Administrator rev ronin Posted May 4, 2013 Author Administrator Share Posted May 4, 2013 Reminder of the rules: Open to PA-Ss and Pre-PAs, (but PAs who have questions are welcome to PM me to avoid spoilers for the others) and go through your exam in order. Mid 30's female presents to your family practice clinic with complaints of worsening bilateral edema x1 week. She is an established patient, so you have some EMR history, but you haven't seen her before. Vitals: 118/70, 64, 97.8, 18. Your MA remarks that she looks and seems normal. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 4, 2013 Author Administrator Share Posted May 4, 2013 Reminder of the rules: Open to PA-Ss and Pre-PAs, (but PAs who have questions are welcome to PM me to avoid spoilers for the others) and go through your exam in order. Mid 30's female presents to your family practice clinic with complaints of worsening bilateral edema x1 week. She is an established patient, so you have some EMR history, but you haven't seen her before. Vitals: 118/70, 64, 97.8, 18. Your MA remarks that she looks and seems normal. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 4, 2013 Administrator Share Posted May 4, 2013 Reminder of the rules: Open to PA-Ss and Pre-PAs, (but PAs who have questions are welcome to PM me to avoid spoilers for the others) and go through your exam in order. Mid 30's female presents to your family practice clinic with complaints of worsening bilateral edema x1 week. She is an established patient, so you have some EMR history, but you haven't seen her before. Vitals: 118/70, 64, 97.8, 18. Your MA remarks that she looks and seems normal. Link to comment Share on other sites More sharing options...
katethegreat1 Posted May 4, 2013 Share Posted May 4, 2013 Any adult illnesses? Family hx? Is she urinating? Link to comment Share on other sites More sharing options...
katethegreat1 Posted May 4, 2013 Share Posted May 4, 2013 Any adult illnesses? Family hx? Is she urinating? Link to comment Share on other sites More sharing options...
katethegreat1 Posted May 4, 2013 Share Posted May 4, 2013 Any adult illnesses? Family hx? Is she urinating? Link to comment Share on other sites More sharing options...
katethegreat1 Posted May 4, 2013 Share Posted May 4, 2013 Any childhood illness? Link to comment Share on other sites More sharing options...
katethegreat1 Posted May 4, 2013 Share Posted May 4, 2013 Any childhood illness? Link to comment Share on other sites More sharing options...
katethegreat1 Posted May 4, 2013 Share Posted May 4, 2013 Any childhood illness? Link to comment Share on other sites More sharing options...
Corpsman2PA Posted May 4, 2013 Share Posted May 4, 2013 Pts Ht/Wt? Bilateral edema where, on hands/feet/legs both? Any assoc pain? Does it pit? Activity level? Worse/better in am/pm? Meds/Allg? Complete ROS. Fatigue? Hx of sleep apnea? LMP? Cough? Any Cardio/Pulm/hepatic/renal issues? Preg hx? Link to comment Share on other sites More sharing options...
Corpsman2PA Posted May 4, 2013 Share Posted May 4, 2013 Pts Ht/Wt? Bilateral edema where, on hands/feet/legs both? Any assoc pain? Does it pit? Activity level? Worse/better in am/pm? Meds/Allg? Complete ROS. Fatigue? Hx of sleep apnea? LMP? Cough? Any Cardio/Pulm/hepatic/renal issues? Preg hx? Link to comment Share on other sites More sharing options...
