"History Taking"
MRCP-PACES 30th November 2005
Station 2:
History Taking:
Scenario:
Letter from GP; 33 years old Malay lady presented with complaint of shortness of breath of three weeks duration associated with fever, cough and pleuritic chest pain. Chest x-ray reviewed a left-sided pleural effusion. Kindly see her for further management.
I started by taking a usual history regarding the history of presenting illness, with questions targeting more on the differential diagnosis of pleural effusion. Nothing much in the past medical history, no allergy, only child, no significant family history. A secretary in a law firm, cigarette smoker, regular alcohol once a week, has a fiance but no sexual relationship. Only concern was patient has shortness of breath and was unable to climb stair case to her 2nd floor apartment (no lift). Surprisingly, she did not have any other social problem or concern. Examiners asked the usual questions like, differential diagnosis of pleural effusion, investigation and general magagement.
Commment:
This case was quite relatively straight forward. Luckily, patient was quite cooperative and there wasn't much concern from her. Questions asked were quite direct. The only thing I feel was, probably I could have asked about some differential diagnosis of shortness of breath too. The case might not just be pleural effusion as diagnosed by the GP. Perhaps, one should think broadly.
Outcome: 3/3
History Taking:
Scenario:
Letter from GP; 33 years old Malay lady presented with complaint of shortness of breath of three weeks duration associated with fever, cough and pleuritic chest pain. Chest x-ray reviewed a left-sided pleural effusion. Kindly see her for further management.
I started by taking a usual history regarding the history of presenting illness, with questions targeting more on the differential diagnosis of pleural effusion. Nothing much in the past medical history, no allergy, only child, no significant family history. A secretary in a law firm, cigarette smoker, regular alcohol once a week, has a fiance but no sexual relationship. Only concern was patient has shortness of breath and was unable to climb stair case to her 2nd floor apartment (no lift). Surprisingly, she did not have any other social problem or concern. Examiners asked the usual questions like, differential diagnosis of pleural effusion, investigation and general magagement.
Commment:
This case was quite relatively straight forward. Luckily, patient was quite cooperative and there wasn't much concern from her. Questions asked were quite direct. The only thing I feel was, probably I could have asked about some differential diagnosis of shortness of breath too. The case might not just be pleural effusion as diagnosed by the GP. Perhaps, one should think broadly.
Outcome: 3/3
Labels: History Taking
posted by Cytusm @ 3/09/2006 05:28:00 PM
3 Comments:
I must say 'well done' for doing this in a relatively stressful period of time in life:)
That further convinces me on the notion that cases in PACES are meant to test our daily skills and practises, contrary to the common belief that it is designed to fool us into traps.
Keep up the good work.
Cheers.
MK32
what was the diagnosis
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