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advise please - sarwatny03
#1
IS THIS STYLE ACCEPTABLE FOR PATIENT NOTES


HISTORY: Include significant positives and negatives from history of present illness, past medical
history, review of system(s), social history and family history.



PHYSICAL EXAMINATION: Indicate only pertinent positive and negative findings related to
patient’s chief complaint.

DIFFERENTIAL DIAGNOSES: In order of likelihood (with
1 being the most likely), list up to 5 potential or
possible diagnoses for this patient’s presentation (in
many cases, fewer than 5 diagnoses are likely).

DIAGNOSTIC WORK UP: List immediate plans (up to 5)
for further diagnostic workup.


48yo female - Chest pain x 90 mins


HPI- Burning


No radiation


Slight burning


Slight nausea & diaphoresis


Resolved spontaneously


Similar episodes 2-3 mos, after heavy meal or exertion


Some relief with antacids

PMH- Increased cholesterol, no follow-up or treatment


Tennis weekly


Smoked 30 pk yrs, stopped 3 yrs ago


No unusual stress
Mother w/ NIDDM, brother with unknown heart
No hx of HTN, has not seen MD x 2 yrs.




BP 160/80 No obvious distress, anxious to leave.
Chest- non tender, clear BS bilat, no wheezes, crackles or rales
Heart- PMI not displaced, reg rhythm, no murmur or rubs
Abdomen- +BS, non-distended, no masses or organomegaly, tenderness in epigastrum w/o rebound




1. Esophageal reflux disease

2. Peptic ulcer

3. Coronary artery disease

4. Cholecystitis

5. Musculoskeletal chest pain



1. Stool for OB

2. EKG

3. CXR

4. Upper GI endoscopy

5.
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