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Thread: History Of The Most Common Symptoms

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    Thumbs up History Of The Most Common Symptoms

    HISTORY OF THE MOST COMMON SYMPTOMS

    1- PAIN
    2- CHEST PAIN
    3- ARM PAIN
    4- FEVER
    5- DYSPNOEA
    6- JAUNDICE
    7- HEADACHE
    8- VOMITING
    9- CONSTIPATION
    10- DIARRHOEA
    11- COUGH
    12- HAEMATEMESIS
    13- MELAENA
    14- RECTAL BLEEDING
    15- HAEMOPTYSIS
    16- HAEMATURIA
    17- CYANOSIS
    18- DYSPHAGIA
    19- WEIGHT GAIN
    20- WEIGHT LOSS



    PAIN

    1- Onset (sudden. Gradual)
    2- Duration
    3- Character (intermittent. Continuous)
    4- Site
    5- Radiation
    6- Nature (stabbing, heaviness, crushing, throbbing, numbness, spasmodic)
    7-progression
    8- Aggravating, relieving factors
    9- Severity
    10- Associated symptoms
    11- Previous attack and what pt did




    CHEST PAIN

    1- character: tight +crushing  MI
    Tearing  aortic aneurysm
    Pleuritic  pericarditis or pulmonary origin
    Burning  esophageal reflux
    Deep +gnawing  peptic acid – related pain
    2- Location (retrosternal)
    3- Radiate (jaw, left arm, shoulder, back)
    4- Precipitating factors: efforts, emotion, food, cold weather, change in posture (bending, lying)
    5- Relieving factors: glycerytrinitrate GTN , antiacid, sitting forwards
    6-trauma Hx




    ARM PAIN

    1- Onset (sudden, gradual)
    2- Stiffness in the neck
    3- Hx of trauma
    4- Hx of cardiac problems
    5- Swollen limb?
    6- Cyanotic limb?
    7- Relieving by rest, aggravate by exercise
    8- There is pain or paraesthesia at thumb, index and middle finger?
    9- Hx of: DM
    Drugs (phenytoin, vincristine)
    Renal or liver failure
    Alcohol abuse




    FEVER

    1. onset (sudden, gradual)
    2. duration
    3. nature (continuous, intermittent)
    4. progression
    5. aggravating, relieving factors
    6. grade (high, low)
    7. documented or not
    8. frequency
    9. interfering with normal activity
    10. associated symptoms
    11. Hx of contact e animal
    12. Hx of raw milk ingestion
    13. family Hx of fever at same time
    14. recent blood transfusion
    15. family Hx or contact with TB
    16. recent vaccination
    17. recent traveling





    DYSPNEA = uncomfortable awareness of breathing

    1. onset (sudden, gradual)
    2. duration
    3. continuous or intermittent
    4. frequency, long of each attack
    5. precipitating factors (trauma, aspiration of foreign body, severe allergy, stressful event)
    6. aggravating factors
    7. relieving factors (sitting position, beta agonist)
    8. progression
    9. associated symptoms (productive cough (green, yellow sputum or blood), wheezing)
    10. grade (I-II-III-IV)
    11. interfere with normal activity
    12. Hx of contact e animal
    13. Hx of contact e TB pt
    14. Hx of smoking
    15. Hx of URTI









    JAUNDICE = yellow discoloration of the skin. Sclera due to accumulation of bilirubin more than 35µmol/L

    1- Age
    2- Occupation
    3- Duration
    4- Onset (sudden, gradual)
    5- Character (continuous, fluctuation)
    6- Depth of the color (lemon, orange, brown)
    7- Who noticed it? How?
    Change in color of urine/ stool 8-
    9-associated symptoms (fever, malaise, weight loss, itching, Haematuria, joint pain, severe abdominal pain)
    10- Family Hx
    11- Previous episodes of jaundice
    12- Hx of (biliary surgery, blood transfusion, anesthesia, alcohol, traveling, contact with patient had jaundice)
    13- Sexual activity
    14- Hx of drugs, exposure to industrial solvents
    15- flu- like symptoms? Rashes?





