question

[MissMedicine]

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if someone comes into your office with chest pain do u ask about fam hx, past med hx or to describe their chest pain further?

 

[DrDre']

BOTH. not to describe it but to put it in context and characterize its parameters. Dull ache for last 2 weeks, increase with movement r/o costochondritis or Hx of increasingly, severe intermittent crushing chest pain. Fam hx will help get an idea of genetic or social component.

Meds may give you help as well.

Sorry if i misunderstood your question

 

[StringBean]

You should ask all three but I believe (for exam purposes) it should be in this order...

describe pain
past medical Hx
family Hx

 

[MissMedicine]

sorry i meant which one first... yeah, string bean, thats what i was thinking.

 

[Stinger86]

Yeah when someone has any kind of pain, you ask about it with an open-ended question ("tell me about the pain", not "tell me about the chest pain")

 

[Yosh]

I would look into the "pressing" problem...and ask to have the "pain" better described....and go into PMH and FHx....providing the pt is not mid MI

 

[Idiopathic]

This was on my exam last week, exactly...I chose 'describe your chest pain', or whatever was closest to that.

 

[MissMedicine]

This was on my exam last week, exactly...I chose 'describe your chest pain', or whatever was closest to that.

damn, how many nbme questions do u think they recycle?

 

[chandler742]

These Doctor-Patient questions are touchy-feely. Does anybody have any ideas for a reference book that we can look at for reading about Doctor-patient interactions. BRS behavioral science is more of a review book, rather than a desk reference.

This was on my exam last week, exactly...I chose 'describe your chest pain', or whatever was closest to that.

 

[Idiopathic]

damn, how many nbme questions do u think they recycle?

Oops...maybe thats where I got it.

To answer your question, I think they keep all the NBME questions in circulation, but they have so many exams that they can spread them out so that each test-taker only gets 2-5 repeats. I think I had 2 at least.