Lesson 1History of present illness: chronological construction, onset, duration, exertional pattern, triggers, progressionExplains how to build de history of present illness for exertional dyspnea, stressing onset, duration, exertional pattern, triggers, progression, and past checks, to make a clear, time-linked sign story.
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 diseaseDetails how to check family history wey matter for exertional dyspnea, focusing on heart muscle problems, irregular heartbeats, blood clot disease, and inherited lung issues, with wording dat improves trust and shows hidden family risk patterns.
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 exposuresDescribes how to check relieving and worsening factors for exertional dyspnea, including body position, medicines, exertion level, and environment exposures, and how dese patterns help separate heart, lung, and body function 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 how to ask about medicines, allergies, and vaccinations in patients wey get exertional dyspnea, using exact wording to better recall, spot interactions, and find preventable breathing or heart problems.
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 levelProvides scripts for social history focused on exertional dyspnea, covering smoking with pack-year count, job, environment exposures, alcohol, fun drugs, and physical activity level, stressing risk grouping and shame-free wording.
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 de overall structure and goals of anamnesis in exertional dyspnea, including patient ID, main complaint wording, and clear, proper informed consent phrasing dat builds trust and sets a focused, quick interview.
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, palpitationsFocuses on systematically getting key linked symptoms dat come with exertional dyspnea, like orthopnea, sudden night shortness of breath, chest pain, cough, wheeze, coughing blood, fainting, and heart flutters, with wording dat sharpens diagnosis meaning.
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 conditionsCovers targeted past medical history for dyspnea, highlighting heart and blood vessel, lung, kidney, thyroid, blood, body process, and mind conditions, and how each changes pre-test chance, outlook, and treatment safety in exertion 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 cluesExplains how to do a targeted review of systems using standard, patient-friendly wording for breathing, heart, body-wide (fevers, weight loss), and mind symptoms, aiming to find missed clues, extra conditions, and warning signs dat sharpen de differential.
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 promptsPresents exact opening prompts and main complaint questions made for exertional dyspnea, balancing open and closed styles, cutting suggestion, and setting a team tone dat encourages true, detailed 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
