Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Histories nips > Head to toe > Flashcards

Head to toe Flashcards

1
Q

Systems review

A

FLAWS
Cardio - Chest pain, SOB
Resp - cough (blood), wheeze
Upper GI - Dysphagia, N+V
Lower GI - tummy pain, Bowel Habit changes, Blood in stools
Gento urinary - urinating more? Blood, Discharge from penis/changes in period
Neuro - Headaches, Blackouts/dizziness. Vision
Endo - Feeling hot or cold recently?
Musc - muscle/joint pain.
Skin/Lump - rash or lumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Headaches

A

SOCRATES

Diagnosis of exclusion = GIMMIST:

GCA - pain when eating/tender scalp
ICP - coughing, straining, position (lying down/standing)
Migraines - sound/smell/light
Meningitis - stiffness of neck
Sinusitis - movement
Trigeminal neuralgia - Pain on touching face or shaving
Tension headache - stress

CHocolate, CHeese
Oral contraceptive pill
Caffeine
alcohOL
Anxiety
Travel
Exercise

Associated Sx:

Previous head injuries
Altered level of consciousness
N & V

Fits, faints, funny turns
Altered smell/hearing
Sensory disturbances - paresthesia, paresis, paralysis
Tremor

Vision
Loss of memory
Anxiety
Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Loss of consciousness

A

Before: What are you doing at the time? Eating and drinking water? Did you get any warning signs (before these events come on, can you predict that it was going to happen? Do you see any lights or anything) e.g. dizziness, funny lights, SOB? Have you had any previous head injury?

During: Has anyone seen these events happen? How long do they last? Any tongue biting, urinary/faecal incontinence? Funny movements? Are you aware during it?

After: How long does it take to recover? Were you confused?

Has this ever happened before? - if yes then ODPARA
(When was the first time? Is it getting better or worse? Anything that brings it on?)

PANFASTVLAD
Cardiac associated symptoms (palpitations, chest pain, SOB, swelling/pain in the legs?)
FLAWS
Systems review

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dysphagia

A 
S: Where does it get stuck? 
O: When did it start? Progressive/intermittent? How long does it last? Getting better or worse?
C: Solids/liquids? Swallowing saliva? 
R:
A: Triple H Was Not Crap
T: Worse at any time of day,
E: Anything make it better or worse? Pickles. Does drinking cold water make it better?
S:
Heartburn
Haematemesis
Hoarse voice
Weight loss
Nausea
Coughing/choking
Regurg
Anaemia
Pain (SOCRATES)

Risk factors - smoking, alcohol, pickled food (GORD), medication

Then carry on with FLAWS + systems review

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vomiting history

A

QUANTIFY - How much (cupfuls)?, How often? Same each time?
QUALIFY - Colour? Any food in it? Blood? Watery or thick?

O: When did this start?
D: How long does it last when you start vomiting?
P: Has it been getting worse?
A: Does anything make the nausea/vomiting go away?
R: Does anything bring the vomiting on?
A:Is there anything you’d like to add?

ABDO systems review (if jaundice then itching + skin colour)

Associated Sx:

Triple H Was Not CRAP (from dysphagia)

Upper GI: Ulcers, difficulty/pain swallowing, nausea and vomiting (blood?), coughing up blood, heartburn, chest pain,
Lower GI: abdo pain, bowel habits (qualify + quantify and blood), bleeding from back passage, pregnancy

Diagnosis of exclusion = 3Ps
Any change you might be Pregnant?
Any Previous head injury?
Any Peculiar food you’ve eaten recently?

(there’s other shit but covered by system review/history)

Drug history - ask about abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Haematemesis

A

Qualify/Quantify. Same as vomiting

Additional Qs: Recent GI endoscopy? Long standing hepatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chest Pain

A

SOCRATES

Associated Sx
CVS Sx = SOB (exertion, PND, lying down), syncope, palpitation, ankle swelling
Sweating, N&V
Vision blurring, paresthesia of lower limbs

Diagnosis of exclusion:
Aortic stenosis - any faints
Anaemia - lethargy, change in diet, bowel habits, coughing up any blood or blood in rectum.
Ass sweating (and grey face (MI)) and N+V
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Palpitations

A

Have you had this before? ODPARA multiple episodes
Before-during-after (tap out rhythm in during!)

