Histories Flashcards
1
Q
Introduction to every history
A
- Wash hands
- Introduce yourself
- Confirm name + DOB
- Explain history + gain consent
2
Q
History structure
A
- Presenting complaint
- History of presenting complaint
- SOCRATES
- Associated symptoms - Past medical history
- Drug history
- Allergies - Family history
- Specific
- General - Social history
3
Q
Past medical history - questions
A
- Conditions
- Hospital visits
- Surgery
… - Mental health
- Immunisation history
4
Q
Social history
A
- Occupation
- Affect on work - Living situation
- Affect on daily life - Mood + stress
- Recent travel
… - Smoking?
- Drinking?
- Recreational drugs?
5
Q
ICE
A
- Ideas
- Concerns
- Expectations
6
Q
Red flag symptoms
A
- Unintentional weight loss
- Or gain - Tiredness/lethargy
- Night sweats
- Fevers
- Recent illness - Skin changes
7
Q
PC/symptom: Breathlessness
A
- Duration, onset, progression, time course
- Diurnal variation
- Seasonal variation - On exertion or at rest?
- Limit to daily activities - Orthopnoea
- Impact on sleep, pillows
- Exacerbating factors
- Allergic factors - Relieving factors
- Inhalers
- Rest
8
Q
PC: breathlessness - associated symptoms?
A
- Recent illness
- Chest pain
- Cough
- Wheeze
- Calf swelling
- Palpitations
9
Q
PC/symptom: Cough
A
- Duration, onset, progression, time course
- Diurnal variation
- Recent change - Exacerbating factors
- Triggers - Relieving factors
… - Sputum
- Quantity
- Colour
- Consistency
- Odour
- Frequency - Haemoptysis
- (as above)
- Frequency
- Recent trauma
- Recent DVT
10
Q
PC: cough - associated symptoms?
A
- Recent illness
- Breathlessness
- Chest pain
- Wheeze
- Calf swelling
- Palpitations
11
Q
Respiratory specific social history
A
- Recent travel
- Occupation
- Asbestos
- Water coolers, air con - Immunisation history
- Housing conditions
- Pets
- Birds - Exercise
… and obviously smoking!
