Medical Diagnosis: History Taking and Symptom Analysis

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Questions and Answers

What is the primary purpose of taking a patient's history?

To guide further physical examination
To determine the correct diagnosis immediately
To identify symptoms and signs of a disease (correct)
To eliminate the need for investigations

What is the difference between a symptom and a sign?

A sign is subjective, while a symptom is objective
A symptom is a physical finding, while a sign is a patient's experience
A symptom is a patient's description, while a sign is a physician's finding (correct)
A symptom is observable, while a sign is not

What type of question is 'How old are you?'?

Multiple-choice question
Closed question (correct)
Leading question
Open-ended question

What is the correct sequence of events in the diagnostic process?

History taking, examination, investigations (C) Signup and view all the answers

What is the primary benefit of taking a thorough history?

It guides the physician's approach to further examination and investigation (B) Signup and view all the answers

What is the primary purpose of asking 'Do you have any drug allergy' during the patient's history taking?

To determine potential allergic reactions to medications (C) Signup and view all the answers

What is the ideal way to document the patient's complaint in their own words?

As briefly and concisely as possible (D) Signup and view all the answers

What is the primary purpose of taking a personal history from a patient?

To establish a rapport with the patient and gather demographic information (C) Signup and view all the answers

What is the purpose of the 'History of the present illness' section in a patient's medical history?

To describe the patient's current symptoms and complaints (B) Signup and view all the answers

What is the benefit of using open-ended questions during the patient's history taking?

To encourage the patient to provide more information about their symptoms and concerns (A) Signup and view all the answers

What is the primary symptom associated with a patient's chief complaint of chest pain?

Dyspnea (A) Signup and view all the answers

A patient presents with palpitation as a symptom. What system is likely to be affected?

Cardiovascular system (D) Signup and view all the answers

What is the likely underlying cause of a patient's symptoms of dyspnea and chest pain?

Cardiac ischemia (D) Signup and view all the answers

A patient presents with chest pain and palpitation. What is the next step in the analysis of the complaint?

Symptom analysis (C) Signup and view all the answers

What is the relationship between dyspnea and chest pain?

They are commonly associated symptoms (C) Signup and view all the answers

What is a risk factor for cancer of the colon?

Family history of cancer colon (C) Signup and view all the answers

Which of the following is a risk factor for Deep Vein Thrombosis?

Immobilization (D) Signup and view all the answers

What is a complication of Hypertension?

Deep Vein Thrombosis (C) Signup and view all the answers

What is a consequence of Consanguinity?

Increased risk of genetic disorders (B) Signup and view all the answers

What is a risk factor for Bilharziasis?

Contact with contaminated water (B) Signup and view all the answers

What is the primary site for checking temperature in a neonate?

Rectal (C) Signup and view all the answers

What is the characteristic of Central Cyanosis?

Involves the tongue in cyanotic heart disease (D) Signup and view all the answers

What is the term for a drop in diastolic blood pressure of more than 10 or systolic blood pressure of more than 20 when standing up?

Orthostatic hypotension (D) Signup and view all the answers

What is the normal range of pulse rate?

60-100 (A) Signup and view all the answers

What is the cause of non-pitting edema?

Lymphedema (A) Signup and view all the answers

What is the term for yellow skin that is not jaundice?

Hypercarotinemia (C) Signup and view all the answers

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Study Notes

History Taking

Good history taking is crucial for reaching a correct diagnosis, followed by physical examination and investigations.
History is the best guide for correct diagnosis.

Symptoms and Signs

Symptoms: patient's description of their complaint.
Signs: findings by the physician.
Same finding can be both symptom and sign, e.g. swelling, redness, rash, deformity.

Types of Questions

Closed questions: specific, direct questions, e.g. "How old are you?" or "Do you have any drug allergy?"
Open questions: encourage patient to elaborate, e.g. "Can you tell me more about your complaint?"

Personal History

Includes: name, age, gender, occupation, address, marital status, habits.

Present Illness History

Analysis of the complaint.
Symptoms related to the affected system.
Relevant medical history, e.g. hypertension, TB, IID, bilharziasis, hepatitis, DVT.

Family History

Includes: family members with cancer or other conditions, consanguinity, socioeconomic state.

General Examination

Inspection: jaundice, yellow skin, cyanosis, pallor, hypercarotenemia.
Temperature: types (continuous, intermittent, remittent, cyclic), causes of increased heat production, sites of measurement.
Blood pressure: precautions, measurement techniques, differences between right and left upper limb, upper and lower limb.

Vital Signs

Pulse: normal range (60-100), causes of increased heart rate, measurement sites.
Congested neck veins: causes, e.g. heart failure, hypervolemia, pericardial effusion, superior vena cava obstruction or syndrome.
Edema: types (generalized, localized), causes, e.g. heart failure, renal, hepatic, hypoproteinemia, DVT, trauma, inflammatory.

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