At GPAShark.com, we understand that identifying, interpreting, and summarizing key clinical findings is crucial to the development of clinical reasoning. The Aquifer Summary Statements offer a powerful way to assess and enhance students’ clinical skills. Faculty members can utilize these summary statements to track their students’ learning progress while providing feedback that improves understanding. For learners, writing accurate and concise summary statements is a valuable skill that helps in framing clinical problems and narrowing down differential diagnoses.
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How to Access Aquifer Summary Statements
Faculty in programs with institutional subscriptions can view summary statements across all students enrolled in a course. However, faculty at institutions where students have individual learner-level access must request students to submit their individual Student Reports for review. These reports allow faculty to compare student-generated summary statements with expert-generated ones, which facilitates a deeper understanding of clinical reasoning.
Guidelines for Writing an Effective Aquifer Summary Statement
Aquifer provides a set of guidelines for writing a summary statement, ensuring that students capture the essence of patient cases:
Accuracy: The statement must include correct and relevant information, avoiding any misleading details.
Focus on Primary Problems: It should frame the understanding of the patient’s primary issue, which helps narrow down the differential diagnosis by including only pertinent key features.
Use of Medical Terminology: Statements should express key findings using appropriate medical terms (e.g., tachycardia) and synthesize data into medical concepts (e.g., retractions + hypoxia + wheezing = respiratory distress).
Qualitative Descriptions: Use abstract, often binary, qualitative terms (e.g., acute vs. chronic, constant vs. intermittent).
A well-constructed summary statement should be concise, complete, and precise. Below are expert summary statements from various Aquifer Family Medicine cases that serve as models for students.
Aquifer Family Medicine Case Expert Summary Statements
Case Name
Expert Summary Statement
Family Medicine 01
N/A
Family Medicine 02
N/A
Family Medicine 03
N/A
Family Medicine 04
The patient is a 19-year-old female who presents with acute onset right ankle pain after an inversion injury. She could bear weight on the joint immediately after the injury but cannot currently walk without assistance in the office. There is no swelling, no tenderness to palpation of the medial malleolar area, no tenderness over the dorsal or lateral aspect of the foot, but tenderness is present over the lateral malleolus of the right foot.
Family Medicine 05
Ms. Waters is a 30-year-old woman who presents with several weeks of palpitations with associated mild dyspnea. She also notes a five-pound unintentional weight loss, oligomenorrhea, increased sweating, and loose stools. She reports minimal caffeine intake and denies drug or alcohol use, but notes high levels of work-related stress.
Family Medicine 06
N/A
Family Medicine 07
Mr. Smith is a 53-year-old man with obesity, Type 2 diabetes, hypertension, hyperlipidemia, and tobacco use who presents with a four-day history of left lower extremity edema. He denies fever, chest pain, dyspnea, known malignancy, trauma, or inactivity. He has an ulcer on the plantar surface of his left foot, and there is edema and erythema in his left leg.
Family Medicine 08
Mr. Martin is a 54-year-old male who presents for a routine physical exam after not engaging in regular healthcare for over a decade. His blood pressure is elevated, but the rest of the exam is unremarkable. He often eats fast food due to his work as a taxi driver and has financial stressors.
Family Medicine 09
The patient is a 50-year-old woman with hypothyroidism, GERD, and a family history of premature CHD who presents with acute onset palpitations, shortness of breath, and diaphoresis during exercise.
Family Medicine 10
Mr. Payne is a 45-year-old male truck driver with a two-week history of low back pain radiating down his left leg. The pain worsens with sitting and improves with lying down. He denies trauma or constitutional symptoms.
Family Medicine 11
Ms. Roman is a 74-year-old female with chronic right knee pain that worsened over the past two weeks. Physical exam reveals mild effusion and crepitus, but no erythema or skin lesions.
Family Medicine 12
N/A
Internal Medicine/Pediatrics Case
Patient Description
Internal Medicine 21
Mr. Ramirez, 78-year-old male with a 3-4 day history of fever, anorexia, malodorous urine, lethargy, presenting with hypothermia, hypotension, tachycardia, tachypnea, mental status changes, and a nonfocal neurologic exam.
