| Course | PA 612 Clinical Clerkship - Internal Medicine |
|---|---|
| Week | 7 |
| Paper type | Hospital course summary |
| Length | About 560 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 612 Week 7
Hospital Course Summary for W.H., March 2 to 13, 2026: Why the Admission Happened and What Turned Out to Be Wrong, Organized by Problem With Dates Inside Sentences, Pending Items Named and the Closed Reasoning Dropped
Student Name
Chamberlain University
PA 612: Clinical Clerkship - Internal Medicine
Instructor Name
Month Day, Year
Hospital Course Summary for W.H., March 2 to 13, 2026: Why the Admission Happened and What Turned Out to Be Wrong, Organized by Problem With Dates Inside Sentences, Pending Items Named and the Closed Reasoning Dropped
Why W.H. Was Admitted, and What Was Wrong
W.H., 74, with a mitral valve repair, was admitted on March 2 with three weeks of fever after two blood cultures grew Streptococcus gallolyticus. The admission found two connected illnesses: endocarditis of the repaired mitral valve, and a sigmoid adenocarcinoma that was the likely entry point for the organism.
Endocarditis
An echocardiogram on March 3 showed a 9-millimeter vegetation on the posterior mitral leaflet beside the annuloplasty ring with moderate regurgitation, meeting definite endocarditis under the 2023 Duke criteria (Fowler et al., 2023). The organism was fully susceptible to penicillin. Ceftriaxone 2 g daily began March 2; gentamicin was not added after discussion with infectious disease. Blood cultures from March 3 onward were negative. Because the annuloplasty ring is prosthetic material, the course is six weeks from the first negative culture, through April 13 (Baddour et al., 2015). A peripherally inserted central catheter was placed on March 6. Cardiac surgery saw W.H. on March 3 and found no indication for valve surgery. No fever after March 4.
Repeat echocardiogram before colon surgery was requested by cardiac surgery to confirm the vegetation is shrinking and the regurgitation is not worse.
Sigmoid Adenocarcinoma
Colonoscopy on March 7 found a 3.5-centimeter sigmoid mass and two small polyps, removed. Pathology on March 9 reported adenocarcinoma. CT of the chest, abdomen and pelvis on March 8 showed no metastases. Surgery is planned after the antibiotic course. The association between this organism and colorectal neoplasia was the reason for colonoscopy this admission (Boleij et al., 2011).
Iron-Deficiency Anemia
Hemoglobin was 9.8 g/dL with ferritin 9 on admission and 9.4 at discharge. Aspirin was stopped March 2. Intravenous iron was given March 11.
Bowel Preparation Complications
On March 6, during bowel preparation, W.H. had orthostatic hypotension and a potassium of 3.1, treated with fluids and potassium; both resolved by March 7. Amlodipine was held March 7 and restarted March 9.
Goals of Care
On March 10, W.H. chose full treatment, including surgery, with the daughter as health care agent. W.H. will discuss limits on prolonged life support with the surgeon before the operation.
Pending at Discharge
Alkaline phosphatase fractionation, sent March 8. Mismatch repair testing on the tumor. Repeat echocardiogram before colon surgery.
Each pending item names who will receive the result: the fractionation and mismatch repair results go to the primary care clinician and the surgeon; the repeat echocardiogram goes to cardiology and the surgeon.
Next Reader
For the outpatient infusion clinic: weekly blood counts and chemistry while on ceftriaxone. For surgery: colon resection after April 13 and repeat echocardiogram. For primary care: aspirin remains stopped until after surgery.
For infectious disease: confirm the stop date of April 13 at the March 27 visit and decide whether any further echocardiography is needed after treatment.
References
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Jr., Tleyjeh, I. M., Rybak, M. J., Barsic, B., Lockhart, P. B., Gewitz, M. H., Levison, M. E., Bolger, A. F., Steckelberg, J. M., Baltimore, R. S., Fink, A. M., O'Gara, P., & Taubert, K. A. (2015). Infective endocarditis in adults: Diagnosis, antimicrobial therapy, and management of complications: A scientific statement for healthcare professionals from the American Heart Association. Circulation, 132(15), 1435-1486. https://doi.org/10.1161/CIR.0000000000000296
Boleij, A., van Gelder, M. M. H. J., Swinkels, D. W., & Tjalsma, H. (2011). Clinical importance of Streptococcus gallolyticus infection among colorectal cancer patients: Systematic review and meta-analysis. Clinical Infectious Diseases, 53(9), 870-878. https://doi.org/10.1093/cid/cir609
Fowler, V. G., Durack, D. T., Selton-Suty, C., Athan, E., Bayer, A. S., Chamis, A. L., Dahl, A., DiBernardo, L., Durante-Mangoni, E., Duval, X., Fortes, C. Q., Fosbøl, E., Hannan, M. M., Hasse, B., Hoen, B., Karchmer, A. W., Mestres, C. A., Petti, C. A., Pizzi, M. N., . . . Miro, J. M. (2023). The 2023 Duke-International Society for Cardiovascular Infectious Diseases criteria for infective endocarditis: Updating the modified Duke criteria. Clinical Infectious Diseases, 77(4), 518-526. https://doi.org/10.1093/cid/ciad271
The Chamberlain PA 612 Week 7 instructions
The seventh week asks for a hospital course summary of about a page. Open with why the patient was admitted and what turned out to be wrong, in two or three sentences that do not repeat the admission note. Organize the body by problem rather than by day, with dates placed inside the sentences where they matter. Drop reasoning that has been closed, such as diagnoses ruled out early, unless the next reader needs it. Say plainly what is pending at discharge. End with what each next reader, such as an infusion clinic, a surgeon or primary care, needs to do. The summary differs from the full discharge summary in that it focuses on the course rather than every order. Cite the guidance behind major decisions.
