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Questions and Answers

What is an essential step to perform after exploring a patient's presenting complaints?

Thank the patient for their time (correct)

Summarize the patient's history

Refer the patient to a specialist

Prescribe medication

When should you usually summarize the information collected during a patient consultation?

At the end of the consultation (correct)

At the beginning of the consultation

Midway through the consultation

After exploring the presenting complaint

Which of the following is necessary for effective communication with patients?

Avoid sharing treatment risks

Listening to and respecting patient's views (correct)

Limiting the patient's questions

Only sharing information with close family members

What should you do if a patient makes an unusual comment or has a minor abnormality?

Consider it as potentially leading to the correct diagnosis Signup and view all the answers

Why might it be beneficial to let patients ask questions at the end of the consultation?

Patients may reveal crucial concerns or misunderstandings Signup and view all the answers

What should you do to ensure a systematic collection of information from a patient?

Use your eyes, ears, nose, and hands systematically Signup and view all the answers

Which phrase can be used to encourage a patient to continue?

You are saying...? Signup and view all the answers

What should you do if you are unsure about information provided by the patient?

Use phrases like 'You said earlier...?' Signup and view all the answers

How should you write down information during patient communication?

In a way that does not interfere with communication Signup and view all the answers

Which phrase is useful for clarifying terms with a patient?

What do you mean by...? Signup and view all the answers

What type of history information should be elicited from patients?

All of the above Signup and view all the answers

What is advised to use when dealing with children to make them feel comfortable?

Offer sweets, candies, or toys Signup and view all the answers

What type of facial expression is recommended when talking to patients?

A smiley face Signup and view all the answers

Which is an example of an open question to start a conversation with a patient?

Can you tell me about your illness? Signup and view all the answers

Which of these actions shows that you are listening to the patient?

Nodding your head Signup and view all the answers

Which prompt is appropriate to use to keep the conversation going?

Tell me more about that Signup and view all the answers

Which disease should always be asked about in past medical history?

Diabetes mellitus (DM) Signup and view all the answers

Which of the following is part of past surgical history?

Type of surgery Signup and view all the answers

What should be recorded under family history?

Number of children (sons and daughters) Signup and view all the answers

What is included in social history?

Geographical residence Signup and view all the answers

Which condition is not a part of the questions for past medical history?

Financial issues Signup and view all the answers

Which of the following is NOT part of Demographic Data?

Systemic Review Signup and view all the answers

What does the Chief Complaint section include?

One or two symptoms and their duration Signup and view all the answers

What involves the system that the chief complaint is encountered within?

History of Present Illness Signup and view all the answers

Which of these is part of the Systemic Review?

Gastrointestinal tract (GIT) Signup and view all the answers

Which main part of history would a detailed story of the condition in the patient's words fall under?

History of Present Illness Signup and view all the answers

Which mnemonic can be used to remember aspects of the pain symptomatology involving 'Quality', 'Intensity', and 'Site'?

SQITARRS Signup and view all the answers

Which of the following drug groups should be asked about directly for their impact on anti-coagulation?

Antiplatelets Signup and view all the answers

What aspect of pain symptomatology does the 'O' in SOCRATES represent?

Onset Signup and view all the answers

Which of the following is NOT included in the SQITARRS mnemonic?

Character Signup and view all the answers

Which group of drugs is commonly checked for its effect on blood glucose levels?

Oral hypoglycemic drugs Signup and view all the answers

What does the presence of bile-stained vomit indicate?

Obstruction distal to the second part of the duodenum Signup and view all the answers

Which character of vomiting is associated with gastric outlet obstruction?

Projectile Signup and view all the answers

What does fecal vomit suggest regarding the location of the intestinal obstruction?

Colon Signup and view all the answers

What symptom is commonly associated with early morning vomiting in pregnant women?

Brain tumors Signup and view all the answers

Which condition could cause effortless vomiting?

Infection Signup and view all the answers

What is a serious factor often associated with vomiting that includes blood?

Gastric ulcer Signup and view all the answers

Which of the following should be ensured for an optimal room environment?

Quiet Signup and view all the answers

What is NOT a principle for good communication with patients?

Make the patient sit uncomfortably Signup and view all the answers

Before starting an explanation, it is important to:

Check what the patient already knows Signup and view all the answers

Which type of question is designed to guide the patient to an answer?

Leading Questions Signup and view all the answers

When can information be retrieved from the patient's relatives?

