Lesson 1Rationale for each question group: linking history elements to common causes of dyspnea and urgent red flagsShows how each question group relates to disease processes and usual causes of shortness of breath, cough, and chest pain, and how response patterns flag urgent issues, direct tests, and form initial treatment plans.
Linking symptom patterns to major diagnosesDistinguishing cardiac from primary lung causesUsing risk factors to refine pretest probabilityInterpreting red flags for time-critical illnessHistory cues guiding initial investigationsHistory-driven early management decisionsLesson 2Red flag screening: chest pain, syncope, hemoptysis, severe dyspnea, sudden deterioration, fever patternTeaches spotting danger symptoms like sharp chest pain, fainting, coughing blood, fast-worsening breathlessness, sepsis signs, and risky fever types that need quick action and possible hospital referral.
Characterizing chest pain and pleuritic featuresSyncope, presyncope, and circulatory compromiseAssessing hemoptysis volume and clotting riskSevere or rapidly progressive dyspnea signsFever pattern, rigors, and sepsis indicatorsEscalation thresholds and emergency referralLesson 3Comorbidities and medication review: hypertension, cardiovascular disease, anticoagulants, ACE inhibitors, inhalers, recent antibiotics or steroidsReviews other illnesses and medicines systematically, covering heart disease, diabetes, blood thinners, ACE inhibitors, inhalers, and recent antibiotics or steroids, to spot interactions, side effects, and safety concerns.
Key cardiometabolic and renal comorbiditiesACE inhibitors, beta-blockers, and coughAnticoagulants, antiplatelets, and bleeding riskInhaler types, technique, and adherenceRecent antibiotics, steroids, and resistancePolypharmacy, interactions, and deprescribingLesson 4Techniques for focused questioning in time-limited encounters and documenting answers concisely for handover to supervising physicianGives tips for targeted, patient-friendly questions in short consultations, using open and closed questions, signposting, and summaries, then writing brief, organised notes for safe handover to supervising doctors.
Using open and closed questions effectivelyPrioritizing key respiratory history domainsManaging tangents and maintaining rapportSummarizing and checking patient understandingSBAR and problem-focused note structureDocumenting red flags and safety nettingLesson 5Social and environmental history: smoking history quantification (pack-years), occupational exposures, recent travel, household contactsFocuses on getting smoking details in pack-years, vaping and bhang use, work and home exposures, pets, mould, and recent travel or sick contacts that affect lung risks and diagnosis options.
Calculating smoking history and pack-yearsDocumenting vaping, cannabis, and passive smokeOccupational dust, fume, and chemical exposuresHousehold factors: pets, mold, heating, ventilationRecent travel, TB risk, and endemic infectionsClose contacts with respiratory or febrile illnessLesson 6Functional and baseline status: baseline exercise tolerance, ADLs, recent weight change, prior respiratory function testsLooks at usual exercise ability, daily tasks, sleep, recent weight or appetite shifts, and past lung tests, to measure long-term illness load, reserves, and past treatment responses.
Baseline exercise tolerance and activity levelImpact on ADLs, work, and social participationSleep quality, nocturnal symptoms, and PNDUnintentional weight loss and appetite changePrior spirometry, peak flow, and imagingTracking progression and response to therapyLesson 7Family history and allergy history: atopy, premature cardiovascular disease, venous thromboembolism predispositionExamines family trends in asthma, eczema, hay fever, COPD, early heart disease, plus clotting risks and blood clots, to narrow chances of asthma, lung clots, and other breathlessness causes.
Family history of asthma, COPD, and atopyEczema, allergic rhinitis, and food allergiesPremature cardiovascular disease in relativesFamily venous thromboembolism or thrombophiliaDrug, latex, and contrast media allergiesEnvironmental allergy patterns and seasonalityLesson 8Systematic exploration of presenting symptoms: onset, duration, progression, character of cough, sputum, triggers, positional factors, exertional limitationUses structured questions on lung symptoms like start, length, worsening, cough and phlegm type, triggers, position effects, and effort limits, to separate sudden from ongoing and mild from serious illness.
Clarifying onset, duration, and symptom chronologyCharacterizing cough type, timing, and associated painAssessing sputum volume, color, and hemoptysisIdentifying triggers, irritants, and relieving factorsEvaluating orthopnea, PND, and positional changeGrading exertional dyspnea and activity limitation
