USMLE study report 3

Case FA number 3: a 74 year old male with Right arm pain.

Point 1: Loss of conciousness VS Pass out
Loose = (adj) not fit
Lost = (adj) unable to find
Loss = (N) the state of no longer having
Lose (ลูซซซ) = (V) to be lost
Did you pass out before your fall? = Did you get fainting that cause you fall?
Did you lose conciouse after your fall? = Did you get head injury from your falling?

Point2:
Systemic illness eg. fever, depress
Dose anything make you feel better/worse
Locallized illness eg. pain
Does anything make the pain better/worse

Point 3:
Anychange"in" your weight
not "with" your weight

Point 4: Exploring the details of fall
fall = (N) the acting of falling
fall - fell -fallen (V)
to break my fall = (idium) to protect my body from injury by fall
Doctor: Can you tell me more about the fall
Patient: I tripped over a toy on the ground and fell on my hand to break my fall.
Doctor: What were you doing when you fell.
Patient : I was playing with my grandchildren.
Doctor : Did you see a doctor at that time?
Patient: No
Doctor : Why not?

Point 5: Permission to do physical exam
I would like to feel your right arm, is that OK with you?
patient may refuse because it produce pain
I am going to check your neck
patient should be OK

Point 6: Closing case
Do you have any questions or concerns?
Allright, After we get the test results, I will meet you again.

Point 7: In case of suspected abused but patient don't tell the truth, may offer help like this
Is everything OK at home? ( S)
Do you have any emergency plan if you get accident again? (E)
Any friend or family member can help in that time? (F)
Excuse me, but I need to ask
Anyone in your family use alcohol or other recreational drug? (A)

We have social worker team who can advise you about safty plan.
And if you need emergency help please contact this number.

...There is some issue about refering to a social worker
not promise to patient that social worker will help in payment!