Group C Blood Collection 1. Obstruction or interruption of normal

The final case analysis allows the student to demonstrate a thorough but directed clinical history, with initial hypothesis generation and subsequent testing through specific questioning, selection of a primary diagnosis and differential diagnoses in order of likelihood, physical examination directed at gathering further data necessary to confirm or refute the hypotheses, thoughtful and critical selection of investigations to gather additional data such as appropriate diagnostic studies and implementation of a targeted and rationalized management plan that considers the holistic patient and includes appropriate medication selection. Case Mrs A is a 58-year-old, Asian American Female who presents with chest discomfort described as pressure under the sternum. The pressure appears after she goes up a flight of steps, it resolves with rest. She has a history of Hypertension, Hyperlipidemia, Hypothyroidism, Diabetes Mellitus Type II and reports she can not feel her feet. She was last seen in the clinic one year ago. She has no current medications available. Se states she ran out of everything except metformin a few months ago. She has no insurance. She is currently unemployed. Her BMI is 28, her B/P is 162/090

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