Every time Stefani wears a tank top or swimsuit, Alicia notices the mole and how it has grown in size; she urges Stefani to see a physician. Stefani finally decides to make an appointment with Dr. Smith, her family practitioner. She logs into her electronic health record (EHR), makes an appointment and briefly outlines the reason for her concern.

At Dr. Smith’s office, Stefani is called to an exam room by a nurse who takes her vital signs and checks her height and weight. The nurse asks Stefani to explain the purpose of her visit. Stefani tells her about the spot on her back. The nurse asks Stefani how much time she spends in the sun and if she uses sunscreen. Stefani replies that during the summer she spends anywhere from three to nine hours a day coaching soccer and that she rarely uses sunscreen. The nurse steps out so Stefani can put on a gown and then returns to take several digital images of the spot and adds them to Stefani’s EHR.

Dr. Smith arrives, shakes Stefani’s hand and looks over her EHR displayed on the monitor. He palpates her lymph nodes and spends a great deal of time inspecting the mole on her back.

He tells her he is going to perform a special procedure, known as an excisional biopsy, to remove the mole and also orders and performs several blood tests.

  1. Review Stefani’s PCP EHR: One test has elevated results. Which result is elevated?

    Internet Research: Why is this concerning?

  2. Review Stefani’s VPE: After watching the video in Virtual Physical Exam (VPE), provide a brief description of how an excisional biopsy is performed.

  3. Internet Research: Why is it important for Stefani to recount the time period when her roommate first noticed the mole until now?

Stefani’s EHR – PCP Chart   Virtual Physical Exam