Charles' Chest Pain

Name	Charles Riley
DOB	11/04/1989 (25 years)
Occupation	History student
History	I am very untalkative and give single word answers. 3 days ago I began experiencing pain under my left nipple. It is a sharp stabbing pain. The pain does not move anywhere. It is better when I am resting and worse when I am lifting things. If asked specifically, I admit it is worse when I press it and that it began right after I went gym for the first time. It is about 4/10 severity. I have no other symptoms.
Past Medical History	I had my appendix removed 3 years ago. Nil else.
Drug History	I take vitamin A, C and D supplements. I want to know what other supplements I should take to remain healthy.
Family History	My mother killed herself, but she was otherwise healthy and I don't know my father.
Social History	I have been in foster care for 2 years. I smoke 10 a day and drink heavily on the weekends. I smoke cannabis most weekdays.

Introduces yourself	0	1
Confirms name & age of patient	0	1
Explains reason for consultation & builds rapport	0	1
Gains consent	0	1
Asks open question	0	1
Establishes site	0	1
Asks about onset	0	1
Elicits character of pain	0	1
Asks if pain radiates	0	1
Excludes associated symptoms including fever, cough, nausea, shortness of breath and palpitations	0	1	2
Enquires about exacerbating factors including physical activity, lying down, coughing and chest tenderness	0	1	2
Enquires about alleviating factors including rest, leaning forward, painkillers	0	1
Asks patient to rate severity of pain	0	1
Asks about previous chest pain	0	1
Asks about recent illnesses	0	1
Asks specifically for recent illness, surgery and calf pain or leg swelling	0	1	2
Asks about any family history of disease	0	1
Asks specifically if any family members have had any pulmonary embolisms or clots	0	1	2
Establishes any drugs patient is on	0	1
Asks if patient has any allergies	0	1
Asks if patient smokes, drinks or takes recreational drugs	0	1	2
Asks about diet and lifestyle	0	1
Asks about any recent travel	0	1
Elicits patients occupation	0	1
Explores and responds to ideas	0	1
Explores and responds to concerns	0	1
Explores and responds to expectations	0	1
Shows empathy	0	1
Avoids jargon	0	1
Summarises back to patient	0	1
Thanks patient	0	1
Patient global score	0	1	2
Gives reasonable differential diagnosis (musculoskeletal injury, anxiety, pericarditis etc)	0	1