Peer Teaching History Revision

Question 1

In a Respiratory History what are the key symptoms to ask about?

Answer 1

cough, wheeze, fever, haemoptysis, dyspnoea,

Question 2

What FH should you ask about in a Respiratory History?

Answer 2

CF, asthma/eczema/hayfever

Question 3

In a Respiratory Social History, what is crucial to ask about?

Answer 3

foreign travel, pets, occupation, living conditions, hobbies (e.g. pigeon fancying), long haul flights

Question 4

In a patient with Asthma that is coming in with an exacerbation of asthma in their asthma review. What should you ask? Remember Medics Basketball

Answer 4

You need to ask have they ever been hospitalized. Do they know what they need to do in an acute asthma attack?

Question 5

Name 4 causes of Cardiac Chest Pain
3 causes of Respiratory Chest Pain
2 causes of GI chest pain

Answer 5

Angina, Pericarditis, Aortic dissection, Heart Attack

PE, Pneumonia or Pneumothorax

Peptic Ulcer or GORD

Question 6

Chest Pain

Answer 6

Site 
Onset 
Character + also is it constant or changes. Is the pain still here now.
Radiation 
Associations 
Time: how long does the pain last for> 
Exacerbating/Relieving Factors:

Ever had this pain before

Question 7

Palpitations: two unlinked causes?

Answer 7

Thyroid disease
Stress!
WHEN DO THE PALPITATIONS COME ON?? ALL THE TIME OR FOR EXAMPLE EXERCISE

Question 8

What systemic symptom do you need to ask for in a cardiac or respiratory history

Answer 8

FATIGUE

Question 9

If a patient has ankle swelling ask

Answer 9

How many pillows are you using at night?
Are they sleeping in a chair?
Can they climb the stairs?
Exercise tolerance?
What was normal for them before?

Question 10

What 4 things can make SOB better?

Answer 10

Rest 
Exertion 
Position 
Fresh air 
Inhalers

Question 11

3 causes of syncope

Answer 11

Vasovagal
Aortic stenosis
Cardiac arrhythmias

Question 12

If someone collapses: always ask what were they doing before AND

Answer 12

How were they feeling before

Question 13

After someone collapses you need to ask: HOW did they feel afterwards AND

Answer 13

were they confuse afterwards and how long it took to feel normal again

Question 14

What are 2 symptoms of pre syncope?

Answer 14

Palpitations and nausea

Question 15

Is a red flag for headaches: gets worse when lying down?

Answer 15

YES

Question 16

What two conditions are SAH more common in?

Answer 16

PKD and Ehlers Danlos

Question 17

What are 3 causes of raised ICP

Answer 17

Brain Tumor
Brain Abscess
Intracranial Bleed

Question 18

What is Temporal Arteritis?

Answer 18

A headache that presents with pain when eating, brushing hair and affects the vision
Treat urgently with high dose steroids

Question 19

When a patient says they have had some visual disturbances ask:

Answer 19

Do they wear glasses or contacts
Is it better when you close one eye?
What is the change you have in your eyesight (please describe)
Is there any pain in the eye

Question 20

How will myasthenia graves present in visual disturbance?

Answer 20

Double vision w/ptosis
Swallowing problems
Worse with use

Question 21

Name 5 RF for breast cancer:

Answer 21

Early menarche 
Late menopause 
Pregnancy >30 yrs 
No children 
HRT 
Family History (i.e. BRCA1 and BRCA2 gene)

Question 22

If a patient has a lesion of the MN and the forehead is spared what MN is affected?

Answer 22

The UPPER MN will be affected

Question 23

Name 5 conditions it is important to ask for in a Neuro History:

Answer 23

Arrhythmias
MIs 
HTN 
Angina 
High Cholesterol 
Diabetes

Question 24

Give 3 symptoms of Bells’ Palsy:

Answer 24

Drooling of saliva
Difficulty speaking
Hypersensitive to sound
Decreased taste

Question 25

Strange Neuro history. If a patient presents with weakness and inability to open joints with muscle weakness. What two questions can you ask to rule out MG and MS

Answer 25

MG: fatiguability with use
MS: sphincter loss or sphincter changes

Question 26

WHAT disease is the only one that affects UMN and LMN

Answer 26

MND

Question 27

What motor neurons do Guillan Barre and Myasthenia Gravis affect

Answer 27

LMN and UMN

Question 28

What are two symptoms of Myasthenia Gravis that happen in the throat/speech?

Answer 28

Dysarthria

Dysphagia

Question 29

IF SOMEONE HAS NUMBNESS OF TINGLING: ask where this is?

Answer 29

Where does the numbness of tingling stop?

Question 30

4 causes of numbness or tingling

Answer 30

Peipheral neuropathy 
Stroke 
Nerve root lesion 
Spinal Cord lesion 
MS

Question 31

Give 3 causes of a polyneuropathy:

Answer 31

Vitamin Deficency vitamin B1 and B12
Kidney failure
Diabetes
Alcohol

Question 32

Name 3 symptoms of GBS

Answer 32

Distal to proximal muscle weakness and loss of sensation
Absent Leg reflexes
Sweating, raised pulse and arrhythmias.

** ULTIMATLEY Respiratory depression!!