Mark Scheme Histories Flashcards
Neuro History HPC
Onset/duration Associated symptoms Timing Exacerbating and relieving Severity Static?Progressive?Relapse and remit? Previous episodes
Neuro history key symptoms
Headache Altered consciousness Altered sensation Weakness Unsteady, stiff, clumsy N&V Visual changes Psychological changes
Neuro past medical history
Attempts to diagnose or treat before?
Head/spinal trauma or injury
Meningitis, encephalitis
AF, HTN, Ca, Epilepsy, DM
Neuro family history
DM, IHD, Stroke, Haemorrhage, Migraine
Headache key symptoms
photophobia and phonophobia autonomic symptoms altered sensation Weakness unsteadiness/stiffness/clumsiness N&V visual and eye changes Psychological changes Seizures Fever Other pains
Seizure/LOC key symptoms
Headache Altered consciousness Altered sensation Weakness Unsteadiness/ stiffness/ clumsiness N&V Visual disturbance Psychological changes Incontinence Tongue biting Preictal symptoms Postictal symptoms
Musculoskeletal HPC
Site Onset/duration Character Radiation Associated symptoms Timing- keeps up at night Exacerbating/relieving Severity Previous episodes
MSK Key symptoms
Pain Stiffness Swelling Fever Weight loss Nail and skin changes Neuro- bowel, urinary, sensation
MSK PMH
Previous attempts to diagnose or treat
Response/SE to previous medications or treatment
Trauma
Recent infections
AI- DM, IBD, Coeliac, psoarisis
Gout risk- HTN, obesity, vascular disease
MSK family history
RA OA Psoarisis Gout UC Crohns Connective tissue disease AI
Thyroid HPC
Onset/duration
Timing
Exacerbating/relieving factors
Severity
Thyroid key symptoms changes
Body weight Appetite, dysphagia, difficulty breathing Voice Bowel habit Energy level Muscle weakness Concentration Mood Heat tolerance Skin, nails, hair Heart rate/rhythm Eyes Menstrual cycle/impotence Pain/ discomfort
What can the eyes be like in thyroid
Pain, grittiness, change in vision
Thyroid PMH
Previous thyroid disease, surgery or treatment
AI- inc B12 deficiency
Peripheral vascular system history
S O C A T E S
Peripheral vascular system key symptoms
Pain, tenderness Altered skin colour Skin temperation Loss of function Loss of sensation
Peripheral vascular system PMH
Previous vascular issues, diagnoses and treatment response
Angina, stroke
DVT risk factors
Smoking, diabetes, cholesterol, HTN
Questions if suspect DVT
Malignancy, prolonged immobility, operations
Peripheral vascular system family history
Prothombotic (Factor V Leiden) MI Stroke Diabetes Vascular problems
Cardiovascular HPC
Site Onset/duration Character Associated symptoms Timing Exacerbating/ relieving Severity
Cardiovascular key symptoms
Chest pain Dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea Palpitations Claudication, rest pain Syncope, dizzy, light headed Oedema Cough Systemic SWAFF
check for if chest pain
Nausea and sweating
Check for if dyspnoea, orthopnoea, PND
Exercise tolerance
Check for if palpitations
Recreational drug use
Amount of tea, coffee, coke, alcohol
Cardiovascular risk factors
Hypertension Hyperlipidaemia Diabetes Smoking Physical inactivity FHx
Cardiovascular PMH
previous cardio -inc PVD and rheumatic fever Resp Stroke/TIA Surgery- inc pacemaker
Cardiovascular FH
Cardiovascular disease inc. stroke with age of onset
Respiratory HPC
Onset/duration Character Associated symptoms Timing Exacerbating/ relieving Severity
Respiratory key symptoms
Dyspnoea Cough Wheeze Haemoptysis Chest pain Fever Weight loss
Check if dyspnoea
How they are normally
Check if cough
Productive
- colour
- quantity
- odour
- consistency
Adjectives for consistency of sputum
Fluid
Mucuous
Purulent
Frothy
Check if haemoptysis
Quantity Origin (coughed up?) Colour Sputum Consistency (clots, liquid, sputum) Trauma Legs (dvt) Bleeding/bruising anywhere
Respiratory PMH
Respiratory
Cardiac (angina, orthopnoea, PND)
HIV
Surgical inc dental
Respiratory FH
Respiratory and age of onset
Respiratory SH
Smoking, alcohol,recreation Home situ, ADLs Infective contacts Pets Travel Hobbies Occupation
GI HPC
Onset/duration Character Associated symptoms Timing Exacerbating/relieving Severity
GI Key Symptoms
Dysphagia, odynophagia N&V Anorexia and Weight loss GORD Pain Abdominal distension Altered bowel habit Skin changes Fevers and Rigors Blood loss Eyes and joints
Check if dysphagia
Where?
