| Course | PA 504 Medical Interviewing and Documentation |
|---|---|
| Week | 3 |
| Paper type | History of present illness draft |
| Length | About 580 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 504 Week 3
History of Present Illness Draft: Six Weeks of Chest Burning That Comes on the Stairs at Work and Eases With Rest, Written as a Chronology
Student Name
Chamberlain University
PA 504: Medical Interviewing and Documentation
Instructor Name
Month Day, Year
History of Present Illness Draft: Six Weeks of Chest Burning That Comes on the Stairs at Work and Eases With Rest, Written as a Chronology
The Draft
A school custodian of 56 describes "a burning in my chest that comes when I work hard," interpreted from Spanish. The patient was well until about six weeks ago, when the burning first appeared while carrying two full trash bins up a flight of 18 stairs at the end of an afternoon shift. It was felt in the center of the chest, did not spread to the arms, jaw or back and eased after about three minutes of standing still at the top. Since then it has come on most workdays, always with the stairs and the bins, and twice in the last week while walking quickly to the bus with groceries. It has never come after meals, when lying down or at rest. With it the patient feels short of breath and "a little sweaty," without nausea or palpitations. An over-the-counter antacid, taken for two weeks on a coworker's advice, made no difference; resting at the top of the stairs always relieves it. The episodes now come after fewer steps than at first, about halfway up rather than at the top. The patient has not had fainting, leg swelling or symptoms at night, and came in because "the medicine for heartburn isn't working."
Notes on the Draft
The complaint in their construction. The first sentence keeps the patient's words, "a burning in my chest that comes when I work hard," rather than translating it at once into "chest pain" or "heartburn." Either translation would have prejudged the cause; the patient's phrase already contains the most important feature, the link to effort.
Start at the last normal day. The chronology begins "well until about six weeks ago," so a reader knows when the illness started and can follow it forward.
Attributes inside the story. Location, radiation, duration, triggers, relief and associated symptoms all appear, but in the order the story needs them rather than in a fixed sequence of questions. A reader learns the trigger and the relief together, because the pattern is the point.
What was tried, and what it did. The antacid's failure is recorded because it argues against acid reflux, and the relief with rest is recorded because it argues for exertional angina.
Change over time. The draft notes that the episodes now come sooner on the stairs. A rising frequency or a lower threshold is a change a reader needs to see early, since it can signal unstable symptoms that need faster evaluation.
No diagnosis in the paragraph. The words "angina" and "reflux" do not appear. The history is the evidence; the diagnosis belongs in the assessment, where it can be argued.
Why It Matters for This Patient
In a large registry of myocardial infarction admissions, a greater share of women than men arrived with no chest pain at all (Canto et al., 2012), so a history that records only the presence or absence of "chest pain" can miss a pattern described in other words. Keeping the patient's own description, and the clear link to exertion, is what allows a reader of the note to recognize possible angina.
References
Canto, J. G., Rogers, W. J., Goldberg, R. J., Peterson, E. D., Wenger, N. K., Vaccarino, V., Kiefe, C. I., Frederick, P. D., Sopko, G., & Zheng, Z.-J. (2012). Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA, 307(8), 813-822. https://doi.org/10.1001/jama.2012.199
What the PA 504 Week 3 assignment asks for
Week three asks you to write the history of present illness from an interview transcript or encounter you are given. Write it as a paragraph, not a list, and start from the complaint in the patient's own words. Begin the story at the last day the patient felt well and move forward in time. Include the attributes of the symptom, such as location, quality, timing, triggers, relief and associated symptoms, but place them where the story needs them rather than in a fixed sequence. Record what the patient tried and what it did. Note any change over time, especially worsening. Leave diagnoses out of the paragraph; they belong in the assessment. Where the material gives conflicting details, such as two start dates, choose and say why. After the draft, explain your choices briefly, with a source where one supports a point.
