History Scenarios

Question 1

Systematic Enquiry for Cardiovascular History

Answer 1

Chest pain
Shortness of breath at rest or exertion
Lie flat, pillow use (orthopnoea)
Breathless at night (may be PND; ask for a clear description of this)
Palpitations
Ankle swelling (peripheral oedema)
Cold/blue hands, feet
Pain in calves on walking (Claudication)

Question 2

Systematic Enquiry for Respiratory History

Answer 2

Cough (time period crucial)
Sputum, colour, volume
Any blood in sputum? (haemoptysis)
Shortness of breath
Wheeze
Fever, night sweats
Recent CXR
Breast: lumps, bleeding, discharge

Question 3

Systematic Enquiry for Gastrointestinal History

Answer 3

Bloating, distension
Indigestion , heartburn
Problems swallowing (dysphagia)
Pain on swallowing (odynophagia)
Change in weight
Bowel habits; change?, colour, consistency
Faecal incontinence

Question 4

Systematic Enquiry for Genitourinary History

Answer 4

Incontinence
Frequency & Volume of urination
Pain on passing urine (dysuria)
Night time urination (nocturia)
Colour of urine
Blood in urine (haematuria)
Hesitancy, dribbling
Genitourinary pain
Genital rashes, lumps
Menstrual cycle

Question 5

Systematic Enquiry for Neurological History

Answer 5

Headaches
Vision, hearing + aids for this
Speech difficulties (dysphasia, dysarthria)
Dizziness, vertigo
Faints, fits, blackouts
Weakness
Numbness
Coordination problems
Walking, unsteadiness, falls
Sleep disturbances
Tremors
Concentration
Memory

Question 6

Systematic Enquiry for Musculoskeletal History

Answer 6

Joints; pain, stiffness, swollen
Variation in joint pain during day
Fingers painful/blue in cold
Dry mouth, red eyes
Fever, skin rashes, ulcers
Nodules or lumps
Back or neck pain

Question 7

Systematic Enquiry for Mental Health History

Answer 7

Any recent change in mood
(Any thoughts of self harm)
Any problems with memory or concentration?
Hallucinations or delusions
Intellectual change

Question 8

Systematic Enquiry for Endocrine History

Answer 8

Prefer hot or cold rooms/weather
Sweating
Fatigue
Hand trembling
Neck swelling
Change in weight
Thirst
Change in urine volume/frequency

Question 9

Systematic Enquiry for Vascular History

Answer 9

Pain at rest or walking (calves – claudication)
Skin changes or ulceration
Cold hands and or feet
Reduced exercise tolerance
Loss of/reduced sensation
Swollen ankles