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Flashcards in Smoking History, Peak Flow Blind or Deaf Deck (12):
1

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

Based solely on this information come up with likely differentials

Asthma
Bronchitis

2

You are the GP

An 68 year old woman has presented with productive cough, wheeze and occasional dyspnoea. She has 30 pack year smoking history

Based solely on this information come up with likely differentials

COPD

3

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You initially suspect asthma and begin to take a history. Which of the above symptoms would be good to explore first?

Dyspnoea

as this is the most serious

4

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You initially suspect asthma and begin to take a history. Take a focused HxPC

TOP ERA

T - duration
O - sudden / gradual
P - worse / better / same

E - cold weather
E - time of day
E - dust
E - allergies
E - NSAIDs

A - Eczema

5

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You initially suspect asthma and begin to take a history. Take a focused PMHx

Previous episodes
Admitted to ITU
Ongoing medical problems

6

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You initially suspect asthma and begin to take a history. Take a focused FHx

FHx
- allergies
- eczema
- asthma
- respiratory problems

7

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You initially suspect asthma and begin to take a history. Take a focused DHx

Name
Dose
Frequency
Reason

Allergies to penicillin

8

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You initially suspect asthma and begin to take a history. Take a focused SHx

Smoking
Alcohol

9

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You suspect asthma and take a structured but focused Hx. On respiratory examination what would you expect to hear?

Wheeze

10

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You suspect asthma and take a structured but focused Hx. You have completed the examination. What should you now do?
You can also do this at the end of the history.

Summarise

Main Concern
+ve symptoms
-ve symproms
AOB
Examination findings

11

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You suspect asthma and take a structured but focused Hx. You have completed the examination and summarised. Which Igx are useful to help confirm asthma

PEF
Spirometry

12

You are the GP

An 18 year old girl has presented with cough, wheeze and occasional dyspnoea. Not coughing up and phlegm.

You have
- Hx + examination
- Summary
- Diagnosed Asthma
- About to take a PEAK FLOW reading

The patient is blind
How should you start the instructions?

 WIPER