| Course | PA 504 Medical Interviewing and Documentation |
|---|---|
| Week | 8 |
| Paper type | Consultant letter |
| Length | About 660 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 8
Consultant Letter: Asking a Cardiologist for an Opinion and Stress Testing This Week for Exertional Chest Burning With a Falling Threshold
Student Name
Chamberlain University
PA 504: Medical Interviewing and Documentation
Instructor Name
Month Day, Year
Consultant Letter: Asking a Cardiologist for an Opinion and Stress Testing This Week for Exertional Chest Burning With a Falling Threshold
The Letter
Dr. Imani Okafor
Cardiology Clinic, Regional Medical Center
October 14
Dear Dr. Okafor,
I am writing to ask for your opinion and for stress testing, this week if possible, for a 56-year-old patient with six weeks of exertional chest burning that now comes on with less effort. I am asking for consultation and testing, with ongoing care to remain with our clinic unless you advise otherwise.
The patient describes, in Spanish through a trained interpreter, a central chest burning that comes on carrying trash bins up a flight of stairs at work and eases after about three minutes of rest, with shortness of breath and mild sweating. It now begins about halfway up the stairs, earlier than at first, and twice came on walking quickly to the bus. It does not occur after meals, lying down or at rest, and two weeks of antacids did not help. There has been no fainting, palpitations or leg swelling.
Blood pressure was 142/86 and the resting electrocardiogram showed sinus rhythm without acute changes. The examination was otherwise unremarkable. The patient's daughter reports that the patient's mother died suddenly at 60, possibly from heart disease; we have not yet confirmed this with the patient. Laboratory results, including lipids and hemoglobin A1c, are pending and will be sent when available.
My working impression is stable angina that may be progressing, given the falling threshold, and I am less concerned about acid reflux. The patient has had knee pain on stairs for a year, which may limit treadmill exercise, so you may prefer a pharmacologic stress study.
I am asking for an appointment within a week because of the change in threshold. The patient knows to call 911 if the burning arrives while sitting still or will not settle within a quarter of an hour. We have started aspirin and discussed a statin pending your evaluation.
Please let me know what you advise. I will contact the patient by phone in one week to check on symptoms and the appointment, and I will see the patient in clinic two weeks after your evaluation. A professional Spanish interpreter will be needed for the visit; the patient prefers in-person interpretation.
Sincerely,
Daniel Reyes, PA student, for Jennifer Hall, PA-C
Family Medicine Clinic
Notes on the Letter
Which of the three. Consultants can be asked for an opinion, a procedure or a transfer of ongoing care, and each places a different obligation on them. The letter asks for an opinion and a test while keeping ongoing care with the clinic, and says so in the second sentence.
History compressed to the request. The history keeps only what bears on the decision to test and how: the exertional pattern, the falling threshold, the failed antacid, the family history and the knee pain that affects test choice.
Say what you already think. The letter states the working impression. A consultant can agree or disagree with a stated view more efficiently than with an unstated one.
Urgency with a reason. The request for a visit within a week is tied to the falling threshold, and the safety plan for symptoms at rest is stated so the consultant knows it is in place. Because infarction in women is more often painless than in men (Canto et al., 2012), the letter quotes the burning as described rather than labeling it.
The interval belongs to you. The clinic, not the consultant, is responsible for the patient between now and the appointment, so the letter states when the clinic will check on the patient and when the patient will be seen again.
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
The Chamberlain PA 504 Week 8 instructions
The final week asks for a letter to a consultant about a patient you have followed through the course. State in the opening lines what kind of help you want, an opinion, a procedure or a transfer of ongoing care, and how soon, with the reason for the timing. Give a history compressed to what bears on the consultant's decision, not the whole record. Include the relevant findings and results, saying which are attached or still pending. State your own working impression and what you are less concerned about, so the consultant can agree or disagree. Mention anything that affects how the consultant will proceed, such as a limitation that changes test choice or a need for an interpreter. Say what has been started and what the patient has been told to do in the meantime, and who is responsible for the patient until the visit. Follow the letter with short notes explaining your choices.
