Margaret Chen — Post-ORIF Hip Day 3, AFib on Warfarin, Cr 1.4, Mild Dementia

About This Case

This clinical reasoning case presents a patient with margaret chen / post-orif hip day 3 / afib on warfarin / cr 1.4 / mild dementia in a geriatrics context. Learners work through a structured 10-phase simulation covering initial differential, history-taking, physical examination, labs and imaging, and management planning.

"She is post-op day 3 from right hip ORIF. Her INR this morning is 1.4 — supratherapeutic for her usual AFib target. Her creatinine is 1.4 (baseline 1.1). She is also on a NSAID ordered by the orthopedic resident. What is the most dangerous drug interaction on her current list — and what is your anticoagulation plan for the remainder of the hospitalization?"

How the Simulation Works

1. Read the patient presentation and form your initial differential diagnosis
2. Interview the AI patient to gather history and explore your hypotheses
3. Perform a focused physical examination based on your differential
4. Order appropriate labs and imaging, then interpret the results
5. Revise your diagnosis and develop a management plan
6. Receive personalized teaching feedback from your AI attending, Dr. Patel

What You'll Learn

This case builds skills in systematic clinical reasoning, hypothesis-driven history-taking, appropriate test ordering, and evidence-based management. It is designed for Medicine students and practicing clinicians seeking to sharpen diagnostic thinking in geriatrics.

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About ReasonDx

ReasonDx is an AI-powered clinical reasoning education platform developed by Dr. Lauren Fine, MD, FAAAAI, Associate Professor and Assistant Dean of Clinical Skills Education at NSU Dr. Kiran C. Patel College of Allopathic Medicine. The platform features 394 simulation cases across 10 health professions, designed to train the cognitive processes underlying accurate diagnosis.