History Taking Flashcards
What are the 4 stages that lead to treatment planning?
- History (symptoms)
- Examination (signs)
- Special investigations/tests
- Diagnosis
- > Treatment plan
In what percentage of cases does history provide a diagnosis? (without examination or special tests)
75%
What does C/O stand for?
Complaining of - symptoms of the disease
Ask the patient to describe the problem in his/her own words
What does HPC stand for?
History of present complaint
What information do you require for HPC?
Ask the patient to:
- Describe the problem
- Duration fo the problem
- Severity of the problem
- Exacerbating or relieving factors
What does the mnemonic acronym SOCRATES stand for?
S = site O = onset C = character R = radiation A = associations T = time course E = exacerbating factors S = severity
What does ‘site’ of pain refer to?
Where is the pain/where is the maximal site of pain
What does ‘onset’ of pain refer to?
When did the pain start, was it sudden or gradual? Progressive or regressive?
What does the ‘character’ of pain refer to?
What is the pain like? An ache? stabbing?
What does the ‘radiation’ of pain refer to?
Does the pain radiate anywhere else?
What do ‘associations’ of pain refer to?
Are there any other signs or symptoms associated with the pain?
What does the ‘time course’ of pain refer to?
Does the pain follow any pattern? e.g. is it worse in the evening
What does ‘exacerbating/relieving factors’ of pain refer to?
Does anything change the pain?
What does ‘severity’ of pain refer to?
How bad is the pain?
What does ‘PDH’ stand for?
Past Dental History
Determine patient’s attitude to dentistry (are they anxious, infrequent attender)
Past dental experiences/treatments
What does ‘SH’ stand for?
Social History
What is it important to understand a patient’s social history?
Understanding your patient’s social conditions will help you to plan treatment in a way that will fit in with the rest of their life
What does PMH stand for?
Past Medical History
What type of questions are on a PMH form?
Structured questions
Lead to a clear idea of the patient’s medical status
Why might the timing of the appointments be important for patients with diabetes?
The timing of appointments in relation to dietary control of condition may be important - risk of hypoglycaemia.
What is an important consideration for patients with epilepsy?
Trying to avoid removable oral appliances if possible
Denture design should provide excellent retention and stability so it does not present a choking hazard to the patient
What effects may tricyclic antidepressants, antihypertensions and diuretics have on a patient’s oral health?
May cause dry mouth. This could result in:
- predisposition to damage from minor trauma
- predisposition to dental caries
- potential problems with denture retention
What can non-soluble forms of aspirin cause?
Ulceration - aspirin burn
What can epanutin-dilantin and cyclosporin cause?
Gingival hyperplasia
Which drugs may have a potentially serious interaction with anticoagulants?
- Aspirin and other NSAIDs
- Carbamazepine
- Imidazole and triazole antifungals
- Erythromycin
- Clarithromycin
- Metronidazole
- Broad spectrum antibiotics (ampicillin and amoxicillin)
What does the BNF stand for?
British National Formulary
What is the purpose of the BNF?
The British National Formulary provides guidance on prescribing, dispensing and administering medicines.
