30 Questions
What is the purpose of taking a medical history?
To form a differential diagnosis and put health in context
Which section of the medical history involves a description of symptoms in the patient's own words?
Presenting Complaint
What is the role of the History of Presenting Complaint section in medical history taking?
To establish time-lines, interventions, and impact
Which part of the medical history aims to document the patient's past medical conditions and surgeries?
Past Medical History
What is the purpose of the Systems Enquiry/Review section in medical history taking?
To understand how different body systems interrelate
What is an important aspect of medication history taking?
Engaging with the patient and finding out who knows best about their medications
What is the purpose of asking about prescribed contraception when taking a medication history?
To ensure awareness of any potential drug interactions with contraceptives
Why is it important to use more than one source of information to confirm a patient’s medication history?
To cross-verify the accuracy of the information provided by the patient
What is the significance of being alert to the use of high-risk medicines during medication history taking?
Accuracy in high-risk medication history is critical due to potential serious consequences
Why is it important to ask about non-prescribed medicines, over the counter medicines, and recreational drug use during medication history taking?
To gain a comprehensive understanding of the patient's medication and substance use
When assessing chest pain, what does the 'R' stand for in the SOCRATES mnemonic?
Radiation
What are potential causes of dyspnoea according to the text?
Asthma, COPD, and pulmonary fibrosis
What should be considered when evaluating cough according to the text?
Duration, characteristics, and potential causes like infections, asthma, or lung tumors
What should be assessed when inquiring about sputum production according to the text?
Color, changes, and potential causes like infection or pulmonary edema
What information should be gathered about wheeze according to the text?
Timing, exacerbators/relievers, and the use of an inhaler
Which type of lung cancer is associated with a male to female ratio of 5:1?
Squamous carcinoma
Which lung disease is characterized by raised angiotensin converting enzyme and hilar lymphadenopathy?
Sarcoidosis
What is the most common biomarker associated with Human Papillomavirus (HPV) positive head and neck cancer?
p16
Which of the following is NOT a type of interstitial lung disease?
Emphysema
What is the most common neoplasm that occurs in the lung?
Adenocarcinoma
Which genetic susceptibility factor is associated with inter-individual variability in response to smoking-related diseases?
AAT
What is the type of lung cancer associated with the poorest prognosis?
Small cell carcinoma
What are the paraneoplastic effects associated with small cell undifferentiated (SCLC) lung cancer?
Demyelination and production of bioactive amines or peptides
What is a characteristic feature of adenocarcinoma – bronchoalveolar (NSCLC)?
Intrapulmonary dissemination
What is a common risk factor associated with mesothelioma?
Asbestos exposure
What is the significance of TNM staging in lung cancer?
It assesses the extent of the tumor, the involvement of lymph nodes, and the presence of metastasis
What is the value of monitoring circulating tumor DNA (ctDNA) in lung cancer?
To assess mutational burden and detect mechanisms of resistance
What is a potential mechanism of resistance in lung cancer treatment?
Immunologically 'cold' tumors
What is the significance of fibrous pleural plaques in the context of lung cancer?
They are associated with asbestos exposure and mesothelioma
What is the role of PDL-1 assessment in lung cancer?
To determine the potential response to immune checkpoint inhibitors
Study Notes
Respiratory Symptoms Assessment
- Use the SOCRATES mnemonic to assess chest pain: Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbators/relievers, Severity
- Identify potential causes of chest pain, such as angina, pneumonia, and rib fracture
- Evaluate dyspnoea by considering its onset, speed of onset, and potential causes like asthma, COPD, and pulmonary fibrosis
- Recognize that dyspnoea can stem from respiratory, cardiovascular, or non cardio-respiratory causes
- Investigate cough by assessing its duration, characteristics, and potential causes like infections, asthma, or lung tumors
- Understand that chronic cough may be associated with red flags such as hemoptysis, weight loss, and chest pain
- Inquire about sputum production, color, and changes, and link these to potential causes like infection or pulmonary edema
- Assess haemoptysis by determining its onset, quantity, and potential causes like bronchial carcinoma or pulmonary infarction
- Gather information about wheeze, including its timing, exacerbators/relievers, and the use of an inhaler
- Inquire about systemic upset, including changes in appetite, weight loss, fever, and tiredness
- Obtain a comprehensive past medical history, including medical conditions, doctor visits, investigations, and operations, to understand the patient's overall health
- Emphasize the importance of taking an accurate medication history and its role in patient care
Assess your knowledge of respiratory symptoms with this quiz. Test your ability to use the SOCRATES mnemonic to evaluate chest pain, identify potential causes of dyspnoea and cough, recognize red flags in chronic cough, and gather comprehensive patient history. Gain insight into assessing haemoptysis, wheeze, sputum production, and systemic upset, and understand the importance of an accurate medication history in patient care.
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