Inside the PA 612 Week 7 example
The opening states the March 2 admission for Streptococcus gallolyticus bacteremia and the two connected findings. The endocarditis section gives the March 3 echocardiogram, definite endocarditis under Fowler et al. (2023), a susceptible organism, ceftriaxone from March 2 without gentamicin, negative cultures from March 3, six weeks through April 13 for prosthetic material (Baddour et al., 2015), a PICC on March 6 and no surgery. The cancer section gives the March 7 colonoscopy, March 9 pathology, a clear CT and surgery after antibiotics, citing Boleij et al. (2011). Short sections cover anemia with iron on March 11, the bowel preparation episode, and goals of care. Pending items are fractionation, mismatch repair testing and a repeat echocardiogram. The last section lists tasks for infusion, surgery and primary care.
Where the points sit in the PA 612 Week 7 rubric
The summary loses the most when it is organized day by day, which forces the next reader to assemble each problem from scattered entries. Next comes a summary that repeats the admission note or keeps closed reasoning that no longer matters. Graders deduct for pending items left unnamed. Faculty reward a short opening that says why and what, problems in their own paragraphs with dates inside sentences and tasks set out for each next reader. Accurate dates and durations are checked. Citation of the guidance behind antibiotic duration and other decisions, in APA form, completes the rubric.
PA 612 Week 7 help: mistakes that cost points
Hospital course summaries most often fall short by reading like a diary: day 1, day 2, day 3. Another common problem is omitting what is still pending, so results arrive with nobody waiting for them. Some summaries also repeat the admission history in full. If your patient's course was different, or the patient went to a nursing facility, send the problems with dates and the discharge destination; a summary written for you would open with why and what, organize by problem with dates inside sentences, name pending items and set out tasks for each next reader. If your patient was discharged to a facility, the next-reader section would address the facility team.
Get a PA-612 Week 7 example written to your instructions
Send the assignment, the rubric and the course summary template your site publishes, and a custom PA-612 hospital course is written to them and returned inside 24-48h, first one free. Where the assignment supplies a case with its events laid out day by day, the example is assembled from those events in the order the next reader needs them.
More PA 612 papers and MPAS samples
- PA 612 Week 1: Inpatient Day Count Post
- PA 612 Week 2: Admission History and Physical
- PA 612 Week 3: Attending Rounds Presentation
- PA 612 Week 4: Overnight Event Summary
- PA 612 Week 5: Problem List Expansion Memo
- PA 612 Week 6: Goals of Care Summary
- PA 612 Week 8: Day of Discharge Checklist
- PA 610 Week 7: Take-Home Instruction Sheet
- PA 608 Week 7: Content Area Audit
- PA 604 Week 7: First Quarter Goals
- PA 603 Week 7: Interview Answer Set
PA 612 Week 7 questions, answered
How is this different from the discharge summary?
The hospital course is one section of a discharge summary, and this week usually assigns it alone. That is deliberate: separated from the medication list and the follow-up block, the course has to carry the reasoning by itself and is marked on whether it does. Where a section assigns the whole discharge document instead, this paragraph is still where most of the points sit.
Can I build it out of the daily notes?
Copying forward is the habit this week is designed to expose. Daily notes are written for people who already know the patient, so a summary assembled out of them arrives carrying abbreviations, reasoning that was never closed, and detail nobody elsewhere will use. A finished example reads as one document written once, and faculty separate the two versions quickly.
My patient is going to a nursing home rather than home.
That changes the audience and therefore the selection. A facility needs the functional detail: what the patient can do now compared with admission, what assistance is required, what equipment was arranged, and which medications changed. A summary written for a primary care clinic weights differently, leaning on diagnosis, pending results and the appointment that follows. Sections naming the destination expect that difference to show.
Where can I find a free PA 612 Week 7 sample paper?
The complete PA 612 Week 7 hospital course summary for endocarditis and colon cancer, organized by problem, is on this page.
What is pending at discharge in the PA 612 Week 7 sample?
Alkaline phosphatase fractionation, mismatch repair testing on the tumor and a repeat echocardiogram before colon surgery.