The medical history

Question 1

What is the structure of a medical history

Answer 1

Introduction
PC
HPC
PDFs
- PMHx + PSHx
- DHx
- FHx
- SoHx (LOST)

Question 2

What is included in the Presenting Complaint

Answer 2

1. Explore symptom(s)
   - Timeframe (DOPT)
   * Duration
   * Onset
   * Progression
   * Timing (intermittent or continuous)
   - Symptom-specific questions e.g. SOCRATES
2. Systems review

Question 3

Past Medical/Surgical History

Answer 3

• Tailor to conditions acting as risk factors in your for your differentials e.g. diabetes, HTN for cardiac pain
• Explore: Diagnosis, Treatment, Control

Question 4

Drug History

Answer 4

Allergies (including reactions)
Medications (doses + frequencies) - including OTC and natural remedies

Question 5

Family history

Answer 5

Ask about conditions relevant to differential

Question 6

Social history (LOST)

Answer 6

Living situation: housing, who is at home, care package, ADLs, mobility aids
Occupation: inc occupational history if relevant
Smoking + alcohol: pack years + weekly units +/- recreational drugs
Travel: pets/hobbies/sexual history if relevant

Question 7

How to calculate pack years

Answer 7

(# of daily smoked cigarettes/20)xnumber of years smoking

Question 8

Rough alcohol units

Answer 8

Beer can - 2
Wine glass - 2
Beer pint - 3
Wine bottle - 9-10
35cl spirit - 15
70cl spirit - 30