COMPLEX PATIENT CASE SHADOW HEALTH
2026 KEY CLINICAL FINDINGS AND
ASSESSMENT SKILLS A+
◉ Chief Complaint: Established chief complaint. Answer: • Reports
pain
• Reports blood in urine
• Reports increased frequency of urination
◉ Orientation: Asked about orientation. Answer: • Oriented to own
person
• Oriented to place
• Oriented to situation
• Oriented to time
◉ History of Present Illness: Asked about onset and duration of
symptoms. Answer: • Reports pain began 3 days ago
• Reports pain has gradually increased since onset
• Reports increased urinary frequency began 3 days ago
• Reports pinkish urine starting early thi smorning
• Reports pain has been constant
, ◉ History of Present Illness: Followed up on urinary frequency.
Answer: • Reports urinating about once an hour
• Reports waking up to use the bathroom
• Reports waking up four to five times a night to use the bathroom
◉ History of Present Illness: Asked about location of pain. Answer: •
Reports pain is lower in left side (flank pain)
• Denies radiating pain
◉ History of Present Illness: Asked about characteristics of pain.
Answer: • Describes pain as sharp and shooting
◉ History of Present Illness: Asked about aggravating factors of pain.
Answer: • Reports nothing makes the pain worse
◉ History of Present Illness: Asked about treatment and relieving
factors of pain. Answer: • Denies home treatment of pain
• Reports hydromorphone has significantly reduced pain
◉ History of Present Illness: Asked about severity of pain. Answer: •
Reports current pain level is 2/10
• Reports pain level before medication was a 9/10
2026 KEY CLINICAL FINDINGS AND
ASSESSMENT SKILLS A+
◉ Chief Complaint: Established chief complaint. Answer: • Reports
pain
• Reports blood in urine
• Reports increased frequency of urination
◉ Orientation: Asked about orientation. Answer: • Oriented to own
person
• Oriented to place
• Oriented to situation
• Oriented to time
◉ History of Present Illness: Asked about onset and duration of
symptoms. Answer: • Reports pain began 3 days ago
• Reports pain has gradually increased since onset
• Reports increased urinary frequency began 3 days ago
• Reports pinkish urine starting early thi smorning
• Reports pain has been constant
, ◉ History of Present Illness: Followed up on urinary frequency.
Answer: • Reports urinating about once an hour
• Reports waking up to use the bathroom
• Reports waking up four to five times a night to use the bathroom
◉ History of Present Illness: Asked about location of pain. Answer: •
Reports pain is lower in left side (flank pain)
• Denies radiating pain
◉ History of Present Illness: Asked about characteristics of pain.
Answer: • Describes pain as sharp and shooting
◉ History of Present Illness: Asked about aggravating factors of pain.
Answer: • Reports nothing makes the pain worse
◉ History of Present Illness: Asked about treatment and relieving
factors of pain. Answer: • Denies home treatment of pain
• Reports hydromorphone has significantly reduced pain
◉ History of Present Illness: Asked about severity of pain. Answer: •
Reports current pain level is 2/10
• Reports pain level before medication was a 9/10
