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Original post by Kinkerz
Don't do that for history presenting.

Start with the presenting complaint. So a sentence or a few sentences on the presenting problem. Then go to history of presenting complaint, where you elaborate on the back story of the presentation. Then go to each heading (past medical, drug, family, social, then systems review). Then it's often worth doing a summary.


Exactly this. But I start with a few patient demographics so something like:

'This is a 35 year old caucasian female who is a student and currently lives with her parents. She presented to A&E with acute abdominal pain' blah blah.

Don't think there's any particular need to do that, but it helps me to sort of set the picture to then start talking about presenting complaint.

To everyone: What are people's opinions on the current mammography debate? Are you for it or against it?

Have to do a presentation to my SpR's journal club, with a critical appraisal of the evidence and whether mammogaphy screening is justifiable or not (its sort of related to my iBSc, I'm doing a review of the potential link between mammography screening and breast cancer to model risk of low dose radiation exposure.). And want to make sure I'm covering most of the points.
(edited 12 years ago)
Original post by Supermassive_muse_fan
Exactly this. But I start with a few patient demographics so something like:

'This is a 35 year old caucasian female who is a student and currently lives with her parents. She presented to A&E with acute abdominal pain' blah blah.

Don't think there's any particular need to do that, but it helps me to sort of set the picture to then start talking about presenting complaint.


Good point. I usually do something similar.
Reply 8862
I tried to tease my brother about his hot chocolate by saying,

"Yeah I'd have a hot chocolate too if I didn't have this Y chromosome."

He said, "Yeah 'Y' chromosome as in, Y aren't U cool enough for hot chocolate?"

Burned. :colonhash:

(edited 12 years ago)
Aw what the ****. Downloads line up is starting to look incredible (Ozzy with BS!) but it's the weekend between my two week block of exams at the end of the year.

I'm going to email my course organiser and see if they can give us any information about if most or all of the exams are in the first week. Considering going regardless and just making sure I do **** loads of work before but getting blasted on the entire weekend will fry my brain >.>
Reply 8864
Original post by Supermassive_muse_fan

To everyone: What are people's opinions on the current mammography debate? Are you for it or against it?

Have to do a presentation to my SpR's journal club, with a critical appraisal of the evidence and whether mammogaphy screening is justifiable or not (its sort of related to my iBSc, I'm doing a review of the potential link between mammography screening and breast cancer to model risk of low dose radiation exposure.). And want to make sure I'm covering most of the points.


There was something about this on the beeb not that long ago - IIRC the tests are very sensitive but not very specific, so there's some concern over the number of healthy people being called for biopsies and I think even the odd mastectomy causing more distress than the relatively low number of detected and treated cancers.

The studies all seemed to disagree though and I think they were generally deemed inconclusive as to how effective the program was. It's problematic that women with dense breasts are more likely to develop breast cancer but these are the hardest to pick up on conventional x-ray mammography. New technology is the way forward (I may be biased though as that's actually what my project is on :colone:)


Original post by RollerBall
Aw what the ****. Downloads line up is starting to look incredible (Ozzy with BS!) but it's the weekend between my two week block of exams at the end of the year.

I'm going to email my course organiser and see if they can give us any information about if most or all of the exams are in the first week. Considering going regardless and just making sure I do **** loads of work before but getting blasted on the entire weekend will fry my brain >.>


Drummer might not go ahead with it (though probably just a bluff).. would be amazing though, the lineup looks immense. Not a fan of new Metallica but would love to hear the black album, plus Megadeth with Dave Ellefson back..! Not to mention BLS, and I caught Kyuss a few months ago and they can definitely still play (new guitarist is no Josh Homme but great all the same).

damnit now I want to go too!
(edited 12 years ago)
Just realised how moist imperial really is today after about 4 months being here.
Some people are so obsessed with getting good grades themselves they want to derail you (whilst being in the same group as you lol).
Reply 8866
Original post by englishman129
Just realised how moist imperial really is today after about 4 months being here.
Some people are so obsessed with getting good grades themselves they want to derail you (whilst being in the same group as you lol).


I'd heard this also, but I must have been lucky not to experience it at all. I have a mix of very bright, hard-working academic friends and some 'just-enough-to-pass' friends (me, basically). We've all had revision sessions, shared notes/books and given each other mini-tutorials on difficult topics.

I'm sure these people are out there, just haven't really had much exposure to them in my experience.
Original post by englishman129

Original post by englishman129
Just realised how moist imperial really is today after about 4 months being here.
Some people are so obsessed with getting good grades themselves they want to derail you (whilst being in the same group as you lol).


Same here at Brum.
Original post by englishman129
Just realised how moist imperial really is today after about 4 months being here.
Some people are so obsessed with getting good grades themselves they want to derail you (whilst being in the same group as you lol).


