What differences do you note between the two H&Ps? One of the main differences that I have noted between my first and third H&P is the detail and depth of my HPI. Granted for the first one the patient had no current complaints, looking back I know believe that I should have gone in more depth in the patient’s past medical history and why they opted for surgery. I also see a difference when it comes to the medications portion. In my first H&P I forgot to log the route of administration for each medication. Compared to my third H&P, …

HISTORY: Date & time: 04/12/22 8:00 am Full Name: Mrs. S Address: Flushing, NY  DOB: 01/15/1957 Age: 65 y/o Sex: Female  Race: African American  Religion: Christian  Source: Pt. herself  Transportation: Self  Reliability: Reliable  Location: New York Presbyterian Queens Chief Complaint: “My chest hurts when I breathe in” x 2 days  History of Present Illness:      50 y/o female with PMH of hypothyroidism and hypertension presents to ED c/o of chest pain for 2 days. Pt. states that she was sitting at home in the afternoon when she had a sudden onset of chest pain that was located in her mid chest …

Full Name: Ms. L Age: 33 y/o Reliability: Reliable Location: New York Presbyterian Queens Source of information: Patient herself Chief Complaint: “I am here for surgery” History of Present Illness: 33y/o female presents with a PMH of morbid obesity, lupus, sleep apnea, asthma, fibromyalgia, and arthritis, pt. has tried changes in exercise, diet, and other lifestyle modifications but has seen no improvements therefore she is being seen today for preoperative workup for a robotic assisted sleeve gastrectomy. Pt. presents with no current complaints and no pertinent positives. Pt. denies any changes in bowel movements, changes in appetite, nausea, vomiting, abdominal …

Calandra James is a 66 year old recovering alcoholic (sober for 8 years) and she now describes her health as basically good, but says that she struggles with what she calls “an addictive nature”.  This has expressed itself in her history of drinking and a past history of smoking (she quit 5 years ago after a total of 40 pack-years), and more recently she has noted that her eating has an addictive aspect as well. She joined Weight Watchers and lost 75 pounds over a year and a half.  However, she has gained back 15 pounds of it over the …

Case 1 CC: Sudden onset substernal chest pain that “woke me up “and lasted until now (about 45 mins)  HPI: 70 y/o man with h/o hypertension, hyperlipidemia, 40 pack-years smoking history, and brother who died of MI at 60y/o brought in by ambulance to the ED with c/o substernal chest pain.  The pain is described as pressure-like and radiating to the left arm and jaw, accompanied by nausea, diaphoresis, and shortness of breath.  Nitroglycerin was administered sublingually, but only provided temporary relief.  Aspirin was given to the patient to chew in the ambulance. PE: VS: BP 150/70, HR 110, Temp …

Cardiology master sheet Name Symptoms/signs ECG/X-ray Diagnostic studies treatment Infectious Myocarditis (follows URI)  genetic predisposition -Heart failure -dyspnea, chest pain, arrhythmias -pericardial friction rub -pleuritic pain – gallop rhythm -ST elevation -ventricular ectopy -cardiomegaly – high WBC, ESR, CRP – endo-myocardial biopsy   -ACEI, BB, NSAID -AVOID DIGOXIN -Fulminant myocarditis = IABP OR LAVD Non-Infectious Myocarditis (caused by drugs like chemo) Same Same BNP Same Dilated Cardiomyopathy (thinning of muscle)  -gradual HF -rales, elevated JVP, cardiomegaly, S3 gallop, edema , ascites -sinus tach, LBBB -cardiomegaly -PE – A and V arrhythmias   -BNP -cardiac MRI -ACEI, ARB, BB, aldosterone antagonists, …

     I really enjoyed watching “The Doctor”, I felt like the movie correctly depicted both the clinician centered and patient centered approaches. In the beginning of the movie Dr. McKee was mainly clinician centered regarding his encounters with all of his patients. The very first scene that displayed this in my opinion was when he was leaving the surgical room and Dr. Bloomfield asked for his opinion regarding one of his patients. Dr. McKee gave his input on the matter, but he also made light of the patient’s symptoms by making unnecessary jokes. Dr. McKee also mocked Dr. Bloomfield amongst …