Internal Medicine 22
Mr. Groszek, 71-year-old male with a history of tobacco use, 2-day history of fever with chills, productive cough, dyspnea, hemoptysis, right pleuritic chest pain, hypoxia, orthostasis, tachycardia, borderline hypothermia, RLL consolidation on lung exam.
Internal Medicine 23
N/A
Internal Medicine 24
Mrs. Cole, 52-year-old female s/p treatment with broad-spectrum antibiotics and mechanical ventilation in ICU for Strep pneumoniae meningitis complicated by septic shock and ARDS, new onset fever with diarrhea and cough, crackles at posterior lung bases, mild generalized abdominal tenderness, urinary catheter, subclavian line.
Internal Medicine 25
Mrs. Kohn, 75-year-old female with a history of hypertension, chronic thiazide diuretic use, s/p surgical repair 3 days ago for fractured hip, 2-day history of delirium, opioids for pain control, presence of Foley catheter, absence of focal neurological findings.
Internal Medicine 26
Mr. Johnson, 58-year-old male with history of alcohol use disorder, hypertension, homelessness, presenting with altered mental status, lethargic, non-focal neurological exam, tachycardia, borderline hypotension, dilated pupils, dry mucous membranes, hypernatremia, anion gap metabolic acidosis.
Internal Medicine 27
Mr. Strout, 65-year-old male with prior tobacco use, hypertension, hyperlipidemia, GERD, diagnosed with community-acquired pneumonia 4 weeks ago, continued productive cough, mild hemoptysis, worsening constipation, malaise, dry mucous membranes, tachycardia, left lower lung field dullness, mild abdominal tenderness.
Internal Medicine 28
Mr. Honig, 70-year-old male with a 6-month history of progressive dyspnea, associated cough, 10-pound weight loss, 2-week history of severe dyspnea, purulent cough, afebrile, tachycardic, hypoxic, labored breathing, diffuse wheezes, prominent S2.
Internal Medicine 29
Mrs. Kapoor, 55-year-old recent immigrant from India, 35-pack-year tobacco history, 1-month history of fever, night sweats, productive cough with hemoptysis, pleuritic chest pain, 15-pound weight loss, chronically ill appearance, fever, tachycardia, right base dullness, decreased breath sounds, no lymphadenopathy.
Internal Medicine 30
Ms. Bond, 55-year-old healthy female on hormone replacement therapy, recently returned from Europe, 3-day history of worsening pain and swelling in left calf, no fever or trauma, tachycardia, tachypnea, hypoxia, left calf tender, edematous, 3 cm larger than the right.
Internal Medicine 31
Mr. Nelson, 40-year-old with 3-month worsening of chronic right knee pain (present for 20 years), deep ache in medial knee, worse in morning and after prolonged sitting, morning stiffness, gelling after inactivity, no relief with conservative therapies, joint swelling, no fever or erythema.
Internal Medicine 32
Ms. Dickerson, 39-year-old female with 3 months of joint pain (hands, wrists, knees, ankles), morning stiffness for 4 hours improving with ibuprofen, fatigue, history of two second-trimester spontaneous abortions, sulfa allergy, symmetric small-joint arthritis, painless oral ulcers, photosensitive rash, normal proximal muscle strength.
Internal Medicine 33
Mrs. Baxter, 49-year-old female with hypertension, type II diabetes mellitus, CVA one month ago, increasing confusion for 2-3 days, acute kidney injury, poor oral intake for several days, taking two diuretics and ARB, normal temperature, tachycardia, orthostatic hypotension, dry mucous membranes, skin tenting, normal bowel sounds, flat neck veins.
Internal Medicine 34
Mr. Farber, 55-year-old male with prostate cancer history, recent UTI, s/p abdominal aortic aneurysm repair, acute radicular low back pain after heavy lifting, no fever, weight loss, numbness, weakness, or trauma.
Internal Medicine 35
Ms. Jankowski, 35-year-old female with recurrent UTIs, recent sulfa use, diphenhydramine for insomnia, oral contraceptives, recent unprotected sex, 3 weeks of fatigue, 10 days of recurrent fevers, fever on exam, systolic murmur, tender posterior cervical lymphadenopathy, rash on back.