That's sad :frown: Obviously everyone wants to do well, but surely it's not good for them or for others to want other people to do badly? Personally I think it's way more important (especially in first year) to get a work-life balance and get "good" grades than to get top top marks at the expense of developing relationships with people.
Am I just being naïve? XD
Original post by GodspeedGehenna
How do you guys present clinical histories? I've been told that it should be broken into significant positive and negative findings. I was under the impression that this format is only for examinations and I'm not quite sure how it would be applied to history taking (risk factors, maybe?)

Any tips?


The comments below are all really good ways of doing it. I like to adopt a similar format to how you describe presenting an examination in that I'll do something like:

1) Clear opening sentence with all of the patient's presenting complaints, e.g. "Mr XY is a 65yr gentleman presenting with a 2hr history of chest pain radiating to the neck and left arm, which is present at rest".

2) Describe the pain in further detail (or SOB or whichever presenting complaint you have), e.g. "The pain came on suddenly while he was out walking with his wife. It is a central, crushing pain and radiates to his neck and left arm. He scores it as a 9/10 in severity and feels nauseous with the pain. He is sweating profusely and is highly anxious. Rest does not relieve the pain".

3) Mention positive findings in the history, e.g. "He has 30 pack-years, previous medical Hx angina & COPD, previous surgical Hx CABG 5 years ago for a similar presentation, and takes antihypertensive medication (which currently controls his HTN well). Prior to this episode, he would experience angina-like pain after walking ~100 yards".

4) Mention negative findings too (paraneoplastics/DDx), e.g. "He does not describe recent weight loss. There is no history of travel or hot, painful calf swelling. He doesn't have a fever, there is no history of trauma and he hasn't had a stroke/TIA in the past. He only drinks on social occasions and there is no family history suggestive of coronary artery disease".

5) Conclude & summarise, e.g. "To summarise, Mr XY is a 65yr old gentleman with a 2hr Hx of crushing central chest pain at rest. My primary differential at this stage is a myocardial infarction, therefore I would like to examine his cardiovascular system" (or if youve examined already, say "on examination, my findings were...XYZ)

So yeah...as long as you've got a system that works for you, go with it :smile: Sorry if that was a waffle!
Original post by RollerBall
Aw what the ****. Downloads line up is starting to look incredible (Ozzy with BS!) but it's the weekend between my two week block of exams at the end of the year.

I'm going to email my course organiser and see if they can give us any information about if most or all of the exams are in the first week. Considering going regardless and just making sure I do **** loads of work before but getting blasted on the entire weekend will fry my brain >.>


Totally buying my tickets this month. Looks amazing.
Original post by englishman129
Just realised how moist imperial really is today after about 4 months being here.
Some people are so obsessed with getting good grades themselves they want to derail you (whilst being in the same group as you lol).


I think it's the same everywhere sadly.

On a side note- does anyone ever think about how lucky we are to actually be alive? This sounds so weird but learning about all this stuff just makes me think I could drop dead any minute.
Original post by billet-doux
On a side note- does anyone ever think about how lucky we are to actually be alive? This sounds so weird but learning about all this stuff just makes me think I could drop dead any minute.


Wait til you get to clinics and start playing "would you rather have x or y?" with your firm.
Original post by billet-doux
On a side note- does anyone ever think about how lucky we are to actually be alive? This sounds so weird but learning about all this stuff just makes me think I could drop dead any minute.

To have even been born in the first place is just ludicrously fortunate.
Original post by billet-doux
I think it's the same everywhere sadly.

On a side note- does anyone ever think about how lucky we are to actually be alive? This sounds so weird but learning about all this stuff just makes me think I could drop dead any minute.


Totally agree! So many things can go wrong, it's a miracle so many people are relatively healthy :dong:
And that's only after 1 semester..
Here begins the medical student syndrome :wink:
Original post by Mushi_master
Here begins the medical student syndrome :wink:


Amuses me that i manage to take this statement to a whole new level.
Reply 8877
Original post by englishman129
Just realised how moist imperial really is today after about 4 months being here.
Some people are so obsessed with getting good grades themselves they want to derail you (whilst being in the same group as you lol).


Harsh!

Before I started medicine I heard stories about this, and people sending each other wrong revision notes to try and throw each other off, generally being really unhelpful, lying about work, keeping past papers to themselves..

Turns out Glasgow has managed to avoid these ****ers.

People help each other.
Reply 8878
Original post by Kinkerz
To have even been born in the first place is just ludicrously fortunate.


:ditto:

Me being alive I can handle... but the possibility of procreating seems mind boggling! :tongue:
Original post by fairy spangles
Amuses me that i manage to take this statement to a whole new level.


Someone's got to :wink:

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