History Questions

Question 1

Cardiac history symptoms

Answer 1

Chest pain
Dyspnoea
Orthopnoea
Paroxysmal nocturnal dyspnoea
Palpitations
Syncope
Leg swelling

Question 2

Red flags to always ask

Answer 2

Weight loss
Fever
Night sweats

Question 3

Resp history symptoms

Answer 3

Dyspnoea
Cough
Haemoptysis
Wheeze
Chest pain
Leg swelling (both oedema and DVT)

Question 4

Upper GI symptoms

Answer 4

Jaundice
Mouth ulcers
Vomiting
Haematemesis
Heartburn
Dysphagia
Odynophagia
Abdo pain

Question 5

Lower GI symptoms

Answer 5

Abdo pain
Abdo distension
Constipation
Diarrhoea
Steatorrhoea
Melaena
Fresh blood in stool

Question 6

Obstetric symptoms

Answer 6

N&V
Reduced foetal movements
Vaginal bleeding
Abdo pain
Headache/visual disturbance
Oedema
Epigastric pain (pre-eclampsia)
Pruritis
Unilateral leg swelling
Chest pain/dyspnoea
Standard systemic symptoms

Question 7

Obstetric history questions

Answer 7

Gestational age
How many children previously
Asking sensitively about miscarriage and stillbirth
Any health problems in previous pregnancy

Question 8

Gynae symptoms

Answer 8

Abdo and pelvic pain
Post-coital vaginal bleeding
Intermenstrual bleeding
Post-menopausal bleeding
Abnormal vaginal discharge
Dyspareunia
Vulval skin changes/itch

Also do menstrual and obstetric history

Question 9

Menstrual history components

Answer 9

Duration
Frequency
Volume of blood
Painful periods
Last menstrual period
Age first started periods
Ask about menopause if appropriate

Question 10

Hyperthyroid history questions

Answer 10

Recent unintended weight loss
Increased appetite
Diarrhoea
Heat intolerance
Over-activity and restlessness
Tremor
Palpitations
Irritability
Muscle weakness
Loss of libido
Oligomenorrhoea
Visual/eye changes
Changes to fingers or legs

Question 11

Female sexual history symptoms

Answer 11

Same as gynaecological history

Question 12

Male sexual history symptoms

Answer 12

Abdo and pelvic pain
Testicular pain or swelling
Itching or sore skin
Skin lesions
Urethral discharge
Dysuria
Systemic symptoms including joint pain (reactive arthritis), fever, weight loss

Question 13

Questions to ask in sexual history (in order)

Answer 13

When did you last have a sexual encounter?
Was this encounter consensual?
Was this a regular sexual partner or a casual encounter?
What sex was the partner?
Where was the partner from?
What type of sex was involved (ask specifically)?
Was contraception used? Barrier contraception? Any problems with this? Was this for every sexual encounter?
Have you had any other sexual partners in the last 3 months?
HIV risk factors (any partners have an STI or are HIV positive? Ever had sex with bisexual man (or had sex with a man if male)? Sexual partner someone from different country? Sexual partner who has injected drugs? Paid someone for sex or been paid for sex?)

Question 14

Important first rank symptoms to ask about in psychosis history

Answer 14

Hallucinations (esp if the command and if the person obeys)
Thought withdrawal
Thought insertion
Thought broadcasting
Delusions
Ideas of reference
Passivity

Question 15

Depression symptoms

Answer 15

Low mood
Poor sleep
Reduced or increased appetite
Difficulty concentrating
Anhedonia
SUICIDE RISK

Screening:
Ask if periods of really high mood in the past
Auditory hallucinations, delusions

Question 16

Self harm history key points

Answer 16

Before:
Anything cause it?
Planned or impulsive?
Getting affairs in order, writing a note?
Avoid being found?
Drugs or alcohol at the time?

During:
What kind of self harm?
Was patient alone?
Where were they?
Did they intend to end their life?
What did they do straight after?

After:
Did they reach out for help?
How did you feel when you got help?
How do they feel about it now? Regret?
Do they feel suicidal or want to do it again?
What would they do if they went home?
Is there anything they think could help prevent this in the future?
Is there anything they want to live for?
Would they like treatment?

Screen for mental health problems (esp depression e.g. anhedonia, poor appetite, sleep problems, low mood)

Question 17

Medication overdose key questions?

Answer 17

What medication?
Where from?
How much?
Taken with anything else?
What was their intention?
What made them decide? How long had they been thinking of doing it?
What did they do after taking the medication?

Question 18

Cutting key questions?

Answer 18

Where are the cuts?
How deep?
How many?
What did the patient hope the cuts would do?
How did the patient feel while they were cutting?

Question 19

Rheumatology symptoms

Answer 19

Pain
Rashes, skin lesions/thickening, nail changes
Systemic enquiry (Raynauds, sjogrens, other stuff)
Red flags for malignancy
Joint swelling
Night sweats

Question 20

Ophthalmology symptoms

Answer 20

Visual disturbance
Red eye
Discharge/watering
Grittiness
Dryness
Photophobia
Swelling around eye
Pain
Trauma

Question 21

Visual disturbance further questions (lot of these are probably overkill)

Answer 21

One or both eyes?
When did it begin?
Sudden or gradual onset?
Come and go?
Severity?
Anything make it worse or better?
Near or far vision or both?
Flashing lights or floaters
Presence of a black curtain across their field of vision
Glare from the low sun or car headlights
Halos around lights
Specific area?
Visual distortions?

Question 22

Important parts of fatigue history?

Answer 22

Sleep
Mood
Snoring
Weight loss/night sweats
Systemic enquiry

Question 23

Breast lump symptoms

Answer 23

Nipple discharge/bleeding
Nipple inversion
Erythema
Ulceration
Dimpling
Fever and weight loss
Malaise
LYMPHADENOPATHY (always forget this)
?Bone pain

Also ask if still getting periods, menarche, age at menopause, contraceptives

Question 24

Headache symptoms

Answer 24

N&V
Visual disturbance
Photophobia
Neck stiffness
Fever
Rash
Weight loss
Sleep disturbance
Temporal region tenderness/jaw claudication
Motor, sensory or cognitive symptoms
Recent trauma