Associated Sx:

Syncope – pre-syncopal/syncopal symptoms
SOB
Sweating
Chest pain

Diagnosis of exclusion:
PTH:
Phaeochromocytoma - episodic headache, sweating, tachycardia, flushing
Thyrotoxicosis - heat intolerance, tremor
Hypoglycaemia - diabetes (poly/nocturia, polydipsia), hunger, dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SOB

A

Associated Sx:

Cough (characterize, quantify + qualify sputum production)
Wheeze, sputum, haemoptysis, chest pain, fever, rigors, night sweats, weight loss, lethargy, swollen glands

Cough (sputum), wheeze, chest pain, rigors, swollen glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Haemoptysis

A

CODPARA

Then Cardiac and resp qs

Then HIBBE(R)T:
Headaches (mycoplasma pneumonia)
I (intubations)
Birds (psittaci)
Bone pain (mets)
Endo (cushings and hypercalcaemia and lambert eaton)
R
Travel

PMH:
Frequent infections as a child?

Drug history:
Warfarin

Social:
Pets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Neck lumps

A

S: Where is it?
O: When did it begin? Sudden or gradual? How did you notice?
C: 3Ss (size, shape, symmetrical), 3Cs (colour, contour, consistency), 4Ts (tethered, tenderness, Temperamental, Temperature), 1D = discharge
R: lumps anywhere else
A: endo Sx + swelling of face (SVCO) + faints (chemodectoma)
T: pain worse at any time of day
E: Anything make it better or worse? Seeing food, eating?

Endo Sx:
Menstrual changes
Increased/decreased hair 
Palpitations
Increased/decreased urine
dryness/hot or cold
Difficulty swallowing/changes in voice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cough

A

CODPARA
Character - Had this before? Are you coughing anything up or is it a dry cough. QUANTIFY/QUALIFY
Qualify - Do you feel weezy? What colour is the sputum? Is it thick or watery? Is there any blood in the sputum? What does it sound like? (could be bovine or gurgling)
O - When did it begin? Worse at any time of day (asthma)
D
P
A -
R - exercise? Lying flat?
A

FLAWS
HIBBERT
Resp symptoms
Cardio symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dyspepsia

A

C- What do you mean by heartburn, Does it fluctuate throughout the day
O-
D-If been going on for a long time, what brought you into hospital?
P
A
R
A- Triple H Was Not CRAP + Gastro systems review + FLAW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Jaundice

A 
O- Acute or Chronic
D- How long?
P-
A
R
Associated symptoms = UR NIPS:

Urine, Rigors, N&V, Itching, Pain, Stool

Risk Factors - ABCDEF-
 Alcohol & smoking
Blood products/blood borne viruses
Coitus
Diabetes/drug 
Expeditions
Food/family hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Abdo pain

A 
S
O
C - colicky, burning, tender
R - to back, scapula, loin → Groin, middle → RIF
A - Triple H Was Not CRAP + YURNIPPPS
E
S

Yellowing, Urine, Rigors, N&V, Itching, Peculiar foods, Pregnancy, PR bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diarrhoea

A

(Need to finish)

CODPARA

What do you mean by diarrhoea? Normal bowel habit?

Qualify - colour, very watery, bloody (IBD, infectious, Ca), mucousy, foul smelling/floating (pancreatic cancer, coeliac, CF), pale (chronic panc, gallstones)

Quantify - increased frequency?

C -
O - Acute or gradual? One-off? Every time or intermittent? Nocturnal?
D -
P -
A - Anything bring it on? Particular foods?
R -
A - WHAT UC

WHAT UC = Weight loss, Heat intolerance, Abdo pain, Tenesmus, Urgency, Chunder

Diagnosis of exclusion:

Infectious gastroenteritis - vomiting, fever, sweating
IBD - urgency, weight loss, uveitis, erythema/pyoderma
Malabsorption - weight loss, floating stools
Hyperthyroid - heat intolerance
Functional bowel disorder - sleep disturbance (at night)
Colon Ca - tenesmus

17
Q

Haematuria

A

Is there any Pain? Is it real (beetroot, ethambutol, porphyria, rifampacin)

ODPARA

C - Qualify/Quantify - Is there blood for the whole stream or beginning middle end. how clear is it? (smoky shows glomerulonephritis), Colour (brown is retention). Frothy (proteinuria). Are there any clots of blood? 
Frequency
Urgency
Nocturia
Dysuria

Stream
Hesitancy
Incontinence
Terminal dribbling

FLAWS

Change in bowel habits, back pain, PR bleeding.
Abdo mass
N + V, Numbness
Trauma to back

PMH - recent catheters

18
Q

Urinary retention

A

Same as haematuria

19
Q

Leg swelling

A

Previous history or similar

SOCRATES for pain/swelling

S - uni/bilateral
O - sudden onset
C - cramping/ shooting
R 
A - Infective signs, ischaemia, skin changes, ulcers
T - Intermittent (claudication), constant (diabetes, cellulitis)
E - walking/ resting. Burgers test
S

Diagnosis of exclusion = HCDD(R)

Hepatic failure - jaundice
Cardiac failure - review
DVT - travel, pregnancy, OCP, bed rest, surgery, thrombophilia history
Diabetes - polydipsia, polyuria, nocturia
(Renal failure - nocturia, increased frequency)

20
Q

Weight loss

A

(quite a lot of crap, so if stuck just whip out a full systems review)

CODPARA:

Most important = characterise = how much, since when/how quickly, intentional, trouser size, happened before

Noticed anything else with it?

