History - Presenting complaint

Question 1

Pain

Answer 1

SOCRATES

Question 2

All symptoms

Answer 2

Timeframe - duration, onset (sudden/gradual), progression, timing (intermittent/continuing)

Question 3

Tiredness

Answer 3

• Timeframe
• Sleep - hours, quality
• How it affects patient
• Associated symptoms
  
  • Anaemia - breathless, dizziness, headache
  • Hypothyroidism - constipation, weight gain, cold interolerance, menorrhagia
  • Depression - mood, early morning wakening
  • Diabetes - polydipsia, polyuria

Question 4

Headache

Answer 4

• Explore like pain
• Meningism - rash, fever, neck stiffness, photophobia
• Giant cell arteritis - visual problems, jaw claudication, scalp tenderness
• Glaucoma - visual blurring, red eye, halos around lights
• Neuro symptoms

Question 5

Weakness

Answer 5

• Pattern
• Characteristic features
• Neuro symptoms

Question 6

Fit/fall/syncope

Answer 6

• Before - warning, circumstance
• During - duration, movements, incontinence/tongue biting, complexion
• After - amnesia, muscle pain, sleepiness, injuries
• Background - previous, impact on life
• Cardiorespiratory and neuro symptoms
• Check if drives

Question 7

SOB

Answer 7

• Current v normal exercise tolerance
• Orthopnoea
• Paroxysmal
• Diurnal/seaonsal variation
• Cardioresp symptoms

Question 8

Cought

Answer 8

• Productive
• Triggers
• Nocturnal
• Cardioresp symptoms

Question 9

Sputum

Answer 9

• How much, how often
• Colour, consistency
• Blood

Question 10

Haemoptysis

Answer 10

• Volume and frequency
• Fresh or altered
• Any sputum

Question 11

Palpitations

Answer 11

• Fast or slow
• Regular or irregular
• DIzziness, LOC, nausea, sweating, dyspnoea
• Cardioresp symptoms

Question 12

Diarrhoea/constipation/vomiting

Answer 12

• How much, how often, night
• Colour, consistency and contents
• Weight loss, apetite
• GI symptoms

Question 13

Dysphagia

Answer 13

• Solids/liquids/both, which first
• Odynophagia
• Weight loss, food intake
• GI and neuro symptoms

Question 14

Dyspepsia/reflux

Answer 14

• Explore as pain
• GI symptoms

Question 15

Vaginal discharge

Answer 15

• Quantity
• Colour
• Gynae symptoms

Question 16

PV bleeding

Answer 16

• Type
• Quantity
• Pain
• Anaemia symptoms
• Thyroid symptoms
• Gynae symptoms

Question 17

Secondary amenorrhoea

Answer 17

• Work down body
  
  • General - weight loss, exercise, diet
  • Head - visual problems, headaches
  • Thyroid - heat intolerance, tremor, palpitations, diarhoea
  • Torso - hirutism, acne
  • Abdomen - pregnancy

Question 18

Back pain

Answer 18

• Explore as pain
• Early morning stiffness
• Sciatica
• Urinary incontinence/retention
• Neuro symptoms of lower limbs

Question 19

Joint pain/stiffness/swelling

Answer 19

• Worse in morning and how long for
• Better with exercise
• Sleep disturbance
• Loss of function
• Rheumatology symptoms

Question 20

Bone/tissue/joint injury

Answer 20

• Explore as pain
• Stiffness/swelling
• Movemenet restriction/ability to weight bear
• Mechanical - locking, giving way
• Neuro distal symptoms

Question 22

Rash

Answer 22

• Sites, size, shape
• Description - appearance, blisters, raised areas, colour, blanch
• Seconday - itchy, painful, crusty
• Exacerbating and relieving factors
• Rheumatology symptoms