i-Human Case Study: Florence Blackman (66-
Year-Old Female) – Chest Pain Complete
Solutions 2024
Patient History & Presenting Illness (Questions 1-20)
1. What is the patient's name?
a) Frances Blackwood
b) Florence Blackman ✓
c) Felicity Blackburn
2. How old is the patient?
a) 66 ✓
b) 70
c) 72
3. What is the primary reason for Florence's visit?
a) Shortness of breath
b) Chest pain ✓
c) Palpitations
4. Where is the location of her chest pain?
a) Right-sided, sharp
b) Substernal ✓
c) Left lateral, pleuritic
5. The quality of her chest pain is best described as:
a) Sharp and stabbing
b) Pressure and squeezing ✓
c) Burning and tearing
6. Does the pain radiate anywhere?
a) To her left arm ✓
b) To her jaw ✓
c) To her back
d) Both A and B are correct ✓
,7. On a scale of 1-10, what is the severity of her pain at its worst?
a) 5/10
b) 7/10
c) 9/10 ✓
8. What was the duration of the pain?
a) A few seconds
b) 15-20 minutes ✓
c) Constant for hours
9. What aggravates (worsens) her pain?
a) Lying down flat
b) Physical exertion ✓
c) Deep breathing
10. What relieves (improves) her pain?
a) Rest ✓
b) Leaning forward
c) Antacids
11. What associated symptom did she experience with the pain?
a) Nausea and diaphoresis ✓
b) Productive cough
c) Hemoptysis
12. She reports the pain started while she was:
a) Sleeping
b) Watching television
c) Walking up a flight of stairs ✓
13. Is this her first episode of such pain?
a) Yes
b) No, she had a similar episode last week. ✓
14. What is Florence's past medical history likely to include? (Select all that apply)
a) Hypertension ✓
b) Type 2 Diabetes Mellitus ✓
c) Hyperlipidemia ✓
d) Asthma
, 15. What key social history factor is highly relevant?
a) 40-pack-year smoking history ✓
b) Alcohol abuse
c) Intravenous drug use
16. What family history is a significant risk factor?
a) Mother with COPD
b) Father with colon cancer
c) Father with a myocardial infarction at age 55 ✓
17. A key review of systems finding might be:
a) Recent weight gain
b) Increasing fatigue ✓
c) Skin rash
18. Her stated drug allergy is to:
a) Penicillin ✓
b) Sulfa
c) Codeine
19. What medication is she most likely taking for her chronic conditions?
a) Lisinopril ✓
b) Warfarin
c) Albuterol
20. The onset of her current symptom was:
a) 1 hour ago ✓
b) 3 days ago
c) 1 week ago
Physical Examination (Questions 21-40)
21. What is a critical first step in the physical exam?
a) Neurological exam
b) Cardiac and lung auscultation ✓
c) Abdominal palpation
22. Her initial blood pressure was most likely:
a) 90/60 mmHg
, b) 150/92 mmHg ✓
c) 110/70 mmHg
23. Her heart rate is most likely:
a) Bradycardic (50 bpm)
b) Normal (72 bpm)
