Comm Skills

Question 1

What 7 ways might a patient with musculoskeletal problems present?

Answer 1

• Pain
• Loss of function
• Deformity
• Stiffness
• Weakness
• Appearance of a swelling
• Paraesthesia

Question 2

How should pain be further characterised?

Answer 2

Site
Onset
Character- gradual or sudden, progressive or regressive
Radiation
Associated symptoms (paraesthesia)
Timing- frequency, duration, diurnal or nocturnal
Exacerbating/releiving factors
Severity- scale of 1-10, night pain, analgesic use

Question 3

How do you gauge the impact of a condition on a patient’s life (severity from most to least)?

Answer 3

• Nocturnal symptoms: a symptom that disturbs sleep is particularly severe and debilitating and may raise concern of particular important pathologies
• Affected activities of daily living (ADLs)- these include walking, hygiene, dressing, eating, and preparing food and household chores
• Affecting employment- unable to work or restricted at work
• Affecting leisure- unable to undertake a favourite sport or activity

Question 4

What other symptom is important in an MSK history?

Answer 4

Giving way

Question 5

What symptoms are important in a CNS history?

Answer 5

• Headache
• Fits
• Fainting
• Paraesthesia/altered sensation
• Loss of power/weakness
• Incoordination
• Confusion
• Visual disturbance
• Psychological changes
• Nausea/vomiting

Question 6

What is important to ask in a neurological family history?

Answer 6

Epilepsy, migraine, cerebrovascular problems, muscle disorders and neuropathies

Question 7

What motor symptoms might present in a neuro exam?

Answer 7

Weakness
Clumsiness
Stiffness
Unsteady gait

Question 8

What sensory symptoms might present in a neuro exam?

Answer 8

Pain
Numbness
Paraesthesia
Cold
Warmth

Question 9

What are the important symptoms in a CVS history?

Answer 9

Chest pain
Palpitations
Dyspnoea (difficult breathing)
Oedema
Pre-syncope (light headedness)

Question 10

What are the important symptoms in a respiratory history?

Answer 10

• Cough
• Spit
• Chest pain
• Dysnpoea
• Haemoptysis (coughing up blood)
• Wheeze

Question 11

What are the important symptoms in a GIT history?

Answer 11

• Anorexia
• Weight loss
• Nausea/vomiting
• Mouth pain
• Dysphagia
• Heartburn
• Abdominal pain
• Jaundice
• Bloating/swelling
• Flatulence
• Constipation/diarrhoea
• Vomiting blood
• Rectal bleeding/meleana

Question 12

What are the important symptoms in a renal history?

Answer 12

• Dysuria (painful)
• Frequency
• Urgency
• Polyuria
• Oliguria/anuria
• Haematuria
• Passing stone
• Oedema
• Incontinence
• Nocturia
• Hesitancy
• Pneumaturia (bubbles)
• Pain

Question 13

What are the important symptoms in a thyroid history?

Answer 13

• Weight loss/gain
• Sweats
• Palpitations
• Constipations/frequent motions
• Appetite changes
• Skin/hair changes
• Lassitude/fatigue
• Agitation
• Cold/heat intolerance