When to mention key hx related to pmhx, sexual hx etc. - USMLE Forums
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Old 09-09-2015
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Default When to mention key hx related to pmhx, sexual hx etc.

Hello everyone, I have a question which might seem a little futile but the answer will dramatically aid in my preparation.

When should key points of past medical hx be asked. For example, a patient with dyparehunia: Should we ask about PID and endometriosis when covering the past hx or as part of the HPI as it is a key point. Also, libido and lubrication: Should that be asked as a part of sexual hx or also right after covering the main complaint in HPI.

This applies to pretty much every case in regards to "key hx" points. Would greatly appreciate your feedback.

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Old 09-16-2015
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Hi there,

It depends. In case of your example, PID, premature menopause, and lack of desire are among Ddx. So you may ask them directly in the HPI. If you follow SIQORAAA, all of these may be cover under the associated symptoms. Actually you would like to narrow your Ddx with the firs couple of questions. Then ask key questions about PID, endometriosis, and vaginal dryness very early after you asked for description of dyspareunia. I hope this will be helpful.

Good luck,
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