Clinical Reasoning Education

James Okoye — Post-Stroke Day 5, AFib, INR 1.8 on Warfarin, Antithrombotic Decision

Clinical reasoning simulation for healthcare students and educators

Neurology Intermediate Pharmacy

Practice This Case

Work through the full clinical encounter with AI patient and attending. Free, no signup required.

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About This Case

This clinical reasoning case presents a patient with james okoye / post-stroke day 5 / afib / inr 1.8 on warfarin / antithrombotic decision in a neurology context. Learners work through a structured 10-phase simulation covering initial differential, history-taking, physical examination, labs and imaging, and management planning.

"James needs long-term antithrombotic therapy for cardioembolic stroke prevention in AFib. He was on warfarin but his INR was subtherapeutic at the time of stroke. He has CrCl 52. His cardiologist asks whether to continue warfarin or switch to a DOAC. Walk through the pharmacological reasoning — including the stroke-on-anticoagulation implications."

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 Pharmacy students and practicing clinicians seeking to sharpen diagnostic thinking in neurology.

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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.