Limb History

Question 1

What do you check in the neurological specific review?

Answer 1

1. ‘Faints, fits or funny turns’ (seizures, LOC)
2. Headaches
3. Mood
4. Cognition
5. Senses – hearing, taste, smell, numbness, vision (including diplopia)
6. Speech and swallowing problems
7. Weakness
8. Numbness or tingling
9. Balance
10. Bladder and bowel function
11. Nausea and vomiting

Question 2

What general thins must you check for in limb history?

Answer 2

1. Malaise / lethargy
2. Appetite change / weight loss
3. Fevers / night sweats
4. Rashes / skin changes

Question 3

What risk factors do you need to ask about if a patient presents with back pain?

Answer 3

1. Immunocompromised e.g. IVDU, Diabetes, older age, chronic steroid use, HIV status
2. Steroid use as risk factor for osteoporosis and subsequent compression fractures
3. Previous history of cancer
4. Recent violent trauma

Question 4

What are the red flags for back pain?

Answer 4

1. Thoracic back pain
2. Pain that wakes you up at night
3. Progressive neurological deficit (weakness / numbness)
4. Reduced peri-anal sensation (does it feel different when you wipe yourself after a
   bowel movement?)
5. Difficulty passing urine or urinary incontinence
6. Difficulty having a bowel movement or loss of bowel control
7. Fever
8. Weight loss
9. History of cancer
10. Recent violent trauma (e.g. RTA)
11. Age<20or>55years

Question 5

What key other qs do you ask in review?

Answer 5

1. weight loss
2. fever
3. lethargy

Question 6

What do you ask in resp systems review?

Answer 6

1. cough

2. SOB

Question 7

What do you ask in CVS systems review?

Answer 7

1. chest pain
2. palpitations
3. oedema

Question 8

What do you ask in neuro systems review?

Answer 8

1. falls
2. blackouts
3. headache
4. mood
5. weakness
6. seizures

Question 9

What do you ask in GU systems review?

Answer 9

1. dysuria
2. haematuria
3. testicular pain/lumps

Question 10

What must you ask about in PMHx?

Answer 10

1. Hypertension
2. Heart disease
3. Stroke or TIA (transient ischaemic attack) Diabetes
4. Cancer

Question 11

What do you ask about in DHx?

Answer 11

numerous drugs that can cause neurological disturbances.

Question 12

What do you ask about in FHx?

Answer 12

pertinent medical or neurological diseas

Question 13

What do you ask in SHx?

Answer 13

1. Hand dominance?
2. Does patient drive or not (DVLA aware?)? Smoking history
3. Alcohol history
4. Illicit drug use