| Course | PA 503 Essential Foundations in Clinical Medicine |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 520 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 503 Week 1
Week 1 Discussion: Initial Post
"There's Been a Little Blood When I Cough": Choosing One Question for a 58-Year-Old Former Smoker With Three Weeks of Streaked Sputum
Initial Post
The complaint, restated. A 58-year-old man, a long-haul truck driver who stopped smoking six years ago after about 36 pack-years, told the clinic, "There's been a little blood when I cough, for about three weeks. It started after a cold." There was no fever, weight was steady and breathing was comfortable. The worry, the patient said, came from a brother who had "something on his lung" last year. The complaint could lead in many directions, and the temptation is to list everything that causes coughing up blood. This post chooses one question instead.
The question I would ask first. Is the blood coming from the lungs and airways at all, or from the nose, mouth or stomach? Bleeding from the back of the nose or the gums can be coughed or spat out and look like hemoptysis; blood from the stomach is vomited, often dark, with food. Determining the origin is the first step in evaluating hemoptysis (Earwood & Thompson, 2015), because every later decision depends on it.
The Two Branches
The answer splits the work in two. If the history points to the nose or mouth, such as nosebleeds, gum bleeding or blood that appears without coughing, the next steps are an examination of the nose and mouth and probably no chest imaging. If the blood is clearly coughed up from below, mixed with sputum, the question becomes why the airways are bleeding, and the patient's age, smoking history and three weeks of symptoms make lung cancer one of the causes that must be considered, along with infection, bronchitis and bronchiectasis. In that branch, chest imaging follows, and a normal chest radiograph would not end the evaluation for someone with these risk factors (Earwood & Thompson, 2015).
How I Would Ask
I would ask the patient to describe exactly what appears: blood streaks in sputum or blood alone, bright red or dark, after coughing or without coughing, and whether there have been nosebleeds, bleeding gums or vomiting. I would also ask about the cold that started it, since a recent infection is a common and reassuring explanation, but not one that can be assumed when the symptom has lasted three weeks.
A Question for You
When you hear a complaint like this, what is your first question, and does it divide the possibilities as cleanly as the origin question does?
Reply to Simone
Simone, your choice to ask first about chest pain in the patient with palpitations is interesting. I wonder what each answer would change. If chest pain makes you order an ECG and its absence also leads to an ECG, does the question divide the work, or would another question do more?
Reply to Reggie
Reggie, I liked that you asked whether the patient with headache had ever had one like it before. That splits new from recurrent headache well. Could you say what you would do differently on each branch, so we can see why it comes first?
References
Earwood, J. S., & Thompson, T. D. (2015). Hemoptysis: Evaluation and management. American Family Physician, 91(4), 243-249.
The Chamberlain PA 503 Week 1 instructions
The first post asks you to take a common complaint and choose one question to ask first. Restate the complaint as a patient would give it. Then commit to a single question, rather than listing everything that could cause the symptom. Explain why that question comes first and what each answer would change: the branches it creates and what you would do on each. Say how you would ask it in plain language. Keep references light, since the week is about reasoning rather than sources. Close by asking classmates to put their own first question to the same test. In replies, ask peers what each answer to their question would change, so the discussion stays on choosing rather than describing.
Inside the PA 503 Week 1 example
The post opens with a truck driver who quit smoking six years ago after about 36 pack-years and has coughed up blood streaks for three weeks after a cold, with a worried mention of a brother's lung mass. It chooses one first question: is the blood coming from the airways at all, or from the nose, mouth or stomach. One branch leads to a nose and mouth examination and probably no imaging; the other leads to chest imaging and to lung cancer as a cause that cannot be ignored, with a normal radiograph not ending the evaluation. The post plans the bedside wording. Replies ask Simone what her chest pain question changes and Reggie what follows each branch.
PA 503 Week 1 rubric: what full points look like
The largest loss here goes to a post that answers a different assignment, describing the complaint at length and never committing to a question. Description is comfortable and earns little, because the exercise is choosing. Close behind is a question with no consequence, one whose answers would lead to the same next step. Posts that list several first questions, or that reach for a diagnosis before choosing a question, also lose points. Strong posts restate the complaint briefly, choose one question, explain what each answer would change, show how they would ask it and invite classmates to test their own questions. Replies earn credit by asking a classmate what their question changes, rather than offering a different diagnosis.
PA 503 Week 1 help: mistakes that cost points
Choosing one question is harder than it sounds, because every complaint invites a long list. If you tell us about a complaint you have seen or been assigned, we can help you find the question that divides the possibilities most cleanly, lay out the branches and plan how to ask it in plain words. A reply that asks a classmate what each answer would change is another thing we can draft with you. The complaint and the reasoning about it are yours. When a section assigns the complaint, the custom sample starts from that exact case text.
Get a PA-503 Week 1 example written to your instructions
Send the exact Week 1 instructions from your classroom, along with the reply count your section expects, and a custom example comes back written to them inside 24 to 48 hours, the first one free. If your section supplies a starting complaint, include it, since the post is built around that complaint rather than around a generic one.
More PA 503 papers and MPAS samples
- PA 503 Week 2: Illness Script
- PA 503 Week 3: Problem Representation Write-up
- PA 503 Week 4: Diagnostic Schema Build
- PA 503 Week 5: Test Characteristics Problem Set
- PA 503 Week 6: Assessment and Plan Draft
- PA 503 Week 7: Verbal Case Summary
- PA 503 Week 8: Diagnostic Error Analysis
- PA 502 Week 1: Clinical Question Post
- PA 501 Week 1: Defining the PA Role Post
PA 503 Week 1 questions, answered
How long should the Week 1 post be?
Sections publish their own limits and the desk matches whichever one yours gives. Where nothing is stated, about three hundred words carries the complaint, one question, its defense and the two branches without padding. Length is rarely what separates a strong post from a weak one in this week; commitment to a single question almost always is.
Can the post name a diagnosis?
It can name possibilities, and two or three is normal, but only as the things the chosen question would separate. A post that settles on one condition before asking anything has skipped the exercise, and markers say so in the comments. Keep the named conditions in service of the question rather than the other way around.
Ours gives a whole scenario, not a complaint. Does the shape change?
Not much. A scenario carries more detail, so the restating line does more work and the defense can point at specifics already on the page. The commitment to one next question stays exactly the same. Attach the scenario and the example works from it directly rather than from a substitute case.
Where can I find a free PA 503 Week 1 sample paper?
This page holds a full PA 503 Week 1 post choosing a first question for a former smoker coughing up blood, with two replies.
What first question does the PA 503 Week 1 sample choose?
Whether the blood is coming from the lungs and airways at all, or from the nose, mouth or stomach, since every later decision depends on the answer.