Diagnosis

Question 1

Diagnosis

Answer 1

• Observation
• Patient history
• Physical examination
• Results of diagnostic tests
• Clinical experience and professional judgement

Question 2

History taking

Answer 2

• Introduction
• Presenting complaint
• History of the presenting complaint
• Past medical (and surgical) history
• Family history
• Social history - Occupational could be COPD miner
• Drug history
• Sytemic review

Question 3

Introduction

Answer 3

• Wash hands
• Introduce yourself
• Identify your speaking to correct indavidual
• Purpose and eye level 1 meter away

Question 4

Presenting complaint

Answer 4

• Active listening
• Open body language
• Building rapport
• Letting the patient speak

Question 5

SOCRATES

Answer 5

• Site
• Onset
• Character
• Radiation
• Accociated symptoms
• Time
• Exacebated
• sever

Question 6

Past Medical history

Answer 6

• Any risk factors associated may link to condition

Question 7

M J T H R E A D S

Answer 7

• Myocardial infarction
• Jaundice, tuberculosis
• Hypertension
• Rheumatic fever
• Epilepsy
• Asthma
• Diabetes
• Stroke.

Question 8

Family History

Answer 8

• Relatives that have had heart conditions
• Hay fever and eczema
• May be genetically related

Question 9

Social History

Answer 9

• Travel been to area with high risk area
• Alcohol intak calculation and smoking per pack calculation
• Asbestos or coal mine dust causing respiratory conditions

Question 10

Drug History

Answer 10

• Side effects
• Drug interection and patient interaction
• Drug disease interaction and complience
• Rash more likely allergic reaction compared to just upset stomach

Question 11

Systems review

Answer 11

• Cardiovascular
• Respiratory
• Gastrointestinal
• Genitourinary
• Neurological
• Locomotor

Question 12

Differential diagnosis

Answer 12

• A list of possible conditions or diseases that could be causing the symptoms
• List of causes plan used to differentiate

Question 13

Professional judgement

Answer 13

• Professional judgement could be described as the use of accumulated knowledge and experience, in order to make an informed decision
• It takes into account the law, ethical considerations and all other relevant factors related to the surrounding circumstances

Question 14

Steps of professional judgement

Answer 14

• Identify the ethical dilemma
• Gather all the relevant information
• Obtain advice from support services, seniors
• Identify the possible options
• Weight up the risk vs benefits and advantages and disasvantages of each options
• Make a decision - must be able to justify it
• Where appropriate or significant document your decision making process and reasoning

Question 15

Diagnostic tests - Blood pressure

Answer 15

• Routine observation in hospital
• Routine as part of BP medication check
• High BP = headache
• Low BP = light headed, falls

Question 16

Diagnostic tests – Heart Rate

Answer 16

• Routine observation in hospital
• Dizziness
• Fainting / light headed
• Palpitations
• Measure pulse for 30s

Question 17

Diagnostic tests – Respiratory rate

Answer 17

• Number of breaths / min
• Count the number of times the patients chest rises in 60 seconds 2 x 30s
• Routine observation in hospital, Shortness of breath
  Respiratory assessment

Question 18

Diagnostic tests - Temperature

Answer 18

• Use of multiple thermometers
• Could possibly be an infection

Question 19

Diagnostic tests- Oxygen levels

Answer 19

• Health patient O2 sat: >95%
• Respiratory conditions (COPD): 88 – 92%
• Shines two types of light through your finger (one red light, one infra-red light)
• Red blood cells absorbtion of infered light allow red light to pass through high oxygen
• Red blood cell with low oxygen absorb read light and infered pass through

Question 20

Diagnostic tests – Ear examination

Answer 20

• Not routinely used
• Dizziness / ringing / crackling sound in ear
  Ear infection
• Hearing assessment: hearing loss / changes in hearing

Question 21

Diagnostic tests- BMI

Answer 21

BMI = Weight (kgs)/[Height (m)]2
- Weight loss clinic
- Diabetes or cardiovascular clinic high BMI is a risk factor

Question 22

Blood sugar monitoring

Continuous glucose monitoring

Answer 22

devices fitted under the patients skin which they can scan using smart phone to check BMs

Question 23

Blood glucose monitoring

Answer 23

• Single use blood tests used to check BMs where patient pricks finger, collects blood and runs the test
• Diabetic patients
• Patients who have collapsed
• Recurrent urinary tract infections

Question 24

Diagnostic Tests – Peak Flow

Answer 24

• Take a deep breath in
• Blow as hard and fast as you can into the peak flow meter = Peak Expiratory Flow (PEF)
• Plot on the chart to see where your PEF score sits
• Respiratory conditions such as asthma identification

Question 25

Throat Swabs

Answer 25

• Sore throat test and treat service
• Patients with sore throat can have a throat swab undertaken by a community pharmacist;
• Bacterial: antibiotics provided OTC
• Viral: self help advice

Question 26

Urine Dip testing

Answer 26

• Urinary tract infection service
• Allows urine to be tested to look for infection markers provided if needed
• Also can highlight excessive glucose, blood which may warrant further investigation and referral

Question 27

Pregnancy testing

Answer 27

• HIV
• Chlamydia / gonorrhoea
• Syphilis
• Tend to be provided in community pharmacy (charge) and sent to be tested and patient contacted by external company