What differences do you note between the two H&Ps? Since I felt more comfortable in the Spring semester, it was easier to elicit pertinent positives and negatives before going through the ROS and to make connections. However, my initial DDx was very narrow and I have to admit patient’s actual problem was not on it during the interview. 2. In what ways has your history-taking improved? Are you eliciting all the important information? I learned to ask why certain things were happening instead of just documenting facts as it is a good way to elicit additional information . It is …

C.Shamrock Clinical Question: Pt is a 55 YOF with Graves Disease.  She is looking for a natural supplement to help decrease the size of her thyroid and nodules as well as help with Ophthalmopathy. She found an article saying Selenium may help normalize her thyroid function. She is asking her PA if this is true and if she should try it and if there’s any associated side effects. PICO Question: Do Selenium Supplements help improve symptoms of autoimmune hyperthyroidism PICO elements P      Adult females I       Selenium Supplements C      No Selenium Supplements O      Thyroid Volume and Thyroid …

HPI R.V Chief Complaint: “Unable to breath*5 hrs Mr.V is a 82 y.o. male with a PMH of ESRD on HD, well controlled HTN and DM who missed his Dialysis for one day, presents to ED with c/o dyspnea*5 days. Mr.V’s dyspnea started this morning, about 5 hours ago and was accompanied by an intense non-productive cough that woke him up from sleep. Food seemed to make it worse but small sips of water made it better. Mr.R also has diarrhea*24 hrs which is mostly opaque water, denies dysphagia, abdominal pain, nausea or blood in stool. Pt admits to DOE …