Hi guys! Welcome back to this blog about medical interview lessons with Ns. Rossi. I am Yuka,
a student intern of Team WADA and managing this program. I played a role as a doctor this
time, so I’d like to introduce what I learned for you.
The setting was:
・49 years old male with possible aponia
・His wife noticed he sometimes stops breathing during his sleep, but he in not aware of it.
・He is a marathon runner.
・He has had some episodes of bradycardia of around 40-50 bpm.
・He frequently feels very tired and is often very sleepy during the day.
The task was:
Give him examination and treatment plan.
I questioned like these:
・(Asked his wife) When did you notice he stops his breathing?
→ A few months ago.
・When do you feel tired?
→ Every morning.
・Have you had any medical problems in the past?
→ I have asthma and take inhaler for it.
The patient also claimed that he lost his weight but had no stress from work. He drank 1 glass
of wine almost every day.
As I prepared, I had no idea about differential diagnoses for aponia and supposed
hypothyroidism and depression. I suggested ECG, blood test and medication to add thyroid
Since I started learning medicine, I haven’t had a chance to study about aponia. In this case,
it was necessary to consider the possibility of brain tumor and adenoid hypertrophy and then
recommend to take brain CT scan. When it comes to suggesting brain CT scan, patients tend
to be scared of it, so it is better to explain why and say “How about taking CT scan?” instead
of “You need CT scan.”

Ns. Rossi also advised me that when I ask a patient about drinking history, I should ask how
big the glass is. The amount of alcohol is completely different from the size of glasses.
She also explained about sleep studies, indicating there is a machine to assess sleep, but most
patients cannot sleep in hospital and feel uncomfortable to be connected to the machine, so
getting accurate data is pretty difficult.
In this lesson, you can not only receive feedbacks from Ns. Rossi and other participants but
also get further information related to a scenario, so if you are interested in this lesson, hit up
Team WADA any time! Ns. Rossi and members all welcome your joining. Have a nice
weekend and stay tuned for the next blog. Bye!