When the patient is severely ill or unconscious Signup and view all the answers

What should be avoided during communication with a patient?

Interrupting the patient Signup and view all the answers

Which of the following factors is considered in evaluating a cough?

Change of posture Signup and view all the answers

What is orthopnea?

Shortness of breath when lying flat Signup and view all the answers

Dysphagia can be described as difficulty in swallowing. Which of the following specifies painful swallowing?

Odynophagia Signup and view all the answers

A significant weight loss is defined as:

More than 10% of body weight in 3 months Signup and view all the answers

Which symptom is characterized by shortness of breath during exertion or exercise?

Exertional dyspnea Signup and view all the answers

In assessing changes in appetite, what should be determined if a decreased appetite is observed?

Whether it is due to loss of appetite or apprehension about pain while eating Signup and view all the answers

What is dyspepsia commonly accompanied by?

Heartburn and belching Signup and view all the answers

What color can the skin and eyes become in non-obstructive jaundice?

Light yellow Signup and view all the answers

Which type of stool suggests fat malabsorption?

Floating stool or un-flushable stool Signup and view all the answers

What term is used to describe absolute constipation?

Obstipation Signup and view all the answers

What is the term for fresh bright bleeding per rectum?

Hematochezia Signup and view all the answers

What is the normal frequency of bowel habits?

3 times/day to once in 3 days Signup and view all the answers

What symptom is associated with obstructive jaundice?

Itching, dark-colored urine, and pale stools Signup and view all the answers

In which condition are stools described as watery in consistency?

Increased bowel motion Signup and view all the answers

Study Notes

Effective Communication

Summarize by patient's words at the end
Explain the next step and give the patient time to digest information
Let the patients ask questions and provide them with a source of information about their disease
Close the interview and ask the patient if they want to tell you anything else or if anything important was missed
It is not necessary to summarize until the end of the consultation

Communication Skills

Listen to, ask for, and respect patients' views about their health
Share information with patients in a way they can understand
Include information they want or need to know about their condition, its likely progression, treatment options, risks, and uncertainties
Answer questions and keep patients informed about the progress of their care
Make sure patients are informed about how information is shared with other professionals involved in their care

Taking a Patient's History

Be alert and use your senses to collect information
Recognize an unusual comment or minor abnormality
Demographic data: age, gender, race, marital status, residence, occupation, and religion
Chief complaint: one or two symptoms that brought the patient to the hospital, and the duration
History of present illness: a detailed story of the condition in the words of the patient
Systemic review: gastrointestinal, cardiovascular, respiratory, urogenital, neurological, musculoskeletal, and integumentary systems

Vomiting

Quantity or volume: small, moderate, or large
Frequency: number of times
Quality: contains previous meal, undigested recognizable food, or clear acidic fluid
Associated blood: serious factor, either fresh or changed
Color and taste: may assess the level of intestinal obstruction
Character: projectile, self-induced, or effortless
Relieve pain or not: and timing, preceding symptoms, or factors

Encouraging Patients to Continue

Repeat the last statement made by the patient with a questioning tone
Use phrases like "You are saying..." or "You mean that..."

Remembering Key Points

You may receive information out of sequence
If unsure, use phrases like "You said earlier..." or "You mentioned before..."

Writing Information Down

Write notes in a way that doesn't interfere with communication with the patient

Clarifying Terms

If unsure, ask the patient to explain
Use phrases like "What do you mean by..." or "Let me understand this..."

Eliciting Information from Patients About Their Histories

Medical, surgical, family, psychosocial, and drug histories

Conversation Tips

Don't talk to more than one patient at a time
Offer sweets or candies to children (remember diabetes)
A smiley face is preferable to a frowning one

Starting the Conversation

Introduce yourself and ask the patient an open question, such as "Can you tell me about your illness?" or "What is bothering you?"

Keeping the Conversation Going

Use open questions to encourage the patient to give more information
Use prompts like "How did it start?" or "What happened next?"
Show you are listening by nodding or making brief comments

Past History

Medical, surgical, family, social, and drug histories

Medical Symptoms Checklist

Cough: frequency, change of posture, productive or dry, sputum color, and amount
Dyspnea: shortness of breath, classification, and associated symptoms
Dysphagia: difficulty in swallowing, intermittent or progressive, and painful or painless
Weight loss: how much, period, and associated symptoms
Appetite: increased, decreased, or remained the same, and associated symptoms

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Description

A summary of the steps involved in a medical consultation, from summarizing patient information to closing the interview.

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