Mock exam 2

Today I practiced mock medical interview with a doctor who also tries to go to abroad.
Recently, we proceed a case book. It means every case becomes difficult.

Usually I pretend a mock patient in first case. After that, we change roles both. I try to ask medical questions as a mock doctor in next case.
There is a time limitation, 15 minutes to take all patient's history. After that, we write the chart in 10 minutes.

In today's case, first I suspected acromegaly based on high blood pressure and foot change. Then suddenly, there was an information about sleep problem. My differential diagnosis changed to sleep apnea syndrome. In physical exam, I listened his gallops on auscultation (of course virtually). Finally I reached to a diagnosis of heart failure.
My differential diagnosis changed time to time. It was interesting, but difficult in time constraints.

Anyway this test is tough.