PLAB PART 2

(Contraceptive) “Do you experience safe sex?” are you on pills? Pregnancy: If she is not active so she is not pregnant. 1. “Have you ever been pregnant? Duration of pregnancy? Mode of delivery? 2. How many children do you have? 3. Any miscarriage or abortion? 4. Any complications before, during or after pregnancy? Pap smear: “When did you have your last pap smear?” What was the report? Was it normal? If it is abnormal: go to GP? Attention in GMC exam when you see these signs and symptoms think of AIDS. 1. Dry cough 2. Weight loss 3. sexual transmitted disease 4. abnormal LFTs 5. jaundice 6. HIV screening IV. Medication “What kind of medication do you use?” are you on medication for any disease? V. Allergy VI. Family history: for Carcinoma history in family ask: “I am very sorry to ask but if anyone in your family diagnosed by sinister disease (cancer) of breast, womb, and egg producing gland?” VII. Travel history VIII. Occupation history “What do you do for living?” IX. Social history: “Where do you live?” “Who do you live with?” X. Anything else: “anything else you what to tell me?” Turn to the examiner and say – “Based upon my history, my most probable diagnosis is ..., my differentials are ... and I should have ruled out ... “(i.e. only if you have forgotten to rule out any thing in your history). P3MAFTOSA I. Present complains II. Past complains III. Personal complains IV. Medication V. Allergy VI. Family history VII. Travel history VIII. Occupation history IX. Social history X. Anything else

Format for history taking: GCSE Greeting Confidentially Concern Sympathy Empathy ODPARA Onset Duration Progression Aggravating Factor Relieving Factor Associated symptoms Anything Else Non-pain related complaint: ODPARA Onset “How did it start? What were you doing when it started? Did any happed prior to …” Duration Most of the time it is written in the task, just check it with the patient. Progression “Has it been getting worse or has it been getting better?” Aggravating Factor “Have you noticed what makes it worse?” Relieving Factor “Have you tried to make it better?” Associated symptoms “Do you have temperature?” (Fever is a clue in GMC exam) “Do you have pain?” If patient says yes go for SOCRATES PDA “Did it start together?” Vomiting? SOCRATES PDA Site Onset Character Radiation Associated symptoms Timing Exacerbating and Relieving Factor Scale Progression Duration Anything Else SOCRATES PDA pain related Site: “where is in the tummy do you feel the pain most?” Onset: “How did the pain start? “ Character: “could you please describe the pain for me?” Radiation:”Does this pain go anywhere else?” No ask: “Has it come from anywhere else?” Yes: ask where? Associated symptom: stick on your diagnosis. Trimming: “Does it from specific timing? “ “Has it happened before? Is the pain constant, or does it come and go?” Exacerbating and relieving factors: “Does anything make it better? Is the pain relieved on defecation?” Scale: “if I was to give to give you the scale1-10, one is lowest and 10 is highest, what do you describe the pain?” If answer is Under 7 ignore it… 8-10 severe like MI Progression: “Is it increased or getting worse?” Duration: always written in your task. Anything else: 3 Ps: Present complaint, Past complains, Personal history I. Present complains: "Do you mind if I ask you what has brought you into hospital (here)?" Tip: First thing comes of patient month is chief complaint. II. Past complains: Similar complains: “has anything like this has been happened to you? For how long? What did you take for it? Is it well controlled?” Medication: “Do you have any long time medical condition?” Yes how long? Is it well controlled?” Hospitalisation: have you ever been hospitalized? Yes. What for? Procedure Endoscopy….. III. Personal complains: “I’m going to ask you few personal Questions; and whatever you say will be confidential.” Smoking (4Qs) 1. Do you smoke? Yes… 2. How many cigarettes do u smoke a day? 3. How many cigarettes are there in a pack? 4. For how long have u been smoking? sleep Alcohol (4Qs) 1. Do you drink alcohol? If he says occasionally leave it. If says yes, 2. Ask what do u prefer to drink? 3. How much? 4. For how long have u been drinking like this? Appetite Recreational drugs 1. “By any change do you take recreation drugs?” Yes. 2. Sorry to ask you but what do you do? 3. How do you take it? 4. If injecting, ask: By any chance do you use new needle all the time? 5. For how long are you doing this? 6. Do you use any other recreational drugs? Weight loss/ gain Have you been weighting on the higher site? (for obesity) Bowel habits 1. How often do you open your bowels? 2. Have you noticed any change? 3. Any alteration in bowel habit? Bladder Sexual history: 1-Are you sexually active? No… Have you ever been sexually active? Yes… 2- Sorry to ask you this but Are you in a stable relationship? For how long? Do you practice safe sex? Do you use condoms? Are you on any contraception? What is your sexual orientation? Which root do you take? Did you travel abroad before your symptoms? Did you have any sex relationship there? 3- I am sorry to ask you but by any chance, your partner has any sexual relationship?” If patient is a woman, ask 4Ps Period (LMP) 1-“When was your last periods?” If > 4 weeks then she might be pregnant. If she is not sexually active then she is not pregnant. 2- How many days do they last? 3- Are they regular? 4- Do you get pain? ( ovulation) 4- Any bleeding between your periods or after intercourse? (ovulation, hormonal imbalance, cervical polyp, PID, cervical erosion) Pills