History taking skills for the SCEE

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Past exams papers

Previous topics that have arised in the SCEE include:

History taking and early management

  • Post-op chest pain
    • Post op patient with central chest tightness, left arm radiation, short of breath, smoking history and one previous episode
  • Antepartum haemorrhage
    • 31 week pregnant lady sudden onset painful PV bleed, uterine tightness, baby moving, previous miscarriage
  • Headache
    • Old lady with sudden onset headache, left sided weakness, nausea, resolving over a few hours. Smoking history.
  • Acute abdominal pain
    • Fat female of fifty with sudden onset right abdo pain, vomiting and rigors.

Difficult patients

  • Break bad news to husband of lady dying of cancer:
    • Explain Cheyne-Stoke respiration, "death rattle"
    • "Can she hear me?" - patient drifting in and out of consciousness
  • Talk to young man with ?meningitis who is refusing LP
    • Try to convince him
  • Recovering alcoholic - who doesn't realise 1/2 bottle of vodka a day is too much
    • CAGE him
  • Angry mother whose child has appendicitis (child not present)
    • Once you calm her she will turn against herself!!

Explanation and Planning

  • Prescribing OCP to young lady
    • Smoker?
    • Foreign travel with risk of DVT
  • Newly diagnosed type II diabetic
    • Mum had a stroke
    • Mum on insulin - explain different modes of therapy
    • Wants cure
    • Also concerned about prostate
  • Depressed teacher
    • Explain depression not = crazy
    • Doesn't want pills - options
    • Doesn't want school to know
  • Mum of a kid who is being admitted with respiratory condition
    • Explain condition