How this PA 504 Week 3 example is built
The draft opens on the custodian's phrase, a burning in the chest that comes when working hard, and places its start six weeks back, while hauling two full bins up 18 stairs at the end of a shift. It follows the pattern forward: center of the chest, no spread, gone after about three minutes standing still, then on most workdays and twice while hurrying to the bus with groceries. Shortness of breath and mild sweating are recorded with it; nausea and palpitations are not. Two weeks of an antacid on a coworker's advice changed nothing, while rest always helped, and the burning now begins about halfway up the flight. The notes section explains keeping the patient's words, starting at the last normal day, placing attributes inside the story, recording the failed remedy, flagging the change in threshold and keeping the words angina and reflux out. A short closing section ties the phrasing to registry data on painless infarction in women.
Reading the PA 504 Week 3 grading rubric
The biggest deduction lands on a history written as a list of attributes, the mnemonic laid out letter by letter, because the assignment grades whether the pattern can be read as a story. Almost as costly is a diagnosis inside the paragraph, such as "GERD symptoms" or "anginal pain," which turns the history into an argument for one conclusion. After those come smaller losses: a start date that is never fixed, a remedy mentioned without what it did, a change in frequency or threshold left to the end or left out, and the patient's words replaced by clinical terms in the first sentence. Strong drafts keep the patient's phrasing, start at the last normal day, put trigger and relief together where the pattern shows, record what was tried and flag worsening early. The explanation after the draft earns its share when each choice is tied to a sentence in the paragraph rather than described in general.
Common PA 504 Week 3 mistakes, and how to avoid them
Turning a transcript into a story is the skill this week tests, and most first attempts either read as a checklist or wander. Share the transcript or case your section supplied and we can help you find the last normal day, order the events and decide where each attribute belongs so that the pattern shows. We can also help with conflicting details, such as two start dates, and how to explain the one you chose. Keeping diagnostic labels out of the paragraph is harder than it sounds, and we can mark the places where a label has slipped in. The case and your clinical reading stay yours. When your rubric sets a length or asks for particular elements, the custom sample keeps to the limit and covers each element inside the narrative rather than as a list.
Get a PA-504 Week 3 example written to your instructions
Send your classroom's assignment and the template it hands out, together with any transcript supplied, and a custom PA-504 Week 3 HPI draft is returned inside 24-48h, free the first time. Section order differs between programs, so the draft is built into the fields your own note format publishes rather than a generic arrangement.
More PA 504 papers and MPAS samples
- PA 504 Week 1: Interview-Only Fact Post
- PA 504 Week 2: Encounter Opening Script
- PA 504 Week 4: Review of Systems Draft
- PA 504 Week 5: Interpreted Encounter Analysis
- PA 504 Week 6: Collateral History Brief
- PA 504 Week 7: Note Revision Exercise
- PA 504 Week 8: Consultant Letter
- PA 503 Week 3: Problem Representation
- PA 502 Week 3: NNT Calculation
- PA 501 Week 3: State Practice Act Analysis
PA 504 Week 3 questions, answered
The transcript gives two different start dates. Which one goes in?
Both, with the discrepancy on the page. A history where the patient said six weeks early on and three weeks later is a more useful document than one silently picking a number, and graders on this course reward the version showing the contradiction. Write what was said each time and let the assessment section deal with it.
How long should the paragraph run?
Long enough to carry a chronology and no longer, which for most material is somewhere between one and two hundred words. Size earns nothing on its own. A draft is judged on whether a reader could restate the course of the illness from it without asking a further question, and padding works against that directly.
Does family or medication material belong in the HPI?
Only where it bears on this illness. A drug started three weeks before the symptom appeared belongs in the story; the rest of the medication list belongs in its own section. The test most rubrics apply is whether the item changes how the present illness reads, and if it does not, moving it out tightens the paragraph.
Where can I find a free PA 504 Week 3 sample paper?
You can read the full PA 504 Week 3 history of present illness for exertional chest burning, written as a chronology with notes, on this page.
Why does the PA 504 Week 3 sample keep the words angina and reflux out?
The history is the evidence and the assessment is where a diagnosis is argued, so a label in the paragraph would prejudge the cause before a reader sees the pattern.