Lesson 1Rationale for each question group: linking history elements to common causes of dyspnea and urgent red flagsDetails how each question group relates to underlying disease processes and frequent triggers of shortness of breath, cough, and chest discomfort, showing how response patterns signal critical warnings, direct tests, and inform early treatment strategies.
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 patternInstructs on identifying critical symptoms like sharp or effort-related chest pain, fainting, coughing blood, quickly worsening breathlessness, infection signs, and dangerous fever trends that demand prompt action and possible urgent referral.
Characterising 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 steroidsExamines thorough check of existing conditions and drugs, covering heart issues, diabetes, blood thinners, ACE inhibitors, puffers, and latest 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 physicianOffers methods for targeted, patient-focused queries in short consultations, employing open and closed questions, signposting, and recaps, followed by brief, organised notes for secure transfer to supervising doctors.
Using open and closed questions effectivelyPrioritising key respiratory history domainsManaging tangents and maintaining rapportSummarising 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 contactsEmphasises gathering details on smoking in pack-years, e-cigarette and cannabis habits, work and surroundings irritants, pets, dampness, and latest trips or infection exposures that alter lung risks and shape diagnosis options.
Calculating smoking history and pack-yearsDocumenting vaping, cannabis, and passive smokeOccupational dust, fume, and chemical exposuresHousehold factors: pets, mould, 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 testsDeals with evaluating usual activity levels, daily tasks, rest, latest weight or hunger shifts, and past lung function or scans, to measure ongoing illness load, capacity, and past treatment effects.
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 predispositionInvestigates inherited patterns of asthma, skin allergies, hay fever, chronic lung disease, and early heart problems, along with clotting risks and blood clot history, to adjust chances of asthma, lung clots, and other breath-related issues.
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 limitationHandles organised probing of lung symptoms, covering start, length, worsening, cough and phlegm traits, causes, position effects, and effort limits, to separate sudden from long-term and mild from severe conditions.
Clarifying onset, duration, and symptom chronologyCharacterising cough type, timing, and associated painAssessing sputum volume, colour, and hemoptysisIdentifying triggers, irritants, and relieving factorsEvaluating orthopnea, PND, and positional changeGrading exertional dyspnea and activity limitation