Solids, liquids or both?
Between meals?
Nocturnal coughing/dyspnoea?
Check if anorexia or weight loss
Are they associated with each other
Check if GORD
Dyspepsia Noticeable hiatus hernia Sour taste Relation to caffeine Early satiety Cough
Check if altered bowel habit
Frequency Urgency Tenesmus Appearance of stool Consistency of stool Float/smell
Check if jaundice
Colour of urine/stool
Itching
Unprotected sex
Check if blood loss
Excess, haematemesis, melaena, rectal bleeding
GI FHx
Gastrointestinal disease, age of onset
Cancer- GI and gynae
GI Travel history
Area of travel
Consumption of food/ contaminated water
Insect/animal bites
GI SHx
Smoking, alcohol, recreation
Sexual history
Home situ and ADLs
Occupation
Breast lump HPC
Size of lump Changing size Onset of lump Painful Lump change with menstruation
Breast lump key symptoms
Nipple discharge or bleeding Nipple invesion Overlying skin changes Weight loss Fever Lethargy Pain Lymph node swelling Similar in past
Breast lump PMH
Gynae- preg, menorrache etc Breast trauma or disease Malignancy Other medical conditions Past surgical history
Breast lump DH
Prescribed inc oestrogens
OTC
Allergies
Breast lump FHx
Malignancy (breast, bowel, uterine, ovarian) and age of onset
Urological HPC
Onset/duration Character Associated Timing Exacerbating/ relieving Severity Previous episodes, onset/duration
Urological key symptoms
Dysuria Frequency Urgency Nocturia Haematuria Hesitancy and terminal dribbling Poor urinary stream Urinary incontinence Fevers and rigors N&V Pain
Check if haematuria
Timing in stream
Presence of clots
Trauma/ exercise?
Urological PMH
Urological illness
Others- DM, gynae, sex
Surgical
Urological FH
Urological disease inc renal stones, PKD
Urological SH
Smoking, alcohol, recreation Home and ADLs Occupation Travel Diet (beetroot?)
Diabetes HPC
Onset/duration Character Associated symptoms Timing Exacerbating/ relieving Severity Previous- onset/duration
Diabetes key symptoms
Polydipsia Polyuria, nocturia Hunger Fatigue Blurry vision Weight loss Cuts/ wounds slow to heal Genital itching, irritation, thrush Infections
Diabetes PMH
Other things
MI
Stroke
Diabetes FH
Diabetes, stroke, MI
AI
Haem HPC
Onset/duration Character Associated symptoms Timing Exacerbating/relieving Severity
Haem key symptoms
Fatigue/weakness Dyspnoea Melaena Easy bruising/bleeding Heavy periods Infections Lymph node swelling Lymph node pain Fever Weight loss Bone pain Polydipsia, polyuria Itching Lump history
Haem PMH
Frequent infections
Bleeding disorders
Radiotherapy
Recent trauma or surgery
Haem SH
Smoking, alcohol Diet Home Origin AIDS- Sexual lifestyle
Haem FH
Blood diseases
-haemophilia, VWD, sickle cell, thalassaemia
Leukaemia (philadelphia chromosome)
Endocrine HPC
Onset/duration Character Associated symptoms Timing Exacerbating/relieving Severity
Endocrine key symptoms
Weight loss, appetite Bowel habit Menstruation/impotence Sweating Hair loss Fatigue Skin changes Lumps Urination, thirst Headache, visual disturbance Emotional/cognitive changes
Endocrine PMH
PMH
Thyroid and pituitary
HTN and DM
TB
Endocrine DH
Prescribed- anticoag, steroids
OTC- NSAIDs, vitamins
Allergies
CAGE
ever felt should Cut down
Annoyed by criticism
Guilty about drinking
Eye opener- morning drink