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            [0] => a:18:{i:0;a:3:{s:8:"question";s:15:"Chief Complaint";s:6:"answer";s:8:"Vomiting";s:13:"preload_value";s:0:"";}i:1;a:3:{s:8:"question";s:26:"History of Present Illness";s:6:"answer";s:523:"The patient is a 13-year-old female with a history of diabetes who presents to the emergency department with a chief complaint of vomiting. Her mother reports that her blood sugars were elevated in the 400s last night and that she has been vomiting since then. Associated symptoms include abdominal pain that is described as achy with no radiation. The patient denies fever, chills, chest pain, shortness of breath, diarrhea, hematochezia, dysuria, hematuria, or any other symptoms. No other reported symptoms at this time.";s:13:"preload_value";s:0:"";}i:2;a:3:{s:8:"question";s:17:"Review of Systems";s:6:"answer";s:89:"All pertinent positive findings are listed in the HPI and all other systems are negative.";s:13:"preload_value";s:0:"";}i:3;a:3:{s:8:"question";s:20:"Past Medical History";s:6:"answer";s:22:"Diabetes (since age 3)";s:13:"preload_value";s:0:"";}i:4;a:3:{s:8:"question";s:19:"Current Medications";s:6:"answer";s:7:"Insulin";s:13:"preload_value";s:0:"";}i:5;a:3:{s:8:"question";s:9:"Allergies";s:6:"answer";s:23:"No known drug allergies";s:13:"preload_value";s:0:"";}i:6;a:3:{s:8:"question";s:14:"Social History";s:6:"answer";s:34:"There is no passive smoke exposure";s:13:"preload_value";s:0:"";}i:7;a:3:{s:8:"question";s:14:"Family History";s:6:"answer";s:49:"Denies family history of heart disease and cancer";s:13:"preload_value";s:0:"";}i:8;a:3:{s:8:"question";s:19:"Initial Vital Signs";s:6:"answer";s:3:"N/A";s:13:"preload_value";s:3:"N/A";}i:9;a:3:{s:8:"question";s:13:"Physical Exam";s:6:"answer";s:2128:"GENERAL: Alert and oriented x3. Appears ill. No significant distress noted. 
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Nares are patent, without epistaxis.  There is no rhinorrhea.  Pharynx is erythematous and moist, without exudate or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are rapid and present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Tachycardic rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is RLQ abdominal tenderness. There is no rebound or guarding. There is no palpable mass. Bowel sounds are present and equal throughout.
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.";s:13:"preload_value";s:1965:"GENERAL: Alert and oriented x3. Appears ill. No significant distress noted. 
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Nares are patent, without epistaxis.  There is no rhinorrhea.  Pharynx is erythematous and moist, without exudate or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are rapid and present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Tachycardic rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: ***
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.";}i:10;a:3:{s:8:"question";s:18:"ED COURSE:
Orders";s:6:"answer";s:45:"Labs - BMET, Arterial Blood Gases, Urinalysis";s:13:"preload_value";s:0:"";}i:11;a:3:{s:8:"question";s:24:"Medications Administered";s:6:"answer";s:38:"0.9% Normal Saline
Insulin
Potassium";s:13:"preload_value";s:0:"";}i:12;a:3:{s:8:"question";s:11:"Lab Results";s:6:"answer";s:16:"Ketones in urine";s:13:"preload_value";s:0:"";}i:13;a:3:{s:8:"question";s:10:"Procedures";s:6:"answer";s:4:"None";s:13:"preload_value";s:4:"None";}i:14;a:3:{s:8:"question";s:23:"Calls/Consults/Rechecks";s:6:"answer";s:210:"***: Rechecked patient who is resting comfortably. Lab results were discussed. The plan for admission to the ICU under the care of Dr. King was discussed. Patient agrees with plan. All questions were addressed.";s:13:"preload_value";s:0:"";}i:15;a:3:{s:8:"question";s:23:"Medical Decision Making";s:6:"answer";s:496:"The patient is a female who presents to the emergency department with a chief complaint of vomiting.  Medical records were reviewed. Lab work was ordered and reviewed. Findings stated above. The patient was admitted to the ICU under the care of Dr. King with a diagnosis of diabetic ketoacidosis. The patient's vital signs and condition remained stable while undergoing evaluation in the Emergency Department. The patient agreed with the plan for care.  All questions and concerns were addressed.";s:13:"preload_value";s:676:"The patient is a @AGE@ @SEX@ who presents to the emergency department with a chief complaint of ***.  Medical records were reviewed. Multiple diagnoses were considered.  Lab work was ordered and reviewed. A *** was also ordered and reviewed. Imaging shows ***.  The patient was provided with *** resulting in *** of symptoms. The patient was diagnosed with ***. The patient was advised to ***. It was recommended for the patient to follow up with ***.  The patient was prescribed ***.  The patient's vital signs and condition *** while undergoing evaluation in the Emergency Department. The patient*** agreed with the plan for care.  All questions and concerns were addressed.";}i:16;a:3:{s:8:"question";s:16:"Final Impression";s:6:"answer";s:21:"Diabetic Ketoacidosis";s:13:"preload_value";s:0:"";}i:17;a:3:{s:8:"question";s:4:"Plan";s:6:"answer";s:134:"The patient is admitted to the ICU under the care of Dr. King in stable condition and does not have any further questions or concerns.";s:13:"preload_value";s:0:"";}}
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            [0] => May 4, 2019 @ 7:11 pm
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    [patient_video_title] => Array
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            [0] => Mock Patient #13: VOMITING - AGE 13
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            [0] => Mock Patient #13 REVIEW: VOMITING - AGE 13
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Array
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    [0] => Array
        (
            [question] => Chief Complaint
            [answer] => Vomiting
            [preload_value] => 
        )

