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Should we counsel during the history when they let us know that they smoke or have multiple sexual partners or should we wait until summarizing or during closure?

Also, should we summarize the history with the closure or should we summarize before the physical exam?

You normally counsel when you are done and are summarizing the case. You already have some differentials, and while you are telling the patient what you think it might be, you should then counsel on the advantages of stopping smoking.

There is an excellent free video about chest examination that could be useful to you. Good luck
http://www.physicalexamvideo.com/ChestEx...Front.html