subjective Qs for RA

Question 1

what are some general tips for effective communication with patients?

Answer 1

-introduce yourself and your role
-keep language simple
-open ended questions
-be empathetic
-be respectful
-listen
-check for understanding and summarise at regular intervals

Question 2

what are examples of serious pathologies in terms of subjective exam?

Answer 2

-infection / TB
-fracture
-cancer (secondary bone mets)
-spinal cord compression / cauda equina compression

Question 3

what are examples of red flags in a subjective?

Answer 3

-thoracic pain
-fever
-unexplained weight loss
-bladder or bowel dysfunction (lack of control / sensation)
-hx of cancer
-presence of medical illness
-progressive neurological deficit
-disturbed ataxic gait
-saddle anaesthesia

Question 4

what is important with regard to pain and its location in subjective exam?

Answer 4

-identify main pain areas
-record on body chart
-code hem as P1,P2 etc
-establish severity of each 0-10 NRS
-establish irritability
-aggs and eases
-history of similar pain?
-note fibromyaglia, RA - multiple pain sites

Question 5

if a patient has for example fibromyalgia, RA etc, what is important re pain ?

Answer 5

-pt may have multiple sites of pain
-establishing severity, irritability etc may not be relevant
-focus on worse affected area and focus on overall severity / irritability of condition

Question 6

what do you need to note about pain behaviour?

Answer 6

-aggs and easing factors
-irritability - time between increase and decrease
-24 pattern - AM, during day, night pain, mechanical behaviour?

Question 7

what are examples of systemic symptoms / features in rheumatology patients?

Answer 7

-fatigue, lethargy
-CV - chest pain on exertion, dyspnoea
-ocular - red eyes, dry eyes, visual probs
-resp- cough, SOB
-renal - abdominal pain, nausea
-vascular - colour changes in peripheries
-neuro - seizures
-dematological - rashes etc

Question 8

what are examples of open ended questions to establish systemic features in rheumatology pts?

Answer 8

-do you have any problems with your breathing?
-do you have any problems with your circulation?
-do you get any skin rashes or itchiness?
-how do these symptoms impact your everyday life?

Question 9

what are examples of medications that could be used in rheumatology?

Answer 9

-analgesics
-NSAIDS
-corticosteroids
-opioids
-disease modifying anti-rheumatic drugs
-anti TNFs

Question 10

what are important questions to ask re medications?

Answer 10

-are you currently taking any prescribed medications or over the counter treatments for xx condition?
-are you taking any other medications for other medical conditions?
-dosage - frequency / number taken
-format of medication eg oral etc
-impact on symptoms - effect on pain or inflammation

Question 11

what are examples of questions you can ask a pt on medical or surgical history?

Answer 11

-have you any medical conditions now or in the past?
-who is managing your care?
-is the condition stable, do they have any symptoms?