Communication Skills Stations

Question 1

For an asthma review, what specific questions must you ask, in addition to the general history structure

Answer 1

• Presenting complaint/HPC:
  
  • need to identify all their symptoms: cough, sputum, SOB, wheeze, more so than before, night symptoms, exacerbations through the day etc.
  • exacerbating + relieving factors:
  • check red flag symptoms just in case
• Probs best place to ask about IDEAS of what could be causing it
• PMHx:
  
  • PREVIOUS HOSPITAL ADMISSIONS for exacerbations
  • Any other conditions (esp atopic conditions)
• DHx:
  
  • How is their asthma controlled
  • inhaler technique, which inhalers do they use, do they take any other tablets/nebulisers etc.
  • how commonly are they having to use them
  • adherence to regime? If not/if finding it difficult: why?
  • use a spacer?
  • have they had recent review with asthma nurse
  • any CHANGES in MEDICATION
  • Ask about allergies/hay fever anyways and how/if it impacts their asthma
• SHx:
  
  • Occupation + CHANGE in occupation
  • Accommodation + CHANGE in accommodation
  • Pets/NEW pets?
  • Smoking + CLOSE CONTACTS/PASSIVE SMOKING
  • IMPACT ON DAILY LIFE
  • ask about alcohol + drugs just in case
• CONCERNS, EXPECTATIONS + ANY OTHER QUESTIONS
• Consider doing a systems review if have time
  
  • chest pain, ankle swelling, orthopnoea, calf tenderness/redness/swelling

Question 2

From what age do people have annual blood screening

Answer 2

65

Question 3

What are the 2 main types of cholesterol and what do they do

Answer 3

• Low-density lipoprotein (LDL).
  
  • the “bad” cholesterol: transports cholesterol particles throughout your body.
  • LDL cholesterol builds up in the walls of your arteries, making them hard and narrow.
• High-density lipoprotein (HDL).
  
  • the “good” cholesterol: picks up excess cholesterol and takes it back to your liver.

both transport cholesterol but LDL is the one which deposits in arteries

Question 4

Risk factors for high cholesterol

Answer 4

• Diet high in saturated fat/trans fat (fatty meat, full fat dairy etc)
• Obesity (BMI >30)
• Lack of exercise (exercise boosts HDL)
• Smoking (lowers HDL)
• Alcohol (overall cholesterol increase)
• Age (>40 - liver deterioration so less able to remove LDL)

Question 5

Which medical conditions can increase cholesterol levels

Answer 5

• CKD
• DIABETES
• HIV/AIDS
• Hypothyroidism
• Lupus

Question 6

Medications for which health problems can cause cholesterol problems

Answer 6

• Acne
• CANCER
• HIGH BLOOD PRESSURE
• HIV/AIDS
• ARRHYTHMIAS
• Organ transplants

Question 7

Complications of high cholestrerol

Answer 7

• Ischaemic Heart Disease
• Heart Attack
• Stroke

high cholesterol and high blood pressure often go hand in hand so always check
+ diabetes