    HEADACHE

    1. duration (acute, chronic)
    2. onset (sudden, gradual)
    3. time
    4. preceded by aura with migraine
    5. nature (throbbing, bursting, tight band like)
    6. Character (continuous. Intermittent)
    7. Frequency, long of each attack. Period between the attacks
    8. site and radiation
    9. aggravating factors (change in posture, coughing, sneezing, certain food, touch, drugs, substance withdrawal)
    10. relieving factors
    11. associated symptoms (neck stiffness, visual disturbances, flashing lights, photophobia, drowsiness, vomiting, ataxia, proximal muscle weakness, nausea, transient neurological deficits, lacrimation)
    12. severity
    13. course
    14. Hx of (drugs, traveling, head trauma)




    VOMITING = forceful ejection of gastric contents through the mouth

    1. duration (acute, chronic)
    2. character (projectile or not)
    3. frequency, period between each attack
    4. nature (bright- red blood, coffee ground, bile, recently eaten food, several days old food)
    5. spontaneous or self- induced vomiting
    6. time (at morning, after meal)
    7. amount
    8. Relief of pain by vomiting?
    9. aggravating, relieving factors
    10. associated symptoms (drowsiness, fits, nausea, vertigo, hearing defect, tinnitus, migraine, photophobia, headache, motion sickness, chest pain)
    11. Hx of (traveling, alcohol, same problem at same time in the family)
    12. Hx of chemotherapy or radiotherapy
    13. Hx of acute infection at children
    14. Hx of GIT problem
    15. Hx of drugs (aspirin, emetics)
    16. Hx of trauma





    CONSTIPATION

    1. onset (sudden, gradual)
    2. any abdominal pain
    3. pain on defecation
    4. bloating
    5. weight loss
    6. past Hx of haemorrhoids
    7. past Hx of abdominal surgeries
    8. Hx of spinal fracture? Prolonged bed rest?
    9. Hx of DM?
    10. Intolerance of cold? (myxoedema)
    11. Vomiting?
    12. Constipation, diarrhea alternating? (irritable bowel syndrome)
    13. Changes in sleeping pattern? (depression)
    14. drug Hx (laxative)










    DIARRHOEA = increased frequency of abnormally loose motion for a particular patient

    1. duration
    2. onset (sudden, gradual)
    3. frequency
    4. consistency, amount, odor, color
    5. present of blood or pus or mucus (fatty, float)
    6. associated symptoms (vomiting, fever, abdominal pain, back pain, distention, weakness, weight loss)
    7. aggravating, relieving factors
    8. preceding symptoms
    9. relation to specific food
    10. Hx of outside food intake , recent change in diet?
    11. Hx of foreign travel
    12. Hx of gastric or pancreatic surgeries? Or resection of the bowel?
    13. Hx of cystic fibrosis? Thyroid diseases (pt. prefer cold weather, sweating)?
    14. Abdominal radiotherapy?
    15. Hx of drugs (recent antibiotic, laxative abuse, Mg- containing antacids)
    16. Hx of same problem in family






    COUGH

    1- Duration (acute, chronic)
    2- Onset (sudden, gradual)
    3-nature (dray, productive)
    If productive: amount, color, smell, blood or pus contain, with each attack of cough or not)
    4- Aggravating, relieving factors
    5- Time (night, day, worse at night?)
    6- Pattern (continuous, intermittent)
    7- Progression
    8- Associated symptoms (wheezing? SOB? Weight loss? Chest pain?)
    9- Past Hx of TB, or contact e TB
    10- Hx of drugs
    11- Hx of alcohol, smoking
    12- Hx of allergy with rhinitis.








    HAEMATEMESIS = vomiting of blood

    1- Duration (acute, chronic)
    2- Amount of the blood
    3- Color, content
    4- Frequency
    5- Period between each attack
    6- Associated symptoms
    Dyspnea, nausea, malaise, peripheral oedema, coma, lethargy, vomiting, weight loss
    7- Recent Hx of epistaxis or haemoptysis? (swallowed blood)e
    8- Hx of excess alcohol consumption?
    9- Hx of liver diseases? (Oesophageal varices)
    10- Retrosternal burning pain? (Oesphagitis) epigastric pain? (Peptic ulcer)
    11- Hx of dysphagia?
    12- Hx of steroids or NSAID medications, or anticoagulants?
    13- Hx of bleeding disorders? Spontaneous bruising or bleeding from other orifices?
    14- Precede by sever normal vomiting
    15- Hx of ( blood transfusion, endoscope, smoking, burn, head injury)
    16- Previous attack
    17- Dietary Hx





    MELAENA = passage of altered blood PR (black + tarry stool)

    Same Q as haematemesis





    RECTAL BLEEDING

    1- Haemorrhoids? Rectal prolapse (something hanging out)?
    2- Painful defecation? Tenesmus?
    3- Hx of penetrating injury to anal canal?
    4- Sexual abuse? Homosexual practice?
    5- Character of blood (dark or bright red? Mixed with stool or streaked on stool? Associated with mucus? Acute massive or repeated small amount?
    6- Change in bowel habit ( constipation, diarrhea)
    7- Abdominal pain?
    8- Hx of bleeding disorders? Anticoagulant drugs? Bleeding from other sites? Spontaneous bruising?
    9- Hx of heart diseases?
    10- Hx of irradiation?



