Breaking Down PA School Interview Questions: Special Edition

I came across a post recently in a Facebook pre-pa group that some interviews are asking students basically to complete a HPI (History of Present Illness).  Now, if you did your patient care experience in mental health (because thats where you had a degree) you might find yourself fumbling.  So, if you run in to a situation that asks you to “talk to a patient about what is going on with them and give a diagnosis” I’ve got your basics covered!

What is an HPI?

  • History of Present Illness
    • Why is the patient coming in to see you and the story that goes along with it! 
  • Start with a “chief complaint”
    • This is usually something obvious such as abdominal pain, chest pain, fever, rash, red eye, sore throat, cough, etc
  • There are 7 vital aspects of the “HPI”
    • Onset
      • When did it start
    • Duration
      • How long has this been going on?
    • Location/Radiation
      • Where is the location of the symptom
      • For complaints like abdominal or chest pain ask the patient (especially if child) to point with one finger where it is the worst
      • Does the pain/symptom travel somewhere else besdies where it starts?
    • Quality
      • Describe what is going on
      • Is the pain sharp, dull, throbbing
      • When they have difficulty swallowing is it solids, liquids, etc
    • Quantity
      • The good old “on a scale of 1 to 10…10 being the worst and 1 being very little”
    • Aggravating/Alleviating
      • What makes symptoms worse
      • What makes symptoms better
    • Associated Manifestations
      • Depends on the chief complaint
      • Abdominal pain: diarrhea, constipation, fever, chills
      • Chest pain: diaphoresis, lightheadedness, palpitations, shortness of breath
      • Fever: Rash, cough, urinary symptoms (dysuria, frequency), recent travel, UTD on immunizaitons
      • Cough: is it productive or dry, short of breath, fever, chest pain

 

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