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            [0] => a:18:{i:0;a:3:{s:8:"question";s:15:"Chief Complaint";s:6:"answer";s:20:"Difficulty Breathing";s:13:"preload_value";s:0:"";}i:1;a:3:{s:8:"question";s:26:"History of Present Illness";s:6:"answer";s:569:"The patient is a 23-year-old male with a history of COPD who presents to the emergency department with a chief complaint of difficulty breathing. Symptoms began last night when the patient’s air conditioner broke and he found it more difficult to breathe in the hot air. Associated symptoms include a cough. He reports similar episodes of this in the past, specifically in the summer. The patient denies chest pain, back pain, abdominal pain, nausea, emesis, 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:4:"COPD";s:13:"preload_value";s:0:"";}i:4;a:3:{s:8:"question";s:19:"Current Medications";s:6:"answer";s:4:"None";s:13:"preload_value";s:0:"";}i:5;a:3:{s:8:"question";s:14:"Social History";s:6:"answer";s:120:"Smoking Status - Yes
Smokeless Tobacco - No
Alcohol Use - Not Asked
Drug Use - Not Asked
Sexual Activity - Not Asked";s:13:"preload_value";s:0:"";}i:6;a:3:{s:8:"question";s:14:"Family History";s:6:"answer";s:15:"Noncontributory";s:13:"preload_value";s:0:"";}i:7;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:8;a:3:{s:8:"question";s:13:"Physical Exam";s:6:"answer";s:2100:"GENERAL: Alert and oriented x3. 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 moist and without erythema, 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. There is accessory muscle use. 
LUNGS: Breath sounds are present and equal bilaterally, there is wheezing in all lung fields. 
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable 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:1902:"GENERAL: Alert and oriented x3. 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 moist and without erythema, 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: ***
LUNGS: ***
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable 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.";}i:9;a:3:{s:8:"question";s:18:"ED COURSE:
Orders";s:6:"answer";s:50:"Oxygen- CPAP 6L/Min
X Chest 1 View Portable
Labs";s:13:"preload_value";s:0:"";}i:10;a:3:{s:8:"question";s:24:"Medications Administered";s:6:"answer";s:19:"Nebulizer Treatment";s:13:"preload_value";s:0:"";}i:11;a:3:{s:8:"question";s:11:"Lab Results";s:6:"answer";s:6:"Normal";s:13:"preload_value";s:0:"";}i:12;a:3:{s:8:"question";s:9:"Radiology";s:6:"answer";s:170:"X Chest 1 View Portable: ordered and images reviewed by Dr. ***. Interpreted by Dr. ***. 
Indication: Difficulty breathing
Interpretation: No pneumothorax or pneumonia.";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:253:"***: Rechecked patient who is resting comfortably. His breathing has improved with the nebulizer treatment and oxygen.  Imaging and lab results were discussed. The plan for discharge 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:880:"The patient is a male who presents to the emergency department with a chief complaint of difficulty breathing.  Medical records were reviewed. Lab work was ordered and reviewed. Findings stated above.  A chest x-ray was also ordered and reviewed. Imaging shows no pneumothorax or pneumonia. The patient was provided with a nebulizer treatment and oxygen resulting in improvement of symptoms.  The patient was discharged home with a diagnosis of dyspnea. The patient was advised to get oxygen for his home. It was recommended for the patient to follow up with Dr. Carter (Respiratory Therapy) within the next week.  The patient was provided prescriptions for an albuterol inhaler.  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:7:"Dyspnea";s:13:"preload_value";s:0:"";}i:17;a:3:{s:8:"question";s:4:"Plan";s:6:"answer";s:103:"The patient is discharged home in stable condition and does not have any further questions or concerns.";s:13:"preload_value";s:0:"";}}
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            [0] => Mock Patient #26: DIFFICULTY BREATHING - AGE 23
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            [0] => Mock Patient #26 REVIEW: DIFFICULTY BREATHING - AGE 23
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Array
(
    [0] => Array
        (
            [question] => Chief Complaint
            [answer] => Difficulty Breathing
            [preload_value] => 
        )

    [1] => Array
        (
            [question] => History of Present Illness
            [answer] => The patient is a 23-year-old male with a history of COPD who presents to the emergency department with a chief complaint of difficulty breathing. Symptoms began last night when the patient’s air conditioner broke and he found it more difficult to breathe in the hot air. Associated symptoms include a cough. He reports similar episodes of this in the past, specifically in the summer. The patient denies chest pain, back pain, abdominal pain, nausea, emesis, 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] => COPD
            [preload_value] => 
        )

    [4] => Array
        (
            [question] => Current Medications
            [answer] => None
            [preload_value] => 
        )

    [5] => Array
        (
            [question] => Social History
            [answer] => Smoking Status - Yes
Smokeless Tobacco - No
Alcohol Use - Not Asked
Drug Use - Not Asked
Sexual Activity - Not Asked
            [preload_value] => 
        )

    [6] => Array
        (
            [question] => Family History
            [answer] => Noncontributory
            [preload_value] => 
        )

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

    [8] => Array
        (
            [question] => Physical Exam
            [answer] => GENERAL: Alert and oriented x3. 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 moist and without erythema, 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. There is accessory muscle use. 
LUNGS: Breath sounds are present and equal bilaterally, there is wheezing in all lung fields. 
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable 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. 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 moist and without erythema, 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: ***
LUNGS: ***
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable 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.
        )

    [9] => Array
        (
            [question] => ED COURSE:
Orders
            [answer] => Oxygen- CPAP 6L/Min
X Chest 1 View Portable
Labs
            [preload_value] => 
        )

    [10] => Array
        (
            [question] => Medications Administered
            [answer] => Nebulizer Treatment
            [preload_value] => 
        )

    [11] => Array
        (
            [question] => Lab Results
            [answer] => Normal
            [preload_value] => 
        )

    [12] => Array
        (
            [question] => Radiology
            [answer] => X Chest 1 View Portable: ordered and images reviewed by Dr. ***. Interpreted by Dr. ***. 
Indication: Difficulty breathing
Interpretation: No pneumothorax or pneumonia.
            [preload_value] => 
        )

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

    [14] => Array
        (
            [question] => Calls/Consults/Rechecks
            [answer] => ***: Rechecked patient who is resting comfortably. His breathing has improved with the nebulizer treatment and oxygen.  Imaging and lab results were discussed. The plan for discharge was discussed. Patient agrees with plan. All questions were addressed.
            [preload_value] => 
        )

    [15] => Array
        (
            [question] => Medical Decision Making
            [answer] => The patient is a male who presents to the emergency department with a chief complaint of difficulty breathing.  Medical records were reviewed. Lab work was ordered and reviewed. Findings stated above.  A chest x-ray was also ordered and reviewed. Imaging shows no pneumothorax or pneumonia. The patient was provided with a nebulizer treatment and oxygen resulting in improvement of symptoms.  The patient was discharged home with a diagnosis of dyspnea. The patient was advised to get oxygen for his home. It was recommended for the patient to follow up with Dr. Carter (Respiratory Therapy) within the next week.  The patient was provided prescriptions for an albuterol inhaler.  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] => Dyspnea
            [preload_value] => 
        )

    [17] => Array
        (
            [question] => Plan
            [answer] => The patient is discharged home in stable condition and does not have any further questions or concerns.
            [preload_value] => 
        )

)

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