    HAEMOPTYSIS = coughing up bloodstained sputum


    1- Onset (sudden, chronic)
    2- Amount?
    3- Associated symptoms: Dyspnea (chronic, acute), Pleuritic chest pain, weight loss, night sweat
    4- Other sites of bleeding
    5- Hx of heavy smoking
    6- Past medical Hx (generalized coagulation disorder, rheumatic fever)
    7- past drug Hx
    8- Coexisting renal disease.




    HAEMATURIA


    1. Dysuria? Frequency?
    2. Total or initial or terminal Haematuria?
    3. Any pain at lion, abdomen, suprapubic?
    4. Difficulty in starting? Poor stream? Nocturia?
    5. Hx of TB? SCA? Exposure to malaria?
    6. Pelvic fracture?
    7. Any recent foreign travel?
    8. Any recent renal biopsy?
    9. family Hx of polycystic kidney disease
    10. Pt. on anticoagulant?
    11. Hx of blood dyscrasia?




    CYANOSIS = blue discoloration of the skin

    1. onset (since birth, acute, chronic)
    2. Chest pain?
    3. Dyspnea
    4. any coexisting respiratory disease
    5. Hx of drugs (phenacetin, sulphonamides, beta blocker)
    6. acrocyanosis (hand blue and cold)
    7. raynaud's phenomenon (white- blue- red)
    8. Hx of trauma
    9. Any pain? Mottling of the skin?





    DYSPHAGIA = difficulty in swallowing


    1- congenital: dripping of saliva, inability to swallow feeds, production of frothy mucus, choking attacks, cyanotic attacks, chest infection
    2- onset (sudden, chronic)
    3- Hx of ingestion of foreign body (false teeth, coin)
    4- Hx of retrosternal burning pain + acid reflex + worse in bending down?
    5- Fluid regurgitation at night?
    6- Weight loss? Anorexia? Symptoms of anaemia?
    7- Food sticking?
    8- Hx of radiotherapy to chest?
    9- Changes in skin (around lips, fingers)
    10- Past Hx of Raynaud's phenomenon
    11- Neck swelling, enlarged swellings in other sites
    12- Reguratiation of food + cough on lying down
    13- Past Hx of mitral stenosis
    14- Hiccups?








    WEIGHT GAIN


    1- Pregnancy
    2- Change in dietary habits?
    3- Rapid or slow gain?
    4- Drug Hx (anabolic steroids, G.H., exogenous corticosteroids)
    5- Associated symptoms: hair growth, acne, pigmented skin, thin skin, bruising, , back pain, abdominal striae, muscle weakness, menstrual irregularity, ammenorrhoea, lethargy, anorexia, goiter, cold intolerance, dry hair, dry skin, constipation, PND, orthopnoea, Ascites, peripheral oedema, periorbital oedema, thirst, polyuria
    6- Hx of neurosurgery





    WEIGHT LOSS


    1- Period? Amount of weight?
    2- Dietary Hx?
    3- Appetite change (increase, decrease)
    4- Perception of body image
    5- Sexual Hx , IV drug (if HIV suspected)
    6- Smoking Hx
    7- Associated symptoms: dyspnoea, orthopnoea, PND, peripheral oedema, haemoptysis, night sweats, lethargy, diarrhea, steatorrhoea, abdominal discomfort, jaundice, dark urine, pale stool, itching, prolonged bleeding, abdominal swelling, confusion, change in bowel habit, tenesmus, blood or mucus mixed with the stool, perianal itching, noticed worms in stool, anorexia, nocturia, oliguria, polyuria, haematuria, frothy rine, skin fragility, pruritus, oedema, bone pains, localized non- tender lymphadenopathy, pyrexia, polydipsia, tremor, staring eyes, heat intolerance, palpitations, malaise, vomiting.
    Thank you GOD

  2. #2
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    Short and sweet.
    Nice share.

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    very useful

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    thanks nice n simple

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    Nice .!!
    Cheerz.....

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    Default Thanks..!~!~

    Thank u so much for compiling all the necessary informations...thank u so much..!~!~

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    zts nice!!!

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    Dost, you have the flair of compiling small books, from the big BIG encyclopedias. THANKYOU.

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    Thanks brief & useful

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    thanks..very good summary to refer to =)

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