Corpsman2PA Posted May 4, 2013 Share Posted May 4, 2013 Pts Ht/Wt? Bilateral edema where, on hands/feet/legs both? Any assoc pain? Does it pit? Activity level? Worse/better in am/pm? Meds/Allg? Complete ROS. Fatigue? Hx of sleep apnea? LMP? Cough? Any Cardio/Pulm/hepatic/renal issues? Preg hx? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 4, 2013 Author Administrator Share Posted May 4, 2013 Patient is 5'9" with a BMI about 30. No childhood illnesses of note. Recently had a URI and mastitis, just finished Keflex for the latter, which has resolved. She is G1P1, still nursing after almost a year, only med is minipill, just finished a period. She has fatigue secondary to being a mom, and admits that her exercise has been irregular for the past year. No known sleep apnea, no cough, no medical allergies. No history of heart, lung, renal, or hepatic issues. No UTI symptoms. Family history is positive for breast cancer. Patient does not have edema now, but she states it gets worse as she goes throughout the day, (it's about noon now) and pain peaks at 8.5/10, edema is worse on legs, but occurs in hands/arms, too. ROS is otherwise unremarkable. So far so good--There's still one relevant question which hasn't been asked before we go to physical exam. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 4, 2013 Author Administrator Share Posted May 4, 2013 Patient is 5'9" with a BMI about 30. No childhood illnesses of note. Recently had a URI and mastitis, just finished Keflex for the latter, which has resolved. She is G1P1, still nursing after almost a year, only med is minipill, just finished a period. She has fatigue secondary to being a mom, and admits that her exercise has been irregular for the past year. No known sleep apnea, no cough, no medical allergies. No history of heart, lung, renal, or hepatic issues. No UTI symptoms. Family history is positive for breast cancer. Patient does not have edema now, but she states it gets worse as she goes throughout the day, (it's about noon now) and pain peaks at 8.5/10, edema is worse on legs, but occurs in hands/arms, too. ROS is otherwise unremarkable. So far so good--There's still one relevant question which hasn't been asked before we go to physical exam. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 4, 2013 Author Administrator Share Posted May 4, 2013 Patient is 5'9" with a BMI about 30. No childhood illnesses of note. Recently had a URI and mastitis, just finished Keflex for the latter, which has resolved. She is G1P1, still nursing after almost a year, only med is minipill, just finished a period. She has fatigue secondary to being a mom, and admits that her exercise has been irregular for the past year. No known sleep apnea, no cough, no medical allergies. No history of heart, lung, renal, or hepatic issues. No UTI symptoms. Family history is positive for breast cancer. Patient does not have edema now, but she states it gets worse as she goes throughout the day, (it's about noon now) and pain peaks at 8.5/10, edema is worse on legs, but occurs in hands/arms, too. ROS is otherwise unremarkable. So far so good--There's still one relevant question which hasn't been asked before we go to physical exam. Link to comment Share on other sites More sharing options...
whoRyou Posted May 4, 2013 Share Posted May 4, 2013 Ulcers? Rash? Chest Pain? Thyroid issues now and in the past? Oh sorry I just jump the gun too fast, didn't see your response about you did not do the 'physical exam' yet. Well, if it is applicable to the physical exam let me know if I am in the ball park. Link to comment Share on other sites More sharing options...
whoRyou Posted May 4, 2013 Share Posted May 4, 2013 Ulcers? Rash? Chest Pain? Thyroid issues now and in the past? Oh sorry I just jump the gun too fast, didn't see your response about you did not do the 'physical exam' yet. Well, if it is applicable to the physical exam let me know if I am in the ball park. Link to comment Share on other sites More sharing options...
whoRyou Posted May 4, 2013 Share Posted May 4, 2013 Ulcers? Rash? Chest Pain? Thyroid issues now and in the past? Oh sorry I just jump the gun too fast, didn't see your response about you did not do the 'physical exam' yet. Well, if it is applicable to the physical exam let me know if I am in the ball park. Link to comment Share on other sites More sharing options...
lolWUT? Posted May 4, 2013 Share Posted May 4, 2013 Surgery/Hospitilizations? U2D on immunizations/paps? Job? Link to comment Share on other sites More sharing options...
lolWUT? Posted May 4, 2013 Share Posted May 4, 2013 Surgery/Hospitilizations? U2D on immunizations/paps? Job? Link to comment Share on other sites More sharing options...
lolWUT? Posted May 4, 2013 Share Posted May 4, 2013 Surgery/Hospitilizations? U2D on immunizations/paps? Job? Link to comment Share on other sites More sharing options...
stellahead Posted May 4, 2013 Share Posted May 4, 2013 Shortness of breath? Palpitations? Constipation? Dry skin? Link to comment Share on other sites More sharing options...
stellahead Posted May 4, 2013 Share Posted May 4, 2013 Shortness of breath? Palpitations? Constipation? Dry skin? Link to comment Share on other sites More sharing options...
stellahead Posted May 4, 2013 Share Posted May 4, 2013 Shortness of breath? Palpitations? Constipation? Dry skin? Link to comment Share on other sites More sharing options...
swooshie1 Posted May 5, 2013 Share Posted May 5, 2013 is she a smoker? Link to comment Share on other sites More sharing options...
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