Student Worksheet for iHuman Case Debrief
Think about the clinical presentation that you would expect for each diagnosis. What signs & symptoms did the
patient present with that were consistent with/expected for that diagnosis? (Include history findings (HPI, ROS,
SH, FH, PMH), physical exam findings, and diagnostic tests). What history/signs/symptoms/diagnostics would
you expect for that diagnosis that was lacking?
DIAGNOSIS: Unstable Angina
Pertinent Positives List the Findings Rationale
Subjective findings
(HPI, ROS, PMFSH)
Constriction in middle of
chest
Chest discomfort started
during exercise.
Pain radiating to left arm
Shortness of breath
History of hypertension
History of
hyperlipidemia
History of smoking
Diagnosis of coronary
artery disease
Stressful work
environment
Family history of heart
disease
These symptoms that the patient
experienced are associated with
unstable angina. The risk factors also
align with the diagnosis of unstable
angina.
Objective findings
(Physical Exam & Diagnostics)
Lipid profile showed a
cholesterol level of 200
and an HDL of 45
No evidence of
cardiomegaly seen on
CXR
No evidence of ischemia
seen on 12 lead ECG
Troponin was not
elevated
TEE showed no evidence
of structural or
functional abnormality
CK-MB was not elevated
BMP was normal
CBC was normal
The findings of the lipid profile show an
elevated cholesterol and unchanged
HDL after six months of lipid lowering
therapy. This finding can contribute to
the cause of unstable angina. The other
diagnostics showed negative findings
which rules out other diagnoses.
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