Internal Medicine 36
Mr. Berlusconi, 49-year-old male with hepatitis C, esophageal varices ligation, ongoing alcohol use, chronic ascites, 3-4 days of increasing fatigue, confusion, fevers, abdominal pain, fever, right upper quadrant tenderness, asterixis, tense ascites, stigmata of chronic liver disease, multiple lab abnormalities.
Pediatrics 01
Thomas, term normocephalic SGA male newborn, normal vital signs and physical exam, born to 20-year-old mother with tobacco and alcohol use during pregnancy, no prenatal care, normal pre-delivery ultrasound and screening labs for infection.
Pediatrics 02
Asia, 9-month-old girl, asymptomatic, thriving, RUQ mass and pallor incidentally noted on routine well-child care exam, no lymphadenopathy, splenomegaly, or jaundice.
Pediatrics 03
N/A
Pediatrics 04
N/A
Pediatrics 05
Betsy, adolescent with progressive fatigue and pallor by parental report, history of menorrhagia, family history of hypothyroidism, menorrhagia with anemia.
Pediatrics 06
N/A
Pediatrics 07
Adam, late preterm LGA infant of a diabetic mother, tachypnea at two hours of life, born via C-section through clear amniotic fluid, normal oxygen saturation, symmetric breath sounds, mild respiratory distress.
Pediatrics 08
Meghan, 6-day-old exclusively breastfed term infant of partial Greek descent, two days of jaundice, otherwise normal physical exam, no significant weight loss, normal voiding and stooling, ABO set-up.
Pediatrics 09
Olivia, 2-week-old female, decreased activity, poor feeding, weight below birth weight, low temperature, normal vital signs, enlarged fontanelles, mild hypotonia, jaundice, umbilical hernia, born post-term AGA at home, no newborn screen.
Pediatrics 10
Holly, 6-month-old fully immunized girl, 2-day history of high fever, poor appetite, tachycardic, dehydrated, inconsolable, no apparent source for fever.
Pediatrics 11
Jason, 4-year-old male, 7-day history of fever, irritability, recent treatment for presumptive strep pharyngitis, diffuse erythematous blanching macular rash, red watery eyes.
Pediatrics 12
Anna, 10-month-old female, 1-week history of respiratory illness, acutely worsening cough, mild respiratory distress, asymmetric breath sounds, unilateral wheezing in right lung, no fever or cyanosis.
Pediatrics 13
Sunita, 6-year-old girl with chronic nasal congestion, history of eczema, 2 months of cough worse at night, with exercise, and exposure to cold air, no fever, SOB, or wheezing, family history of asthma.
Pediatrics 14
Rebecca, 18-month-old girl, acute onset of fever, ear tugging after 3 days of URI symptoms, history of language delay, past otitis media, day care, smoke exposure.
Pediatrics 15
Ben, 8-week-old formula-fed baby boy, 1-week history of repeated, forceful, non-bilious, now blood-streaked emesis, fatigue, weight loss, no fever or diarrhea, decreased urine output.
Pediatrics 16
Isabella, 7-year-old girl with vomiting, diffuse abdominal pain, dehydration, polydipsia, enuresis, lethargic, tachypneic, tachycardic, normotensive, no peritoneal signs.
Pediatrics 17
Emily, 4-year-old previously healthy girl with acute right leg pain, refusal to walk, low-grade fever after recent URI symptoms and minor fall, limited internal rotation of right hip.
Pediatrics 18
Tyler, 6-week-old term infant, recent onset of progressive dyspnea with feedings, diaphoresis, weight loss (12% below birth weight), tachypnea, normal oxygenation, nasal flaring, hyperdynamic precordium, 3/6 holosystolic murmur, hepatomegaly.
Pediatrics 19
Sophia, 7-year-old girl with recent non-pruritic erythematous rash, recent treatment for strep throat 2 weeks ago, new fever, mild edema of face and feet, elevated blood pressure.
Pediatrics 20
Jack, 12-year-old male with 4 months of progressively worsening fatigue, intermittent fevers, epistaxis, gingival bleeding, weight loss, weakness, marked pallor, no lymphadenopathy or hepatosplenomegaly.
These expert answers provide clarity on how to properly synthesize key patient findings, ensuring students develop strong clinical reasoning skills. At GPAShark.com, we aim to assist you in mastering these essential components of clinical education.
