The Medical Interview

From the deepest darkest depths of my previous PCL group.

The Complete Medical Interview that is probably way too long hence impossible to finish in OSCEs

1. Ensure the patient's comfort -
   Invite the patient to sit.
2. Introduce yourself.
3. Clarify your role.
4. Consent.
5. Confidentiality.
   
6. Patient's name.
7. Chief complaint.
8. History of present illness -
   (WWQQAA+B).
9. Systems review.
   
10. Medical history.
11. Surgical history.
12. Obstetrics & Gynecology.
    Menarche - When was the first period?
    Menstrual - Length, frequency, amount, quality of blood, pain.
    PGA (paragravida abortion) -
    Para = no. of live births;
    Gravida = no. of pregnancies;
    Abortion = therapeutic & spontaneous.
    Menopause
    
13. Medication -
    Conventional, traditional, recreational etc.
14. Immunization
    
15. Allergy -
    Anesthetic, medication, food etc.
16. Smoking -
    Status, type, frequency, amount, duration, Prochaska Dichelemente Cycle
    
17. Alcohol-
    Status, type, frequency, amount, purpose, CAGE
    
18. Family history -
    At least 3 generations.
19. Social history -
    Living environment, social status, marital status, family dynamics, sexual activity etc.
    
20. Occupational history -
    Employment, environment, workplace dynamics etc.
    
21. Travel history -
    Frequency, location, purpose etc.
    

Arbitrary Reminders
WWQQAA+B

• When.
• Where.
• Quality.
• Quantity.
• Aggravating & alleviating factors.
• Associated symptoms.
• Beliefs.

Prochaska-Diclemente Cycle

• Pre-contemplation.
• Contemplation.
• Preparation.
• Action.
• Maintenance.
  
• Relapse.
  

CAGE

• Cut down on drinking.
  
• Annoyed by requests to quit.
• Guilty feeling when drinking.
• Eye-opener to kick-start day.