Inside the PA 504 Week 8 example
The letter is addressed to a named cardiologist at a regional center and opens by asking for an opinion and stress testing within a week for six weeks of exertional chest burning with a falling threshold, while ongoing care stays with the clinic. The second paragraph compresses the history: burning on the stairs with the bins, easing with rest, sooner than at first, breathlessness and sweating, no relation to meals and no help from antacids. Findings follow: blood pressure 142/86, a normal resting tracing, a reported family history not yet confirmed and lipids and A1c still pending. The impression is stable angina that may be progressing. Knee pain is flagged as a reason to consider a drug stress study. The safety plan, aspirin and a statin discussion are stated, along with the clinic's phone check in a week and the need for an in-person interpreter. Notes then explain each part of the letter.
Where the points sit in the PA 504 Week 8 rubric
The largest deduction goes to a letter whose request appears only at the end, or never, because a consultant reading three paragraphs of history cannot tell what is being asked. Close behind is a letter that pastes the full record, burying the few facts that bear on the decision. Further losses come from leaving out the writer's own impression, from urgency stated without a reason, from results retyped in full instead of named and attached, from no word on who is responsible for the patient before the appointment and from missing practical needs such as an interpreter. Strong letters name the request and the timing first, compress the history to the decision, state an impression, flag anything that changes how the consultant will proceed, give the interim safety plan and set out follow-up. The notes after the letter earn their points by explaining choices rather than summarizing the letter.
PA 504 Week 8 help from the desk
Consultant letters are short, which means every sentence has to earn its place. If you share the case your section has followed through the course, we can help you decide which kind of request fits, write the opening lines so the request and timing come first and cut the history down to what the consultant needs. We can also help you state a working impression with appropriate confidence and write a clear interim plan. Results are often the hardest part to place, and we can help you decide which values belong in the body and which go in an enclosure. The case and the clinical judgment remain yours. If your program uses a letterhead, a set closing or a particular referral form, the custom sample is laid out to match it.
Get a PA-504 Week 8 example written to your instructions
Send the week's assignment and rubric, plus any case material your section issues, and a custom PA-504 Week 8 consultant letter is returned inside 24-48h with the first one at no cost. Programs differ on letterhead, salutation and whether a copy line is expected, so send the format your classroom requires as well.
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 3: HPI Draft
- 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 503 Week 8: Diagnostic Error Analysis
- PA 502 Week 8: Journal Club Brief
- PA 501 Week 8: Professional Commitment Memo
PA 504 Week 8 questions, answered
Do results go inside the letter or attached?
Attached, with the letter naming what is enclosed and quoting only the values carrying the argument. Retyping a full panel into a paragraph buries the request underneath it. Where your section supplies the material as text rather than as documents, list them under an enclosure heading and reference them by date in the body.
How much of the working list goes in?
Enough to show what has been considered and set aside, which is usually two or three entries rather than an exhaustive run. A consultant reading a very long list learns that no thinking has been done. Say what you believe most likely, what you cannot exclude, and which of those you are asking the reader to settle.
What if the patient is being sent on before anything has been worked up?
Then say that plainly and give the reason, whether it is urgency, an unavailable investigation, or a finding outside your scope. Rubrics on this course accept an early referral that explains itself and penalize one that looks like an incomplete assessment. Name what you would have done next had the patient stayed with you.
Where can I find a free PA 504 Week 8 sample paper?
This page has a complete PA 504 Week 8 consultant letter asking a cardiologist for an opinion and stress testing within a week, with notes on each part.
Why does the PA 504 Week 8 sample mention the patient's knees?
Knee pain on stairs may limit treadmill exercise, so the letter flags it in case the cardiologist prefers a drug stress study.