FLAWS first for this one

Then exclusion

Diagnosis of exclusion:
HAMIM CDD:
Hyperthyroidism - PATHS = palpitations, anxiety, tremor, hot/cold, sweating/swelling
Addison’s - weakness, dizziness, skin pigmentation
Malnutrition - diet + changes
Infection - fever, N&V, rigors, night sweat, sputum, rashes, lumps
Malabsorption - diarrhoea, abdo pain, vomiting, abdo pain
Cancer - FLAWS
Diabetes - polydipsia, polyuria, nocturia, UTIs(dysuria)
Depression - low mood, early morning weakness
Uro questions- dysuria, hesitancy, stream

PMH - think IBD (bowel resection→ malabsorption)
Personal history- Smoking and recreational drugs
Meds - diuretics + laxatives + thyroxine
Fam history of diabetes and thyroid shiz + malignancies (breast)
TRAVEL HISTORY - dutty diseases
Occupation - stress + sleeping

21
Q

Diet

A

Weight
do you know how much you weigh?
Increasing or decreasing?
Noticed clothes getting tighter/looser?

How do you feel about your weight? Any concerns about it?
Unintentional loss (malignancy, hyperthy, IBD, diabetes)
Unexpected gain (hypothy, Cushing’s, oedema, ovarian cancer)
Are you happy with your weight? (anorexia, bulimia, body image disorders)

Can you take me through a typical day’s food and drink? (From wake up to bedtime)
Ask good diet - carbs, protein, fats, fruit + veg (5-a-day)
Ask bad diet - Maccy D’s diet = high fat, sugar, salt
Snacks - in between meals, bedtime, at night
Drinks - fizzy, alcohol, tea/coffee (calorific/vitamin deficiency, anxiety)

Do you eat a special diet?
Medically - gluten free
Cultural/Religious diet
Veggie/vegan
Fad diets
Food allergies/intolerance
22
Q

Breast

A

HPC:

Lump characterisation = 3S 3C 4T 1D

S: Where is the lump? 
O: When did you notice it?
Characterise the lump: how big is the lump? Is it painful? Does it move? Any nipple discharge? Any discharge from the lump? Any changes in your skin?
R:
A:
T:
E: Does the size/change with your periods? Is it more painful around your periods
S: pain out of 10
Do you have any medical conditions?
RF: 
When did you have your first period?
Do you have any children? Did you breastfeed?
Do you smoke? Drink alcohol?

Family history
Any family history of breast cancer?
Any family history of ovarian cancer?

Drugs
On the OCT? HRT?

23
Q

Lethargy

A

(To be completed)

Diagnosis of exclusion:
Anaemia
Hypothyroidism
Diabetes
Renal failure
Malignancy
Addison’s disease
Cardiac failure
Chronic infection
Depression
Chronic fatigue syndrome
IBS
24
Q

Bloody stools

A

Need to finish!

25
Q

Constipation

A

Need to finish!

26
Q

Ehe

A

nips

27
Q

Dom

A

loves Megan

28
Q

Great

A

manoeuvre

29
Q

Vision loss

A

Visual Loss

C- Is it in one eye or both eyes? Blurring, loss of vision, whole visual field, double vision, presence of false image, loss of colour
O - when did it come on? How quickly? Was it sudden or gradual?
D - how long does it last?
P - has it been getting better or worse?
A- what makes it go away
R- what makes it come on
Associated symptoms:
Pain (GCA/Acute Glaucoma)
Thyroid - hot or cold?
Halos around light (glaucoma)

PAN

Diagnosis of exclusion = ‘GIMMMIC’:

Giant cell arteritis - pain when brushing hair
ICP - worse when lying down, coughing, laughing, straining
Migraine - photophobia, pulsatile, unilateral
Macular degen - bits missing in people’s face
MS - incontinence, paresthesia in limbs - do you ever lose control of your bladder
Inflammation - red eye/itchiness - is your eye itchy
Cataracts - problem driving at night. bothered by glare, headlight

Histories nips (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions