The role of the connective and is here considered as a preface to questions in spoken interaction. Using data from informal medical encounters, it is argued that and-prefacing is used to link a question to a preceding question/answer pair or pairs. In such contexts, and-prefacing indicates that the questions it prefaces have a routine or agenda-based character. This in turn can be a resource which invokes and sustains an orientation to an activity or course of action that is implemented through a series of question/answer pairs, but transcends any individual pair. The general characteristics of and-prefaced questions are contrasted with “contingent” or “follow-up” questions, which are not normally and-prefaced. Some strategic uses of and-prefaced questions are described, and the role of the device within the more general sociolinguistic context of the data is discussed. (Connectives, conversation analysis, discourse, institutional interaction, medical encounters, turn design)

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