    [1] => Array
        (
            [question] => History of Present Illness
            [answer] => The patient is a 13-year-old female with a history of diabetes who presents to the emergency department with a chief complaint of vomiting. Her mother reports that her blood sugars were elevated in the 400s last night and that she has been vomiting since then. Associated symptoms include abdominal pain that is described as achy with no radiation. The patient denies fever, chills, chest pain, shortness of breath, diarrhea, hematochezia, dysuria, hematuria, or any other symptoms. No other reported symptoms at this time.
            [preload_value] => 
        )

    [2] => Array
        (
            [question] => Review of Systems
            [answer] => All pertinent positive findings are listed in the HPI and all other systems are negative.
            [preload_value] => 
        )

    [3] => Array
        (
            [question] => Past Medical History
            [answer] => Diabetes (since age 3)
            [preload_value] => 
        )

    [4] => Array
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            [question] => Current Medications
            [answer] => Insulin
            [preload_value] => 
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    [5] => Array
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            [question] => Allergies
            [answer] => No known drug allergies
            [preload_value] => 
        )

    [6] => Array
        (
            [question] => Social History
            [answer] => There is no passive smoke exposure
            [preload_value] => 
        )

    [7] => Array
        (
            [question] => Family History
            [answer] => Denies family history of heart disease and cancer
            [preload_value] => 
        )

    [8] => Array
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            [question] => Initial Vital Signs
            [answer] => N/A
            [preload_value] => N/A
        )

    [9] => Array
        (
            [question] => Physical Exam
            [answer] => GENERAL: Alert and oriented x3. Appears ill. No significant distress noted. 
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Nares are patent, without epistaxis.  There is no rhinorrhea.  Pharynx is erythematous and moist, without exudate or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are rapid and present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Tachycardic rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is RLQ abdominal tenderness. There is no rebound or guarding. There is no palpable mass. Bowel sounds are present and equal throughout.
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.
            [preload_value] => GENERAL: Alert and oriented x3. Appears ill. No significant distress noted. 
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Nares are patent, without epistaxis.  There is no rhinorrhea.  Pharynx is erythematous and moist, without exudate or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are rapid and present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Tachycardic rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: ***
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.
        )

    [10] => Array
        (
            [question] => ED COURSE:
Orders
            [answer] => Labs - BMET, Arterial Blood Gases, Urinalysis
            [preload_value] => 
        )

    [11] => Array
        (
            [question] => Medications Administered
            [answer] => 0.9% Normal Saline
Insulin
Potassium
            [preload_value] => 
        )

    [12] => Array
        (
            [question] => Lab Results
            [answer] => Ketones in urine
            [preload_value] => 
        )

    [13] => Array
        (
            [question] => Procedures
            [answer] => None
            [preload_value] => None
        )

    [14] => Array
        (
            [question] => Calls/Consults/Rechecks
            [answer] => ***: Rechecked patient who is resting comfortably. Lab results were discussed. The plan for admission to the ICU under the care of Dr. King was discussed. Patient agrees with plan. All questions were addressed.
            [preload_value] => 
        )

    [15] => Array
        (
            [question] => Medical Decision Making
            [answer] => The patient is a female who presents to the emergency department with a chief complaint of vomiting.  Medical records were reviewed. Lab work was ordered and reviewed. Findings stated above. The patient was admitted to the ICU under the care of Dr. King with a diagnosis of diabetic ketoacidosis. The patient's vital signs and condition remained stable while undergoing evaluation in the Emergency Department. The patient agreed with the plan for care.  All questions and concerns were addressed.
            [preload_value] => The patient is a @AGE@ @SEX@ who presents to the emergency department with a chief complaint of ***.  Medical records were reviewed. Multiple diagnoses were considered.  Lab work was ordered and reviewed. A *** was also ordered and reviewed. Imaging shows ***.  The patient was provided with *** resulting in *** of symptoms. The patient was diagnosed with ***. The patient was advised to ***. It was recommended for the patient to follow up with ***.  The patient was prescribed ***.  The patient's vital signs and condition *** while undergoing evaluation in the Emergency Department. The patient*** agreed with the plan for care.  All questions and concerns were addressed.
        )

    [16] => Array
        (
            [question] => Final Impression
            [answer] => Diabetic Ketoacidosis
            [preload_value] => 
        )

    [17] => Array
        (
            [question] => Plan
            [answer] => The patient is admitted to the ICU under the care of Dr. King in stable condition and does not have any further questions or concerns.
            [preload_value] => 
        )

)

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