Exam 2 HPI Examples Questions with Accurate Answers

Left-sided HF - ANSWERSMrs. Patel, a 70-year-old woman with a history of hypertension, presents with a three-week history of worsening shortness of breath, especially on exertion, and a persistent dry cough that worsens at night. She reports swelling in her ankles and legs, which has been progressively increasing, and has had to start sleeping on three pillows due to orthopnea. Mrs. Patel notes decreased exercise tolerance, often feeling fatigued after minimal activity. Despite taking her prescribed medications, including an ACE inhibitor, she has noticed a decline in her overall energy levels and an increase in her abdominal girth. Right-sided HF - ANSWERSMr. Davis, a 60-year-old male with a history of chronic obstructive pulmonary disease (COPD) and hypertension, presents with worsening lower extremity swelling and abdominal distention over the last two months. He reports a significant increase in his waist circumference and a feeling of fullness in his abdomen, especially after meals. He experiences discomfort in his right upper quadrant and has noted a significant decrease in appetite. Mr. Davis also reports nocturia, awakening multiple times at night to urinate, and acknowledges a weight gain of 8 pounds over the past month despite dietary modifications. His breathing has become more labored, and he now experiences shortness of breath, even at rest. DILATED cardiomyopathy - ANSWERSMrs. Garcia, a 55-year-old woman, presents with progressive fatigue, shortness of breath, and swelling in her legs for the past three months. She describes a history of recurrent respiratory infections, which she noticed became more debilitating. She reports decreased exercise tolerance, finding it increasingly difficult to perform household chores without getting winded. Mrs. Garcia denies chest pain but has experienced episodes of palpitations and dizziness. She has a significant past medical history, including uncontrolled hypertension, and has a family history of heart disease. Despite compliance with her medications, her symptoms have worsened, prompting her to seek medical attention. Peripartum cardiomyopathy - ANSWERSMrs. Johnson, a 35-year-old woman, presents with shortness of breath, swelling in her ankles, and fatigue, which started a month after giving birth to her third child. She describes a rapid onset of symptoms, initially attributing them to the demands of caring for her newborn. However, her breathing difficulties worsened, especially at night, and she noticed a persistent cough. Mrs. Johnson denies any history of heart disease or hypertension before pregnancy. She has no significant medical history and is not on any medications. Her symptoms have prompted her to seek urgent medical care, concerned about her declining health despite the recent birth of her child. HYPERTROPHIC cardiomyopathy (HCM) - ANSWERSMr. Anderson, a 42-year-old man, presents with recurrent episodes of chest pain and palpitations during physical activity for the past six months. He reports a family history of sudden cardiac death in his younger brother. He experiences fatigue and shortness of breath with exertion and occasional dizziness. He denies any significant medical history, drug use, or recent infections. Mr. Anderson is concerned about his symptoms and their impact on his daily life, especially as he has been unable to continue his regular exercise routine due to these issues. RESTRICTIVE cardiomyopathy - ANSWERSMrs. Lewis, a 60-year-old woman, presents with gradually worsening shortness of breath and fatigue over the past year. She reports swelling in her ankles and abdomen and has noticed a significant decrease in her exercise tolerance. She denies chest pain but describes a persistent dry cough, especially at night, and has experienced occasional palpitations. Mrs. Lewis has a history of amyloidosis, which was diagnosed two years ago, and her symptoms have intensified recently, leading her to seek medical attention. ARRHYTHMOGENIC cardiomyopathy (ACM) - ANSWERSMr. Davis, a 35-year-old man, presents with recurrent palpitations and episodes of lightheadedness for the past several months. He reports a family history of sudden cardiac death in his father at the age of 40. He describes occasional chest discomfort during exercise and has noticed his heart "skipping beats." Mr. Davis denies shortness of breath or swelling but expresses significant concern about his symptoms, especially after learning about his family history, which prompted him to seek medical evaluation. TAKOTSUBO cardiomyopathy - ANSWERSMrs. Walker, a 62-year-old woman, presents with chest pain and acute shortness of breath following a recent emotional stressor. She describes a sudden onset of severe chest discomfort radiating to her left arm, associated with nausea and diaphoresis. Upon further questioning, she reveals that she recently lost her spouse unexpectedly. Mrs. Walker denies any history of heart disease or hypertension but reports a history of emotional stressors in her life. Her symptoms, coupled with her recent emotional distress are prompting her urgent hospital admission for further evaluation and management. ATHEROSCLEROTIC CARDIOVASCULAR DISEASE (ASCVD) - ANSWERSMr. Johnson, a 58-year-old man with a history of hypertension, diabetes, and hyperlipidemia, presents with a pressing, squeezing chest pain radiating to his jaw and left arm that started 30 minutes ago. He describes associated shortness of breath and diaphoresis. The pain was exacerbated by physical activity and relieved by rest. Mr. Johnson reports a sedentary lifestyle, a high-fat diet, and a family history of heart disease. His symptoms, concerning acute coronary syndrome, prompted him to seek immediate medical attention, fearing a heart attack. ISCHEMIC HEART DISEASE - ANSWERSMr. Rodriguez, a 62-year-old man, presents with recurrent episodes of chest pain for the past six months. He describes the pain as a heaviness and pressure in his chest, typically occurring during physical exertion and alleviated with rest. Recently, the pain has become more frequent and occurs even at rest, lasting for several minutes. Mr. Rodriguez also reports occasional shortness of breath and fatigue. His medical history includes hypertension, hyperlipidemia, and a 20-pack-year smoking history, making him concerned about his heart health and prompting his visit to the clinic.