Case 1: An 89-year-old female complains of a “stabbing chest pain” and points to the area just below her scapula at the right mid-clavicular line. She states that she had an upper respiratory infection last week that “just seems to hang on.” No other complaints. 

Case 2: A 58-year-old male presents with a complaint of severe chest pain over the last hour. He states that he did not call 911 because he cannot afford an ambulance. 

Case 3: A 15-year-old immigrant was brought to the clinic by her mother because patient complains of shortness of breath, chest pains, diaphoresis and easy fatiguability. She claims she has had on and off bouts of tonsillitis since she was a child that resulted in tonsillectomy surgery when she was 12. Last week, she was unable to participate in the cheer leading tryouts because of knee pain and a rash that she noticed on her trunk for the past 2 weeks.

For the case you have chosen, post to the discussion:

• Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed.
• In SOAP format, list: 
  • Pertinent positive findings that validate your main diagnosis
  • Pertinent negative findings that make you think of other differential diagnoses
  • Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
• Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
• Initial post must have a minimum of 300 words, excluding references.
• In your peer replies, please reply to at least one peer who chose a different case study.