Lesson 1History of present illness: chronological construction, onset, duration, exertional pattern, triggers, progressionThis lesson covers building the story of the current illness for shortness of breath during activity, stressing the start, how long it lasts, patterns with effort, what sets it off, how it worsens, and past checks, creating a clear timeline of signs.
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 on cardiopulmonary, thromboembolic, and hereditary lung diseaseIt explains how to ask about family medical background related to breathlessness on effort, targeting heart muscle issues, irregular heartbeats, blood clot problems, and inherited lung conditions, with questions that boost trustworthy answers and uncover hidden family risks.
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 3Relieving and aggravating factors: posture, medications, exertion, environmental exposuresThis part describes inquiring about what eases or worsens breathlessness during activity, covering body position, medicines, level of effort, and surroundings like dust or smoke, and how these help tell apart heart, lung, or body-wide causes.
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, and vaccination questions with phrasing for accuracyDetails ways to ask about current medicines, allergies, and vaccines in those with effort-related breathlessness, employing exact wording to aid memory, spot drug clashes, and find avoidable lung or heart issues.
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 questioning scripts: smoking (pack-years), occupation, environmental exposures, alcohol, recreational drugs, physical activity levelOffers ready scripts for social background questions on breathlessness with effort, including smoking measured in pack-years, job type, workplace hazards, alcohol use, street drugs, and daily movement, focusing on risk levels and non-judgmental language.
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 and goals of anamnesis: identification, chief complaint, informed consent phrasingIntroduces the layout and aims of taking a medical history for effort-related breathlessness, covering patient details, main problem statement, and straightforward consent talk that fosters trust and keeps the chat focused and quick.
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 for associated symptoms: orthopnea, paroxysmal nocturnal dyspnea, chest pain, cough, wheeze, hemoptysis, syncope, palpitationsCenters on methodically drawing out linked symptoms with effort-related breathlessness, like trouble breathing when lying flat, sudden night shortness of breath, chest discomfort, coughing, whistling breath, coughing blood, fainting, and heart flutters, using words that pinpoint diagnosis.
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 probing: cardiovascular, pulmonary, renal, thyroid, hematologic, metabolic, and psychiatric conditionsExamines key past health issues for breathlessness, spotlighting heart and blood vessel, lung, kidney, hormone, blood, body process, and mental health problems, and their impact on initial odds, outlook, and treatment safety for activity 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 of systems: standardized phrasing for respiratory, cardiac, systemic (fevers, weight loss), and psychiatric symptoms to detect differential cluesShows how to do a focused check of body systems with standard, easy-to-understand questions for breathing, heart, general body (like fevers or losing weight), and mind symptoms, to spot missed hints, extra conditions, and warning signs that sharpen cause lists.
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 for chief complaint and opening promptsGives precise starting questions and main problem prompts suited to breathlessness on effort, mixing open and yes/no styles, avoiding hints, and creating a teamwork vibe that draws out true, full symptom stories.
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
