| Course | PA 531 Emergency Medicine |
|---|---|
| Week | 2 |
| Paper type | Chief complaint brief |
| Length | About 660 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 531 Week 2
Chief Complaint Brief for "The Worst Headache of My Life, It Hit Me Like a Bat": The Words Left Alone, Eleven Entries Ordered Fatal First Across Five Systems, and Migraine Kept on the List
Student Name
Chamberlain University
PA 531: Emergency Medicine
Instructor Name
Month Day, Year
Chief Complaint Brief for "The Worst Headache of My Life, It Hit Me Like a Bat": The Words Left Alone, Eleven Entries Ordered Fatal First Across Five Systems, and Migraine Kept on the List
The Complaint, Left Alone
"Worst headache of my life. It hit me like a bat, right at the back, while I was throwing snow." Recorded as said by A.N. at 01:52. It is not rewritten as "thunderclap headache, query subarachnoid hemorrhage," because translating the complaint into a diagnosis at this stage is how the other possibilities get dropped.
The List, Ordered Fatal First
Table 1
Possibilities for the Complaint as Spoken
| Entry | System | What would make it the answer |
|---|---|---|
| Aneurysmal subarachnoid hemorrhage | Vascular, intracranial | Blood in the subarachnoid spaces on CT or xanthochromia in spinal fluid |
| Intracerebral hemorrhage | Vascular, intracranial | Blood within brain tissue on CT, often with deficits |
| Cervical artery dissection | Vascular, neck | Neck pain with headache after strain, with a narrowed or torn vessel on CT angiography |
| Cerebral venous thrombosis | Vascular, venous | Headache with risk factors, filling defect on CT venography |
| Pituitary apoplexy | Endocrine | Sudden headache with visual loss or eye movement palsy, bleed into a pituitary mass on imaging |
| Bacterial meningitis | Infection | Fever, neck stiffness, altered mental state, spinal fluid findings |
| Hypertensive emergency with posterior reversible encephalopathy | Vascular, pressure | Very high pressure with confusion, visual change or seizures, typical MRI pattern |
| Reversible cerebral vasoconstriction syndrome | Vascular | Recurrent thunderclap headaches over days, often after exertion or certain drugs, segmental narrowing on angiography |
| Carbon monoxide poisoning | Toxic | Headache in more than one person in the same building, raised carboxyhemoglobin |
| Acute angle-closure glaucoma | Eye | Red painful eye, blurred vision, halos, a hard eye |
| Migraine or primary exertional headache | Primary headache | Prior similar episodes, normal workup, recovery |
Note. Note. Entries are ordered by how quickly each can kill or disable, not by how likely they are.
Fatal First, Rare or Not
Subarachnoid hemorrhage sits first even though most patients with a sudden severe headache do not have one, because missing it costs a life or a rebleed. Pituitary apoplexy is rare but sits above meningitis's more common relatives because it can blind within hours. The order reflects consequence and speed, not probability.
Across Systems, Not Inside One
A headache list built only from neurology would miss the toxic entry, carbon monoxide from a gas heater in a snowed-in house, and the eye entry, angle-closure glaucoma. A.N. heats a workshop with a propane heater; that detail moves carbon monoxide from theoretical to worth a question.
The Ordinary Explanation, Kept
Migraine and primary exertional headache stay on the list, at the bottom. A.N. has never had migraines, which lowers that possibility, but a list that drops the ordinary explanation makes every normal test look like a failure to find the "real" diagnosis. If the workup is normal, these will be the answer, and the list should say so from the start.
Questions, Not Findings
The list leads to questions rather than to conclusions already drawn. Was the onset truly instant, or over minutes? Any neck pain, fever, visual change or eye pain? Anyone else at home with a headache? Any previous headache like this in the past weeks? Any blood thinners, cocaine or decongestant use? Each question sorts several entries at once. The answers, gathered at the bedside, are recorded in the next document.
What the Guideline Adds
The Ottawa rule's validation established that investigation is required for this kind of presentation (Perry et al., 2013), and a CT within six hours of onset that is read as normal by a qualified radiologist is very sensitive for subarachnoid hemorrhage (Perry et al., 2011). Those findings shape the workup, not this list.
