History taking Flashcards
Things to ask in a social history
SAADLES
Smoking
Alcohol
ADL – activities of daily living : how do you manage with bathing, cooking, cleaning, shopping? Occupation – job, ?
Enjoyment activities – recreational/hobbies
Social support – family, friends, neighbours, carers, district nurse, financial problems.
Recent travel history
PET (in respiratory history especially) exposure to cats, pigeons…
Generally, always ask about…
FAWR Fever Appetite Weight loss Reduced energy
Important questions in endocrine history
Anxiety Palpitations Changes in appetite Polydipsia and plyuria Tiredness Tremor Weakness Carpal tunnel syndrome ( acromegaly, hypothyroidism, hyperparathyroidism) Hair changes: thinning, hirsutism Headache Muscle or bone pain Pigmentation Skin changes Sweating Visual fields defects or decreased acuity Changes in libido Galactorrhoea, gynaecomastia, impotence, infertility, Menstrual disorders
Cushing’s History
History – STEROIDAL
Skin is steroidal and thin
Thin arms due to Tissue wasting and associated muscle weakness and pain
Easy bruising and striae (red/purplish colour)
Reddened complexion (plethoric), elevated ACTH
Obesity without change in diet – trunk, abdo, buffalo hump, supraclavicular fat pads, moon face
Infertility and ammenorhoe, impotence
Diabetic symptoms – polyuria, polydipsia
Androgenic sxs: acne, hair growth, frontal balding
Lethargy, depression, psychosis
