Lesson 1Social and behavioural history: smoking, alcohol, job, home setup, exercise, salt eatingLearn to get a sharp social and lifestyle history, covering smoking, booze, work hazards, home conditions, eating habits, exercise levels, and salt use, and how these boost heart and lung risks in Kenyan communities.
Smoking history, pack‑years, and cessation stageAlcohol intake, screening, and counselingOccupation, dust, and chemical exposuresHome environment, heating, and dampnessPhysical activity, exercise, and limitationsDietary patterns, salt intake, and weightLesson 2Danger signs and urgent symptoms: fainting, chest pain, coughing blood, sudden breath trouble, low blood pressureSpot and dig into danger symptoms like fainting, sharp chest pain, coughing blood, sudden breathlessness, and low pressure, stressing timing, linked signs, and knowing when to rush for emergency help.
Characterizing acute chest pain and onsetAssessing syncope, presyncope, and collapseEvaluating hemoptysis volume and triggersSudden dyspnea and suspected pulmonary embolismRecognizing shock, hypotension, and poor perfusionEscalation thresholds and emergency referralLesson 3Talking skills and note-taking: open questions, sharp follow-ups, safety advice, and logging key times and answersBuild trust, use open and pointed questions, uncover worries, recap, give safety nets, and record symptoms, times, and replies clearly for legal clinic notes in Kenyan practice.
Structuring the cardiopulmonary interviewUsing open questions to elicit the narrativeFocused clarifying questions for key symptomsChecking understanding and shared agenda settingSafety netting, red flag advice, and follow‑upAccurate, time‑stamped clinical documentationLesson 4Past health checks: high blood pressure, heart vessel disease, valve problems, rheumatic fever, COPD, sleep apnoea, anaemia, kidney diseaseTarget questions on heart and lung past issues like high pressure, blocked heart vessels, valve faults, rheumatic fever, COPD, sleep stops, anaemia, and kidney trouble, shaping risks and likely causes.
Clarifying prior cardiac diagnoses and interventionsDocumenting hypertension duration and controlHistory of rheumatic fever and valvular sequelaeChronic lung disease, COPD, and asthma detailsSleep apnea, obesity hypoventilation, and CPAP useRenal disease, anemia, and cardiorenal interactionsLesson 5Body-specific symptom checks: cough, wheeze, chest pain, heart flutters, swelling patterns, urine changesScreen for lung, heart, and kidney signs like cough, wheeze, chest ache, flutters, swelling sites, urine shifts, and general clues to narrow down causes in primary care.
Respiratory review: cough, sputum, and wheezeCardiac review: chest pain and palpitationsPeripheral edema pattern and distributionNocturia, oliguria, and renal congestion signsSystemic symptoms: fever, weight loss, fatigueLinking system findings to differential diagnosisLesson 6Focused symptom story: breathlessness start, worsening, lying-flat trouble, night breath attacks, effort limitsMaster digging into breathlessness, lying-flat issues, night attacks, effort capacity, cough, and linked signs, focusing on start, build-up, triggers, and daily life effects.
Onset and progression of dyspnea timelineOrthopnea and paroxysmal nocturnal dyspneaExertional tolerance and activity limitationCough, sputum, and wheeze characterizationChest tightness, pain, and palpitationsImpact on sleep, work, and daily functioningLesson 7Family history and risks: early heart disease, heart muscle weaknesses, clotting disordersDraw out family early heart disease, muscle issues, rhythm faults, clotting risks, sudden deaths, and blend family genes with shared living risks for better risk sorting.
Premature coronary artery disease in relativesInherited cardiomyopathies and channelopathiesFamily history of venous thromboembolismSudden unexplained death and arrhythmiasShared lifestyle and environmental factorsWhen to consider genetic counseling referralLesson 8Medicine check and sticking to it: prescribed, over-counter, herbal, sticking hurdles, recent shiftsSystematically review medicines, covering scripts, shop-bought, herbs, new changes, sticking barriers, side effects, and clashes tied to heart-lung worsening in local settings.
Listing all prescription and OTC medicationsIdentifying cardioactive and respiratory drugsRecent medication changes and decompensationAssessing adherence, beliefs, and routinesDetecting adverse effects and drug interactionsInhaler technique and device‑related issues