References
Perry, J. J., Stiell, I. G., Sivilotti, M. L. A., Bullard, M. J., Emond, M., Symington, C., Sutherland, J., Worster, A., Hohl, C., Lee, J. S., Eisenhauer, M. A., Mortensen, M., Mackey, D., Pauls, M., Lesiuk, H., & Wells, G. A. (2011). Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: Prospective cohort study. BMJ, 343, Article d4277. https://doi.org/10.1136/bmj.d4277
Perry, J. J., Stiell, I. G., Sivilotti, M. L. A., Bullard, M. J., Hohl, C. M., Sutherland, J., Emond, M., Worster, A., Lee, J. S., Mackey, D., Pauls, M., Lesiuk, H., Symington, C., & Wells, G. A. (2013). Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA, 310(12), 1248-1255. https://doi.org/10.1001/jama.2013.278018
The Chamberlain PA 531 Week 2 instructions
Week two calls for a brief built from a chief complaint. Place the complaint at the top in the words supplied, without rewriting it as a diagnosis. Under it, list the possibilities in a single ordered column, with a line for each saying what would make it the answer. Put the conditions that kill or disable quickly first, and write them out even if they are rare. Range across body systems rather than staying inside one specialty. Keep the ordinary, common explanation on the list. Finish with the questions the list generates for the bedside, not with findings or conclusions. Keep it to two pages, mostly list. Cite any evidence that will shape the workup that follows.
How the PA 531 Week 2 example is put together
The brief quotes A.N. at 01:52 and explains why the words are not converted into thunderclap headache with a query. Table 1 lists eleven entries, from aneurysmal subarachnoid hemorrhage and intracerebral hemorrhage through dissection, venous thrombosis, apoplexy, meningitis, hypertensive encephalopathy, vasoconstriction syndrome, carbon monoxide and angle-closure glaucoma to migraine, each with its system and defining finding. A section explains ordering by speed and consequence. Another shows how crossing systems catches carbon monoxide from a propane-heated workshop and an eye cause. Migraine is kept at the bottom with the reason. A questions section lists onset speed, neck pain, fever, vision, others at home, prior sentinel headaches and drugs. A final section cites the Ottawa rule and the six-hour CT study as shaping the workup.
Where the points sit in the PA 531 Week 2 rubric
Faculty grade the complaint line first: rewriting the patient's words into a diagnosis at the top of the page loses the largest share, because it is the error the week is designed to catch. The order comes next: lethal conditions must lead, regardless of rarity, and a list ordered by likelihood is marked down. Credit goes to entries that cross body systems and to a defining finding for each. Keeping the ordinary explanation earns marks. The brief should end in questions; ending in a diagnosis or a list of findings costs points. Brevity is part of the format, with the list doing most of the work. Evidence cited should bear on the workup rather than general reading.
PA 531 Week 2 help: mistakes that cost points
The most common mistake in this brief is opening with a diagnosis in place of the patient's words. Share the complaint as your case words it, and the brief prepared on that basis would keep those words intact, list possibilities fatal first across several body systems with a defining finding for each, and keep the ordinary explanation on the list. It ends with the bedside questions the list raises. If your complaint is chest pain, abdominal pain or shortness of breath, the systems and entries change but the order of thinking does not. The brief stays within two pages. Use the questions and entries that fit your own patient rather than copying the model's.
Get a PA-531 Week 2 example written to your instructions
Send the exact complaint your classroom hands out, along with any vital signs or arrival details attached to it, and a custom PA-531 Week 2 brief is written to that wording and returned in 24 to 48 hours. The first one is free. If your section publishes a cap on entries, include it.
More PA 531 papers and MPAS samples
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- PA 531 Week 8: Return Precautions Sheet
- PA 530 Week 2: Knee Mechanism of Injury Brief
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PA 531 Week 2 questions, answered
How long should the column of entries be?
Classrooms are not uniform on this, and some publish a number. Where none is given, the useful test is coverage rather than length: every system that could produce the complaint represented at least once, and every entry that could end badly inside a few hours written out. A column of twenty padded with variants of one thing scores below a column of eight that reaches wider.
Does the thing the patient probably has still belong on the page?
Yes, and leaving it off is a real loss. The brief is a map of one complaint, so the common and harmless explanations are part of what it maps; they simply sit at the bottom rather than the top. Removing them to make the page look serious produces a list nobody would use, and several sections mark proportion on its own row.
Ours attaches vital signs to the complaint.
Then they belong in the opening block and they legitimately move the order, but the list is still built from the complaint rather than from them. A finished example shows the figures once, says which entries they raise and which they do not touch, and keeps the rest of the column intact. Send the figures with the assignment and the sample uses those.
Where can I find a free PA 531 Week 2 sample paper?
The full PA 531 Week 2 chief complaint brief is on this page, eleven possibilities for a sudden severe headache ordered fatal first across five systems.
Why is carbon monoxide on the PA 531 Week 2 list?
The patient heats a workshop with a propane heater, and a list that crosses body systems catches toxic causes a neurology-only list would miss.