Difficulty with taking Medical Histories

[MedStudent219]

Hi, hope I am posting this in the right place. I'm a First Year in Med and I've been having the occasional visits to the hospital where we take histories from patients. One thing I am struggling with is knowing what to ask patients when their disease is related to a system we have not yet covered e.g. neuro. As a result, I often stumble up during the HPCs because I am not sure what to ask next. Also, what do you do when a patient says they only have a single symptom e.g. abdominal pain? Do you quiz them about relevant symptoms? or just move on? Thanks!!

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[AlbinoHawk DO]

At your level, just do the OPQRST with a broad ROS (fever, chills, headache, dizziness, chest pain, palpitations, SOB, cough, nausea, vomiting, diarrhea, constipation, trouble urinating, muscle pain or weakness, anxiety, depression). If you want associated symptoms, just think of what "stuff" is near the area of complaint. For example, if they have RUQ pain think of the liver, gallbladder, intestines, stomach and don't forget to always ask for "any family history of problems with (area)?"

 

[MedStudent219]

At your level, just do the OPQRST with a broad ROS (fever, chills, headache, dizziness, chest pain, palpitations, SOB, cough, nausea, vomiting, diarrhea, constipation, trouble urinating, muscle pain or weakness, anxiety, depression). If you want associated symptoms, just think of what "stuff" is near the area of complaint. For example, if they have RUQ pain think of the liver, gallbladder, intestines, stomach and don't forget to always ask for "any family history of problems with (area)?"

So as we learn the systems more and interact with patients further, we will be able to better know what to ask regarding what symptoms might be related to the patient's PC? and for now while we're learning just query broadly in the ROS?

 

[Gurby]

Good thing we have 4 years to practice!

 

[AlbinoHawk DO]

So as we learn the systems more and interact with patients further, we will be able to better know what to ask regarding what symptoms might be related to the patient's PC? and for now while we're learning just query broadly in the ROS?

My experience was that most of first and second year was memorize, regurgitate then forget. It wasn't until I began to really buckle down for board studying and doing questions in random during second semester that things began to "click" and integrate. I would honestly not worry about it at all at this stage. I'd focus my efforts on being comfortable with just seeing how different real world patients are compared to your standardized patients (mainly the fact that they can be all over the place on their story) and to learn to keep a systemic approach.

 

[NickNaylor]

Congratulations, you're performing at a developmentally-expected level. Keep learning and practicing, you'll get it... eventually.

 

[Tenk]

This is exactly the reason they have you do this.