AQUIFER CASE STUDY: INTERNAL MEDICINE 02: 60-YEAR-OLD FEMALE WITH CHEST PAIN (2026/2027) UPDATE|EXAM QUESTIONS WITH MULTIPLE CHOICES |VERIFIED & REVISED ANSWERS (NEW)!!!

AQUIFER CASE STUDY: INTERNAL
MEDICINE 02: 60-YEAR-OLD FEMALE
WITH CHEST PAIN (2026/2027)
UPDATE|EXAM
QUESTIONS WITH MULTIPLE
CHOICES |VERIFIED & REVISED
ANSWERS (NEW)!!!
Listmbelowmthreempotentialmcausesmofmchestmpainminmeachmofmthemcategoriesmmentionedmandmdesi
gnatemthemconditionsmyoumwouldmconsiderm"cannotmmissmdiagnoses."m-
mCORRECTmANSWERmCardiac:mAcutemMyocardialmInfarction,mAorticmDissection,mPulmonarymEmbol


ism

Gastrointestinal:mEsophagealmRupturem(critical),mAcutemCholecystitism(considermurgency),mPepticm
Ulcerm(ifmperforated)

Pulmonary:mPneumothoraxm(especiallymtension),mARDSm(ifmsevere)

Musculoskeletal:mAcutemThoracicmSpinemInjurym(ifmfractureminvolved),mRibmFracturem(withmlungminj
ury)

Psychogenic:mPanicmAttackm(importantmtomrulemoutmcardiacmcauses).



Question

Basedmonmwhatmyoumknowmaboutmthempatientmsomfar,mwritemamone-mtomthree-
msentencemsummarymstatementmtomcommunicatemyourmunderstandingmofmthempatientmtomothermp


roviders.m-mCORRECTmANSWERmSusanmJohnstonmismam60-year-
oldmfemalemwithmampastmhistorymofmobesity,mhypertension,mandmdyslipidemiamwithmamfamilymhistor
ymofmcardiacmdiseasemwhompresentsmwithmamthree-
monthmhistorymofmintermittentmburningmanteriormchestmpainmassociatedmwithmdyspnea,mthatmoccu
rsmwithmexertionmandmimprovesmwithmrest.mOthermthanmhypertensionmandmhermelevatedmBMI,mherm
physicalmexammismwithinmnormalmlimits.

, Themidealmsummarymstatementmconciselymhighlightsmthemmostmpertinentmfeaturesmwithoutmomitti
ngmanymsignificantmpoints.mThemsummarymstatementmabovemincludes:



Epidemiologymandmriskmfactors:m60-year-
oldmfemalemwithmhistorymofmobesity,mhypertension,mandmdyslipidemia,masmwellmasmamfamilymhistory
mofmcardiacmdisease.



Keymclinicalmfindingsmaboutmthempresentmillnessmusingmqualifyingmadjectivesmandmtransformativeml
anguage:

Burningmchestmpain

Threemmonthsmofmintermittentmsymptoms

Associationmwithmdyspnea

Occursmwithmexertionmandmimprovesmwithmrest

Physicalmexammunremarkablemothermthanmhypertension



Question

Whichmofmthemfollowingmaremthemtopmtwomdiagnosesmonmyourmdifferentialmatmthismpoint?



A.mAorticmdissectionm(AD)

B.mGastroesophagealmrefluxmdiseasem(GERD)

C.mMusculoskeletalmpain

D.mMyocardialminfarctionm(MI)

E.mPleurisy

F.mPneumothorax

G.mPulmonarymembolismm(PE)

H.mStablemAnginam-mCORRECTmANSWERmAnswermComment

ThemCORRECTmANSWERsmaremB,mH.