the L arm, occurs with SOB, is worse with cold<br>temperatures and exertion, and improved by rest. On physical exam she is pain free with<br>stable vital signs. PMH risk factors include: distant history of smoking (5 pack\/years), a<br>history of HTN, and high cholesterol, and a family history of coronary vascular disease.<\/li>\n\n\n\n<li>Stresstest: 2-mm ST segment depression in inferior leads, 2, 3, and aVF and V3-6<br>Diagnosis: Coronary artery disease: stable angina<br>Plan:<\/li>\n\n\n\n<li>Determine need for coronary angiography based on stress test results and ECHO. Her<br>Duke score of 10.5 is slightly above moderate risk, and arguments could be made for<br>both a trial at medication intervention since the pt needsimprovement on both HTN and<br>HLD<br>o Augment management of preexisting HTN and HLD with a BB (metoprolol 25 mg<br>XR daily); a statin (atorvastatin 40 mg daily); and ASA 81 mg daily<\/li>\n\n\n\n<li>Continue use of HCTZ 25 mg daily<\/li>\n\n\n\n<li>Encourage lifestyle modification:<br>o Decrease intensity of aerobic workoutsfor next 3 months<br>Powered by TCPDF (www.tcpdf.org)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Florence Blackman 66 Year-old Female \u2013 Chest Pain 2DIFFERENT VERSIONS OF THE ANSWER EXPERT FEEDBACK(SOLUTIONS)CONTENTS : ALL QUESTIONS, OLD-CARTS for the HPI,(PMH,FH,SH asNeeded),PHSICAL EXAM,EXAMS FEEDBACK,CASEFINDINGS,FEEDBACK,DIFFERENTIAL RANKING ,DIAGNOSIS,CASE PLAN 1This study source was downloaded by 100000853504600 from CourseHero.com on 01-14-2023 14:03:38 GMT -06:00https:\/\/www.coursehero.com\/file\/67771889\/Oral-Comprehensivedocx\/VERSION 1Florence Blackman (66 y\/o female) \u2013 Chest Pain 2<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center 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