c) Tachycardic (110 bpm) ✓
24. What respiratory rate would be concerning in this context?
a) 16 breaths per minute
b) 24 breaths per minute ✓
c) 12 breaths per minute
25. Her oxygen saturation on room air is likely:
a) 88%
b) 92%
c) 98% ✓
26. On cardiac auscultation, you might hear:
a) A mid-systolic murmur
b) An S4 gallop ✓
c) A friction rub
27. What lung sound is most expected?
a) Clear bilaterally ✓
b) Wheezing
c) Crackles at the bases
28. What finding on jugular venous distension (JVD) would be significant?
a) Absent JVD
b) JVD at 6 cm above the sternal angle ✓
c) Visible carotid pulsations
29. On palpation of the chest, what is the expected finding?
a) Reproducible tenderness
b) No reproducible tenderness ✓
c) Subcutaneous emphysema
30. What abdominal finding would be a "red flag"?
a) Soft, non-tender abdomen
Year-Old Female) – Chest Pain Complete
Solutions 2024
Patient History & Presenting Illness (Questions 1-20)
1. What is the patient's name?
a) Frances Blackwood
b) Florence Blackman ✓
c) Felicity Blackburn
2. How old is the patient?
a) 66 ✓
b) 70
c) 72
3. What is the primary reason for Florence's visit?
a) Shortness of breath
b) Chest pain ✓
c) Palpitations
4. Where is the location of her chest pain?
a) Right-sided, sharp
b) Substernal ✓
c) Left lateral, pleuritic
5. The quality of her chest pain is best described as:
a) Sharp and stabbing
b) Pressure and squeezing ✓
c) Burning and tearing
6. Does the pain radiate anywhere?
a) To her left arm ✓
b) To her jaw ✓
c) To her back
d) Both A and B are correct ✓
,7. On a scale of 1-10, what is the severity of her pain at its worst?
a) 5/10
b) 7/10
c) 9/10 ✓
8. What was the duration of the pain?
a) A few seconds
b) 15-20 minutes ✓
c) Constant for hours
9. What aggravates (worsens) her pain?
a) Lying down flat
b) Physical exertion ✓
c) Deep breathing
10. What relieves (improves) her pain?
a) Rest ✓
b) Leaning forward
c) Antacids
11. What associated symptom did she experience with the pain?
a) Nausea and diaphoresis ✓
b) Productive cough
c) Hemoptysis
12. She reports the pain started while she was:
a) Sleeping
b) Watching television
c) Walking up a flight of stairs ✓
13. Is this her first episode of such pain?
a) Yes
b) No, she had a similar episode last week. ✓
14. What is Florence's past medical history likely to include? (Select all that apply)
a) Hypertension ✓
b) Type 2 Diabetes Mellitus ✓
c) Hyperlipidemia ✓
d) Asthma
, 15. What key social history factor is highly relevant?
a) 40-pack-year smoking history ✓
b) Alcohol abuse
c) Intravenous drug use
16. What family history is a significant risk factor?
a) Mother with COPD
b) Father with colon cancer
c) Father with a myocardial infarction at age 55 ✓
17. A key review of systems finding might be:
a) Recent weight gain
b) Increasing fatigue ✓
c) Skin rash
18. Her stated drug allergy is to:
a) Penicillin ✓
b) Sulfa
c) Codeine
19. What medication is she most likely taking for her chronic conditions?
a) Lisinopril ✓
b) Warfarin
c) Albuterol
20. The onset of her current symptom was:
a) 1 hour ago ✓
b) 3 days ago
c) 1 week ago
Physical Examination (Questions 21-40)
21. What is a critical first step in the physical exam?
a) Neurological exam
b) Cardiac and lung auscultation ✓
c) Abdominal palpation
22. Her initial blood pressure was most likely:
a) 90/60 mmHg
, b) 150/92 mmHg ✓
c) 110/70 mmHg
23. Her heart rate is most likely:
a) Bradycardic (50 bpm)
b) Normal (72 bpm)
c) Tachycardic (110 bpm) ✓
24. What respiratory rate would be concerning in this context?
a) 16 breaths per minute
b) 24 breaths per minute ✓
c) 12 breaths per minute
25. Her oxygen saturation on room air is likely:
a) 88%
b) 92%
c) 98% ✓
26. On cardiac auscultation, you might hear:
a) A mid-systolic murmur
b) An S4 gallop ✓
c) A friction rub
27. What lung sound is most expected?
a) Clear bilaterally ✓
b) Wheezing
c) Crackles at the bases
28. What finding on jugular venous distension (JVD) would be significant?
a) Absent JVD
b) JVD at 6 cm above the sternal angle ✓
c) Visible carotid pulsations
29. On palpation of the chest, what is the expected finding?
a) Reproducible tenderness
b) No reproducible tenderness ✓
c) Subcutaneous emphysema
30. What abdominal finding would be a "red flag"?
a) Soft, non-tender abdomen
