Smoking History, Peak Flow Blind or Deaf Flashcards
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
Based solely on this information come up with likely differentials
Asthma
Bronchitis
You are the GP
An 68 year old woman has presented with productive cough, wheeze and occasional dyspnoea. She has 30 pack year smoking history
Based solely on this information come up with likely differentials
COPD
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You initially suspect asthma and begin to take a history. Which of the above symptoms would be good to explore first?
Dyspnoea
as this is the most serious
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You initially suspect asthma and begin to take a history. Take a focused HxPC
TOP ERA
T - duration
O - sudden / gradual
P - worse / better / same
E - cold weather E - time of day E - dust E - allergies E - NSAIDs
A - Eczema
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You initially suspect asthma and begin to take a history. Take a focused PMHx
Previous episodes
Admitted to ITU
Ongoing medical problems
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You initially suspect asthma and begin to take a history. Take a focused FHx
FHx
- allergies
- eczema
- asthma
- respiratory problems
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You initially suspect asthma and begin to take a history. Take a focused DHx
Name
Dose
Frequency
Reason
Allergies to penicillin
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You initially suspect asthma and begin to take a history. Take a focused SHx
Smoking
Alcohol
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You suspect asthma and take a structured but focused Hx. On respiratory examination what would you expect to hear?
Wheeze
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You suspect asthma and take a structured but focused Hx. You have completed the examination. What should you now do?
You can also do this at the end of the history.
Summarise
Main Concern \+ve symptoms -ve symproms AOB Examination findings
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You suspect asthma and take a structured but focused Hx. You have completed the examination and summarised. Which Igx are useful to help confirm asthma
PEF
Spirometry
You are the GP
An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.
You have
- Hx + examination
- Summary
- Diagnosed Asthma
- About to take a PEAK FLOW reading
The patient is blind
How should you start the instructions?
WIPER