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so we talked about the chief complaint and the HPI and I want to just share with you how I look at the past medical history a little bit different than youve probably been taught in medical school the past medical history is predictive of the president and also of the future so past is prologue you need to know what the past is before you can determine what the persons present is and so for example if someone has a history of lung cancer wed like to know how high of a chance is this lung cancer to be causing whatever theyre here to see me and neuron fourth and so the in order to do that I need to have the stage of the tumor which means I need to know how extend how extensive is the cancer it can either be confined to the lung it can be outside of the lung it can be any widespread metastasis so in a patient who has stage 1 lung carcinoma thats a totally different risk than someone who has stage 4 lung cancer for whatever their complaint is and wed like to know what treatment the p