Medical History Flashcards
What does the GDC state regarding medical histories?
‘You must make and keep complete and accurate patient records, including an up-to-date medical history each time you treat patients’
What are the reasons you should take a medical history?
Safe treatment
Possible drug interactions with prescribing
Assess the likelihood of a medical emergency in a dental setting
Allows you to give a history in case of medical emergency
What does the history of presenting complaint tell you? (HPC)
What occurred preceding the incident
What does SOCRATES stand for?
Site
Onset
Characteristics
Radiation
Associated Symptoms
Time
Exacerbating Factors
Severity
In the past medical history, what systems should be asked about?
Cardiovascular
Respiratory
Gastrointestinal
Neurological
Endocrinology
Musculoskeletal
Blood Disorders
What type of speech should be avoided?
Jargon
What questions should be asked after the systems approach?
Is there other medical conditions?
Is there previous hospital admissions?
Have you had previous surgery?
What is included in the past medical history apart from conditions?
Medications
What are some notable drugs that can affect dental work?
Anticoagulants (warfarin, factor 10a inhibitors)
Anti-platelets (clopidogrel, aspirin)
Bisphosphonates (Alendronic acid)
Steroids (prednisolone)
What are NOT symptoms of allergies that patients may refer?
Nausea and Diarrhoea
What might the dental history include?
Regular attender?
Phobias
Adverse effects to LA
History of excess bleeding after extraction
Effect of sedation (Oral, RA, IV)
How many alcohol units is recommended per week?
No more than 14
What is the family history trying to discover?
Trying to establish if there are genetic predispositions
What is a differential diagnosis?
List of possible conditions that may cause patient’s symptoms
