Hello! I am Takusei, a 5th-year intern student in Team Wada. I had the great opportunity to learn about medical examination and clinical reasoning from Dr. Nogi, a hospitalist at Queens Medical Center in Hawaii. I am going to share my experience in the blog.

Here is today’s case:

63 years old Man from Chuuk with right side headache.

Dr. Nogi thankfully gave us much practical advice. Let me introduce some of them.

When taking history regarding headaches, we find a systemic way to ask about symptoms in the HEENT section, using anatomy as a queue. Take an ear for example. As this patient also had hearing difficulty, we should ask them about the other symptoms related to the ear as well, such as ear pain, tinnitus, and ear discharge. And it is important to gather as detailed information as possible to understand the condition of the disease, by asking about the frequency, color, exacerbating factors, the time when the symptoms happen, and so on.

Another thing we have to be careful about interviewing a patient is that we should use appropriate terminology and explain accurately. Dr. Nogi taught us a lot of useful phrases for the assessment.

In addition, it is essential to understand the anatomy, because anatomical findings would sometimes be a clue for the disease.

After an interview with the patient portrayed by Dr. Nogi, we discussed semantic qualifiers, and the differential diagnosis of this patient.

I had a great time and learned many things in this lesson. I want to be more accustomed to history taking and clinical reasoning by practicing a lot. Thank you for reading this article. If you are interested in this great lesson, feel free to join us!

We will welcome you at any time! See you next time!