Histories Flashcards
What must you ask in regards to vomiting?
- colour: bile, blood, clear
- frequency
- how much
- triggers?
What must you ask in regards to changes in bowel habit?
- establish normal
- constipation/diarrhoea
- steatorrhoea
- Mucus
- Blood and it’s colour
- frequency of change?
List some associated symptoms in GI history?
- n/v
- change in bowel habit
- rectal bleeding
- mouth ulcers
- reduced appetite
- weight loss
- jaundice
- fever
What specific q do you ask about family history in GI hx?
IBD, cancers
What do you ask in a joint pain history?
- site: bilateral or uni, symmetry, joints affected, changed or evolved
- stiffness and time of stiffness
- hand deformities or nail changes
- appearance-:red or swollen or blue
- fever
- weight bear?
- trauma
- urinary sx and visual sx
- diarrhoea
- skin nodules or rashes
PMHx / Fx in joint pain history?
- PMHx of ra/oa/osteoporosis
- Fx of psoriases, ra, IBD, cancers
What are some things you’d ask about in a urinary hx?
- FUNI SHID
- fever
- flank mass or pain
- urine appearance
- recent flu like symptoms
- stool changes
- headaches?
- change in sexual activity or partner?
Elderly male with voiding symptoms?
BPH
Elderly male with painless haematuria?
Bladder cancer
F postpartum with incontinence?
Stress incontinence
Overweight px w polydipsia, polyuria and initial weight loss?
T2DM
3 sections of a collateral hx
Before during after
What to ask about before a collapse?
- triggers?
- prodromal sx: aura, nv, tinnitus, visual or olfactory disturbances, déjà vu
Qs to ask about during a collapse?
- lose consciousness?
- injury?
- signs of seizure?
- vomit?
- incontinence?
- signs of cyanosis?
Qs to ask about after a collapse?
- how long did it take to return to normal state?
- anything that helped resolve?
- in any pain?
Syncopal épisode while driving?
Advise not to drive till fully investigated!
Generally how do you navigate a chronic disease hx station?
- Understanding why the pt is here, what they understand about the results and it it’s abnormal or not
- Symptoms: how the pt is currently feeling, symptoms they get with condition or any new sx
- PMHx: specific for certain ones
- DHx: what meds, instructions, missed any doses, coping okay with regime
- SHx, same as standard plus impact condition has on daily life
- FHx: condition specific
Things to consider in a diabetic review concerning HBA1c levels?
- do the patient know why they’re here?
- establish t1 or 2
- positives of HBa1c reduction
- current symptoms
- then standard DHx, SHx, impact on life
What do peak flow and spirometry measure?
Peak flow is total lung volume (FVC)
Spirometry generates functional lung capacities
Restrictive spirometry?
Reduced FEV1 and FVC but normal ratio
Obstructive spirometry?
Reduced FEV1 and slightly reduced FVC
Reduced ratio
Things to cover in LFTs counselling?
- explain results, establish why pt is here
- sx: how are you feeling? Jaundice, RUQ pain, flu like sx
- DHx and vaccines
- SHx of alcohol, ivdu, recent travel, contaminated food, sexually active plus impact
FHx of Gilbert’s
Main thing to cover in cancer marker counselling?
Explain tumour markers are non specific so may be raised in cancer but there are also other reasons
