Lesson 1Functional impact, activities of daily living, an occupational influencesDis section explore how fi assess functional impact, activities of daily living, an occupational exposures, an how dese elements inform severity assessment, disability risk, work restrictions, an tailored follow-up planning.
Evaluating baseline versus current functionAssessing basic an instrumental daily activitiesIdentifying workplace exposures an ergonomicsExploring symptom impact on job performanceDiscussing temporary restrictions an supportsDocumenting disability an return-to-work needsLesson 2Medication, allergy, an adherence assessment relevant to acute symptomsDis section cover how fi elicit a precise medication list, allergy history, an adherence patterns, an how fi connect dese data to acute presentations, adverse drug events, interactions, an diagnostic reasoning at di point of care.
Verifying current prescription an OTC medicationsIdentifying recent medication changes an new startsClarifying drug, food, an environmental allergiesDistinguishing true allergy from nonallergic intoleranceAssessing adherence, barriers, an missed dosesLinking medications to suspected adverse eventsLesson 3Comorbidities an risk factor elicitation (HTN, diabetes, family history)Dis section focus on efficiently eliciting key comorbidities an risk factors, such as hypertension, diabetes, cardiovascular an thromboembolic history, an family history, an integrating dem into pretest probability an triage decisions.
Targeted review of chronic medical conditionsFocused cardiovascular an thrombotic historyEliciting diabetes an metabolic risk factorsClarifying prior surgeries an major proceduresCollecting focused family history by systemUsing comorbidities to refine pretest probabilityLesson 4Symptom characterization: onset, progression, triggers, an severityDis section detail how fi characterize symptoms by onset, time course, triggers, relieving factors, quality, location, an severity, an how dese dimensions alter likelihoods of common an life-threatening diagnoses.
Clarifying onset, tempo, an progressionIdentifying precipitating an relieving factorsDescribing location, radiation, an qualityQuantifying severity an functional limitationDistinguishing acute, subacute, an chronicUsing symptom patterns to narrow diagnosesLesson 5How fi prioritize ten or more high-yield questions fi a single focused visitDis section explain how fi design an prioritize a concise set of high-yield questions tailored to di chief complaint, balancing diagnostic value, safety, an time constraints during a single focused visit in urgent or primary care.
Defining di diagnostic goal of di encounterRanking questions by impact on managementUsing branching logic based on early answersBalancing open an closed questions efficientlyAdapting question sets to specific complaintsTimeboxing history while preserving safetyLesson 6Social determinants affecting diagnosis an follow-up (substance use, support, access to care)Dis section examine how social determinants, including substance use, housing, support networks, an access to care, shape symptom onset, diagnostic options, follow-up reliability, an risk of deterioration in undifferentiated adult patients.
Screening fi alcohol, tobacco, an drug useAssessing housing, food security, an safetyEvaluating caregiver support an social isolationExploring insurance, transport, an clinic accessRecognizing work, legal, an financial stressorsIncorporating social risks into follow-up plansLesson 7Documenting an using patient responses to shape a differential diagnosis quicklyDis section teach how fi document patient responses in structured, concise language an immediately translate dem into problem representations, illness scripts, an prioritized differential diagnoses dat guide testing an initial management.
Transforming narratives into problem statementsHighlighting key discriminating historical featuresRecognizing pattern versus red flag mismatchBuilding an updating a dynamic differential listLinking each diagnosis to supporting dataDocumenting reasoning an diagnostic uncertaintyLesson 8Associated symptoms: cardiopulmonary, neurologic, constitutional, an GI/GU screeningDis section cover systematic screening fi associated cardiopulmonary, neurologic, constitutional, an gastrointestinal or genitourinary symptoms dat refine localization, uncover occult disease, an identify early warning signs.
Cardiopulmonary chest pain an dyspnea reviewNeurologic deficits, headache, an seizure queriesConstitutional symptoms an weight changeGI symptoms including pain, nausea, an bleedingGU symptoms including dysuria an retentionTailoring review of systems to chief complaintLesson 9Red flag questions fi immediate escalation (syncope, severe dyspnea, chest pain, hemorrhage)Dis section define red flag symptoms dat require immediate escalation, such as syncope, severe dyspnea, chest pain, an hemorrhage, an teach precise questions dat rapidly uncover instability an guide urgent action.
Identifying hemodynamic instability symptomsTargeted chest pain an dyspnea red flagsRecognizing neurologic emergency symptomsEliciting hemorrhage an severe anemia signsDetermining sepsis an systemic toxicity cluesEscalation thresholds an handoff essentialsLesson 10Principles of focused history-taking in internal medicineDis section introduce principles of focused history-taking in internal medicine, emphasizing hypothesis-driven questioning, efficient structure, patient-centered communication, an integration wid physical examination an early management.
Structuring di interview around di complaintUsing hypothesis-driven, iterative questioningIntegrating past history wid current symptomsMaintaining rapport while staying efficientCoordinating history wid targeted examinationRecognizing when to broaden di history scope
