Interviewing the standardized patient

Question 1

Olga
Loves
Pomeranians
And
Alsatians
Quincy
Raises
Skye 
Terriers

Answer 1

Mnemonic for HPI
Onset (When)
Location (Where)
Precipitating factors (what were you doing)
Alleviating/Aggravating factors (what makes it better/worse)
Associated syndromes
Quality
Radiation (do you feel it anywhere else at same time)
Severity (how bad is it? mild, moderate or severe)
Timing/duration (how long has it been this way?)

Question 2

General state of health
Past illnesses
Injuries
Hospitilizations
Surgery
Allergies (envtl and medications)
Immunizations
Substance abuse, alcohol use, tobacco use
Diet
Sleep patterns
current medications

Answer 2

What to ask to get PMH

Question 3

1. Allergies: drugs, food, environment (If they do, ask what happens when they’re exposed)
2. Medication: current medication
3. History of chronic illness
4. Hospitalization w/in last year

Answer 3

4 major categories

Question 4

SODA

Answer 4

Mnemonic for social history:
Smoking: Y/N, if Y how many packs/day
Occupation: what is it? how long have you worked there, married/single, family/kids
Drugs: Illicit drug use
Alcohol: do you drink, how much per week, if person drinks excessively every day use CAGE mnemonic for follow up questions

Question 5

CAGE

Answer 5

Cutting back: have you thought about cutting back
Annoyed: do you find yourself becoming annoyed with people who tell you about your drinking
Guilty: do you feel guilty about how much you drink?
Eye opener: have you ever needed a drink to help you get up in the morning / start your day

Question 6

headache
fever
nausea
vomiting
chest pain
shortness of breath
palpitations
fatigue
weight gain
appetite changes
skin rash
skin changes
changes in temperature
recent travel
trauma
constipation
diarrhea
joint pain
night sweats
chills
depression
diet
exercise
weakness
numbness
tingling
hair changes

Answer 6

What to ask review of symptoms (ROS)

Question 7

PAM HUGS FOSS

Answer 7

Mnemonic for PMH
Past medical history (mjr illness)
Allergies (medications and envtl)
Medication (what are you taking and how long have you been taking it)
Hospitalizations in the past year
Urinary (any problems stopping or starting burning sensation, blood)
GI (constipation, diarrhea, abdominal pain)
Surgeries in last year
Family medical history (are parents alive or dead, give condolences if dead and ask how they died, what they died of, and how old they were when they died)
OB/GYN (if woman) (pap smears, pregnancies, babies, abortions how long, how many
last menstrual period, duration, flow (heavy or light) how many pads do you use, painful period
any clots or bleeding in between periods
Sexual history (before I begin these questions I need to say “everything is confidential and these are standard questions I ask everyone”. is the person
Social history (SODA)

Question 8

1. before I begin I say “everything is confidential and these are standard questions I ask everyone
2. Ask are you sexually active ( with men, with women, or with both)
3. If Y, do you use condoms (Y/N), If N, then I say having sex w/o condoms increases rick of contracting an STI, I have info and condoms that I would feel comfortable leaving with you today
4. If married ask if there is sex outside the relationship, if Y ask question 3 about condoms

Answer 8

What to ask for sexual history

Question 9

1. Head/neck
2. shoulders, upper limb (arm, forearm, and hand), and back
3. abdomen/GI
4. genitourinary
5. lower limb (thighs, knees, legs, feet)

Answer 9

How to proceed with ROS

Question 10

Conclude by asking if there is anything I missed and ask if there was anything the patient would like to discuss with me

Answer 10

How to conclude interview

Question 11

1. Knock, wait for permission to enter
2. introduce myself (Hello/good morning/ good afternoon Mr./Mrs./Ms./Dr. my name is Lauren Lamb, I am a medical student at Meharry Medical College (shake hands) am I pronouncing your name correctly? (pause for response) I’ve been asked to interview you.

Answer 11

How to begin medical interview