CLIN CVS/MSK/NEURO Systems Review - Week 0

Question 1

Cardio Systems Review Qs

Answer 1

• Chest pain/heaviness
  o Have you experienced chest pain? Is it worse with exertion?
• Dyspnoea (Exertional dyspnoea)
  o Have you experienced shortness of breath? Is it worse with exertion?
• Paroxysmal nocturnal dyspnoea
  o Do you wake in the night short of breath?
• Orthopnoea
  o Do you get breathless lying flat? How many pillows do you sleep on?
• Ankle swelling
  o Have you noticed any ankle swelling? Is it worse at a particular time of the day?
• Palpitations (abnormal awareness of one’s heart beats)
  o Have you experienced palpitations? Are they associated with chest pain, dizziness, shortness of breath or LOC?
   Can ask pts to tap it out…
• Intermittent claudication
  o Do you ever get pain in your legs when walking? Change in distance able to walk? Does it stop quickly?
• Syncope (fainting)
  o Do you ever feel dizzy? Have you ever fainted? Associated symptoms before & after (incl. aura)?
• Fatigue
  o Have you been more tired lately?

Question 2

MSK Systems Review Qs

Answer 2

• Pain – Do you have any pain in that joint? Do you have pain in any other joints?
• Swelling – Check for heat, colour change (e.g., redness). Is there any swelling in any other joints?
• Morning stiffness – How long does it last for? Where?
• Joint stiffness after inactivity – How long does it last for? Where?
• Loss of motion – gauge range compared to normal/other side of body & specific movement affected (e.g., flexion, abduction)
• Loss of function – How is this impacting your daily life?
  o If ‘yes’ – follow with WWQQAAA
• Deformity – Does your joint look different to how it normally does?
• Weakness – Have you noticed any changes in the strength/weakness in this part of the body?
• Instability – Have you had any problems weight-bearing? Have you had any falls? Have you felt unstable? How is this impacting your daily life?
• Changes in sensation – Have you experienced any numbness/tingling or any temperature changes?
• Systemic features – Have you had a fever? Fatigue? Weight-loss/gain? Loss of appetite?

Question 3

NEURO Systems Review Qs

Answer 3

• Seizures/fits – associated with tongue biting & loss of continence & confusion
• Fainting – fast resolving
• Dizziness (light-headedness)
• Vertigo (spinning)
• Headache
• Facial pain
• Neck stiffness
• Head injury
  o Check for loss of consciousness (LOC)
• Altered cognition
• Neck/back pain
• Visual, hearing, smelling disturbances
• Parasthesia/anaesthesia
• Weakness/numbness
  o If yes, determine location and if unilateral or bilateral or proximal or distal
• Gait problems
• Movement problems
  o Incl. tremor & other involuntary movements
• Speech & swallowing disturbances
• Disturbance of sphincter control (loss of bowel or bladder control).