Lesson 1History a present illness: chronological construction, onset, duration, exertional pattern, triggers, progressionExplains construction a di history a present illness fi exertional dyspnea, emphasizin onset, duration, exertional pattern, triggers, progression, an prior evaluations, fi build a coherent, time-linked semiotic narrative.
Defining onset, tempo, and first episodeCharacterizing exertional thresholds and limitsIdentifying triggers and relieving maneuversDocumenting progression and stepwise changesPrior tests, treatments, and responsesSynthesizing a chronological symptom timelineLesson 2Family history questions focused pon cardiopulmonary, thromboembolic, an hereditary lung diseaseDetails how fi explore family history relevant to exertional dyspnea, focusin pon cardiomyopathies, arrhythmias, thromboembolic disease, an hereditary lung disorders, wid wordin dat improve reliability an reveal subtle inherited risk patterns.
Cardiac family history and premature sudden deathInherited arrhythmias and cardiomyopathiesFamilial thromboembolic and clotting disordersHereditary pulmonary hypertension patternsGenetic lung diseases and early respiratory failurePedigree building and red flag clusteringLesson 3Relievin an aggravatin factors: posture, medications, exertion, environmental exposuresDescribes how fi explore relievin an aggravatin factors fi exertional dyspnea, includin posture, medications, exertion level, an environmental exposures, an how dese patterns help distinguish cardiac, pulmonary, an functional etiologies.
Postural changes and orthopnea assessmentExercise intensity and exertional thresholdsMedication timing, relief, and side effectsEnvironmental and occupational exposuresTemporal patterns and day to night variationIntegrating patterns into pathophysiologic cluesLesson 4Medication, allergy, an vaccination questions wid phrasin fi accuracyDetails how fi question medications, allergies, an vaccinations inna patients wid exertional dyspnea, usin precise phrasin fi improve recall, detect interactions, an identify preventable respiratory or cardiac complications.
Current prescription and over the counter drugsInhalers, oxygen, and adherence assessmentDrug and food allergies with reaction detailsVaccine history for influenza and pneumococcusCOVID and other relevant immunizationsIdentifying interactions and contraindicationsLesson 5Social history questionin scripts: smokin (pack-years), occupation, environmental exposures, alcohol, recreational drugs, physical activity levelProvides scripts fi social history focused pon exertional dyspnea, coverin smokin wid pack-year quantification, occupation, environmental exposures, alcohol, recreational drugs, an physical activity level, emphasizin risk stratification an stigma-free wordin.
Smoking history, pack‑years, and cessationOccupational dust, fumes, and irritant exposureHousehold and environmental inhalational risksAlcohol intake patterns and cardiopulmonary riskRecreational drugs and route of useBaseline physical activity and functional classLesson 6Structure an goals a anamnesis: identification, chief complaint, informed consent phrasinIntroduces di overall structure an goals a anamnesis inna exertional dyspnea, includin patient identification, chief complaint formulation, an clear, ethical informed consent phrasin dat builds rapport an frames a focused, efficient interview.
Patient identification and demographic contextFormulating and recording the chief complaintExplaining purpose and scope of the interviewInformed consent and confidentiality wordingSetting agenda and time framing with patientBalancing open listening with focused inquiryLesson 7Questions fi associated symptoms: orthopnea, paroxysmal nocturnal dyspnea, chest pain, cough, wheeze, hemoptysis, syncope, palpitationsFocuses pon systematically elicitin key associated symptoms dat accompany exertional dyspnea, such as orthopnea, paroxysmal nocturnal dyspnea, chest pain, cough, wheeze, hemoptysis, syncope, an palpitations, wid phrasin dat sharpens diagnostic meanin.
Orthopnea and paroxysmal nocturnal dyspneaCharacterizing exertional and resting chest painCough, sputum, and wheeze characterizationHemoptysis severity and red flag featuresSyncope, presyncope, and exertional dizzinessPalpitations, rhythm description, and triggersLesson 8Past medical history probin: cardiovascular, pulmonary, renal, thyroid, hematologic, metabolic, an psychiatric conditionsCovers targeted past medical history fi dyspnea, highlightin cardiovascular, pulmonary, renal, endocrine, hematologic, metabolic, an psychiatric conditions, an how each modifies pretest probability, prognosis, an therapeutic safety inna exertional symptoms.
Cardiovascular diseases and prior cardiac testingChronic lung disorders and prior exacerbationsRenal disease, volume status, and anemia linksThyroid dysfunction and exercise intoleranceHematologic and metabolic contributors to dyspneaPsychiatric comorbidity and symptom perceptionLesson 9Targeted review a systems: standardized phrasin fi respiratory, cardiac, systemic (fevers, weight loss), an psychiatric symptoms fi detect differential cluesExplains how fi conduct a targeted review a systems usin standardized, patient-friendly wordin fi respiratory, cardiac, systemic, an psychiatric symptoms, aimin fi uncover overlooked clues, comorbidities, an alarm signs dat refine di differential.
Respiratory ROS for chronic and acute symptomsCardiac ROS for ischemia and heart failureSystemic ROS for fever, weight loss, night sweatsPsychiatric ROS for anxiety and panic featuresStandardized phrasing to reduce ambiguityPrioritizing and documenting positive findingsLesson 10Exact question scripts fi chief complaint an openin promptsPresents exact openin prompts an chief complaint questions tailored to exertional dyspnea, balancin open an closed formats, minimizin suggestion, an settin a collaborative tone dat encourages accurate, detailed symptom narratives.
Neutral openers for first patient statementsClarifying the main breathing concernExploring patient expectations and fearsAvoiding leading or judgmental questionsTransitioning from open to focused inquiryChecking understanding with patient summaries
