Histories Flashcards
Allergies
what and the reaction
SHx
living situation
occupation
smoking (pack yrs) and alcohol (glass wine 2, beer 2, bottle wine 10)
travelling
ICE
what do you think is going on?
what are you worried it could be/about?
was there anything else you wanted to address today?
expectations from todays consultation
any qs for me
pain
Site
Onset
Character
Radiates
Associated symptoms
Timing
Exacerbating/relieving factors
Severity
general systems review
fever, rigors, night sweats, weight loss, fatigue, skin rashes/bruising
Neuro review
fits, falls, LOC, headaches, dizziness, vision/hearing, memory loss, neck stiffness, photophobia
weakness/wasting, incontinence
pain, numbness, tingling
ENT review
hearing loss, tinnitus, otalgia
rhinorrhea, epistaxis
sore throat, odynophagia
Cardio resp review
chest pain, palpitations, sob/wheeze, cough, sputum, haemoptysis, leg swelling
GI review
weight loss, appetite changes
dysphagia, nausea, vomiting, indigestion, heart burn, abdo pain, bowel habit, tenesmus, blood, mucus, flatus
Uro review
frequency, volume, urgency, nocturia, incontinence
dysuria, haematuria, odor
hesitancy, poor flow, dribbling, incomplete emptying feeling
Rheum review
pain, stiffness, swelling
skin (rashes, ulcers, raynauds), hair loss, eyes (redness/dryness), mouth (dryness), chest (breathlessness, SOB), GI (IBD symptoms), genitourinary (discharge)
Ortho Review
pain, swelling, stiffness, movement - restriction, ability to weight-bear
locking, giving way
weakness, numbness
