Landon Smith Focused Exam: Long Bone Fracture -
Comprehensive Study Guide
Instructions: Use this guide to prepare for the simulation. The questions are organized
by phase of the patient encounter: Pre-Exam, History, Physical Exam, Documentation
(SOAP Note), and Post-Exam Reflection.
I. Pre-Exam & Patient Overview
1. What is the chief complaint for Landon Smith?
ANSWER: Pain and swelling in his right lower leg after a skateboarding accident.
2. What is the patient's demographic information?
ANSWER: Landon Smith is a 16-year-old male.
3. What is the primary mechanism of injury?
ANSWER: A skateboarding fall where he landed directly on his right leg, which twisted
under him.
4. Before starting the exam, what is the primary clinical suspicion?
ANSWER: A suspected fracture of the tibia and/or fibula in the right lower leg.
5. What are the key objectives for this focused exam?
ANSWER: To obtain a detailed history of the injury, assess neurovascular status,
perform a focused physical exam, and provide initial education and pain management.
II. History of Present Illness (HPI)
6. How did the injury occur?
ANSWER: Landon was skateboarding, tried a trick, fell, and landed on his right leg,
which twisted.
, 7. When did the injury happen?
ANSWER: Approximately 2 hours prior to the interview.
8. What was the immediate sensation at the time of injury?
ANSWER: He felt a "snap" or a "pop" and immediate, severe pain.
9. On a scale of 0-10, what is his current pain level?
ANSWER: He rates it as an 8/10.
10. Can Landon describe the quality of the pain?
ANSWER: He describes it as a sharp, throbbing pain.
11. Where is the pain located?
ANSWER: It is localized to the mid-shaft of his right tibia (shin).
12. Does the pain radiate anywhere else?
ANSWER: No, it is localized to the site of injury.
13. What makes the pain worse?
ANSWER: Any movement of the leg or bearing weight on it makes the pain significantly
worse.
14. What has he done to try to alleviate the pain?
ANSWER: He has not taken any medication. He is keeping the leg still, which provides
some relief.
15. Has he noticed any swelling?
ANSWER: Yes, there is significant swelling at the injury site.
16. Has he noticed any bruising or discoloration?
ANSWER: Yes, he has noticed bruising beginning to form.
17. Has he noticed any deformity?
ANSWER: He reports that the leg "looks wrong" or "bent," indicating a possible
deformity.
18. Did he hear or feel a "snap" or "pop"?
ANSWER: Yes, he felt and heard a "pop" at the moment of injury, which is classic for a
fracture.
19. Has he been able to move his ankle or toes since the injury?
ANSWER: He is hesitant to move it due to pain, but he can wiggle his toes.
Comprehensive Study Guide
Instructions: Use this guide to prepare for the simulation. The questions are organized
by phase of the patient encounter: Pre-Exam, History, Physical Exam, Documentation
(SOAP Note), and Post-Exam Reflection.
I. Pre-Exam & Patient Overview
1. What is the chief complaint for Landon Smith?
ANSWER: Pain and swelling in his right lower leg after a skateboarding accident.
2. What is the patient's demographic information?
ANSWER: Landon Smith is a 16-year-old male.
3. What is the primary mechanism of injury?
ANSWER: A skateboarding fall where he landed directly on his right leg, which twisted
under him.
4. Before starting the exam, what is the primary clinical suspicion?
ANSWER: A suspected fracture of the tibia and/or fibula in the right lower leg.
5. What are the key objectives for this focused exam?
ANSWER: To obtain a detailed history of the injury, assess neurovascular status,
perform a focused physical exam, and provide initial education and pain management.
II. History of Present Illness (HPI)
6. How did the injury occur?
ANSWER: Landon was skateboarding, tried a trick, fell, and landed on his right leg,
which twisted.
, 7. When did the injury happen?
ANSWER: Approximately 2 hours prior to the interview.
8. What was the immediate sensation at the time of injury?
ANSWER: He felt a "snap" or a "pop" and immediate, severe pain.
9. On a scale of 0-10, what is his current pain level?
ANSWER: He rates it as an 8/10.
10. Can Landon describe the quality of the pain?
ANSWER: He describes it as a sharp, throbbing pain.
11. Where is the pain located?
ANSWER: It is localized to the mid-shaft of his right tibia (shin).
12. Does the pain radiate anywhere else?
ANSWER: No, it is localized to the site of injury.
13. What makes the pain worse?
ANSWER: Any movement of the leg or bearing weight on it makes the pain significantly
worse.
14. What has he done to try to alleviate the pain?
ANSWER: He has not taken any medication. He is keeping the leg still, which provides
some relief.
15. Has he noticed any swelling?
ANSWER: Yes, there is significant swelling at the injury site.
16. Has he noticed any bruising or discoloration?
ANSWER: Yes, he has noticed bruising beginning to form.
17. Has he noticed any deformity?
ANSWER: He reports that the leg "looks wrong" or "bent," indicating a possible
deformity.
18. Did he hear or feel a "snap" or "pop"?
ANSWER: Yes, he felt and heard a "pop" at the moment of injury, which is classic for a
fracture.
19. Has he been able to move his ankle or toes since the injury?
ANSWER: He is hesitant to move it due to pain, but he can wiggle his toes.
