History Taking

Question 1

Which questions do you ask as part of a smoking history?

Answer 1

• Are they a current smoker?
• What age did they start smoking?
• Do they smoke cigarettes or roll-ups?
• How many cigarettes a day do they smoke? (if they smoke roll-ups, how much tobacco is used in a week?- half an ounce / 15g of tobacco is around 20 cigarettes)
• Have they ever smoked more or less than they do now?
• Any breaks from smoking?
• Have they ever tried to give up?
• Does anyone else in the house smoke i.e are they a passive smoker?

Question 2

When checking drug history, what should you always ask about?

Answer 2

Allergies

Question 3

How do you screen for red flags?

Answer 3

FLAWS

F - Fever
L - Lethargy
A - Appetite (loss of it)
W - Weight loss 
S - Sweats (ie. night sweats)

Question 4

Which mnemonic can we use for a social history?

Answer 4

LOST

L - Living Situation (ie. Who do you live with? Is it a bungalow? Do you have grab rails? Etc.)
O - Occupation (what do you do for work? Have you had any exposure to asbestos? Etc.)
S - Smoker (+ Alcohol and IVDU)
T - Travel (Have they been to any tropical countries recently? Any long-haul flights?)

Question 5

How do you work out a persons pack-year history?

Answer 5

You multiply the number of packs of cigarettes (20 cigs in a pack) they smoke in a day by the number of years they have been smoking for.

Ie. 1 pack a day for 20 years is 20 pack years.

10 cigs a day for 10 years is 5 pack years

40 cigs a day for 15 years is 30 pack years

Question 6

Which set of questions are important to ask at the start of a history?

Answer 6

ICE after presenting complaint

Question 7

When dealing with an explanation station, how should you approach it to start with?

Answer 7

At the start, ask them 2 things

1. What do they already know?
2. What do they want to know?

As you go through it, use the chunk and check approach. Ie. give them a chunk of information, and then check that they understand it