Chief Complaint: Palpitations

Mini 3 was this morning.  We probably won't get the grades back until a couple days from now.  I still feel like biochemistry went the worst, but we'll see.  I'm not too stressed about the results, mostly because the Final is in 8 days so there isn't any time to sulk about it.  Whatever my scores end up being, it's all going to come down to the final and it always has.  So that part of the equation hasn't changed.

The DPS Practical was 2 weeks ago.  And because it was a written exam, only now did they get the grades back to us.  Doctor, Patient, Society may be the "gimmie" class but remember, I got an 83.33% on Mini 1 and for some reason I got a 43.75% on Mini 2.  I was still passing but DPS is the last thing I want to worry about in these last days.

I knew I killed it when I walked out of the exam hall:

Jonathan's 1st Semester DPS Practical Score:

• DPS Practical = 90.0%

To put it in perspective, I got a 79% last time around.  It's basically the second easiest exam of the semester, right behind the 1st Histology Practical where you're just identifying functions and features of epithelium and tissues from slides.

Here we basically had to write up an imaginary HPI with an imaginary patient while pretending to be imaginary doctors.  The school does this to ease students into the idea of "interviewing" as a clinical skill.  It's basic stuff but the structure of the interview really gets hammered into your brain and it does force you to put everything you learned from first semester into a coherent narrative.  If you're unable to connect the dots from what you've learned, your HPI isn't going to make a lot of sense.  I think it's very effective.

(In 2nd or 3rd semester (?) you have to actually perform an HPI on an actor.  And in the 3rd and 4th semesters students are sent off to the local clinics and hospitals.)

If you remember from last semester my interview was really funny.  Our topic was a chief complaint of "chest pain."  My imaginary patient was a professional thief who clumsily got his leg caught on a fence while trying to break into a house, attempting to steal an expensive diamond ring.  In his excitement he began feeling the symptoms of an MI.  The symptoms all fit and my differential diagnosis was pain he felt from landing on his chest and left arm after falling from the fence.

This time I used my same thief but our chief complaint was "palpitations."  I didn't want to do MI again because that's too easy.  So this time I had the thief still attempting a theft, but this time he was convinced that he was having a heart attack when he really wasn't.  (There was a lot of "I think it's a heart attack!" and "Don't you think it's a heart attack!?" going on in the interview.)  He had this thought because of an extensive family history of the men on his father's side of the family all dying of heart attacks.  There was also an extensive family history of pheochromocytoma and panic attacks on his mother's side of the family which could also explain the palpitations.  Of course at the last minute he casually mentions that he was adopted at the age of 2 and isn't related to any of those people by blood.

He also clumsily tripped over the fence and had pain in his left arm.  Eventually you figure out that he downed 5 Red Bulls and 4 Caffeine Pills shortly before the incident.  And of course, he only mentions this casually like it's no big deal after digging deeper and deeper with a combination of open ended and specific questions.

They only allow 1 and a half hours for the practical and I used the entire time both times.  I would have taken 3 hours to write it if I could.