OCSE Hx Flashcards
Chest Pain
WIPER (5)
ICE (2)
PC: SOCRATES (6)(Associated CVR; SOB, Palp, Calf swell, SOB when prone (2), Associated Systemic; Nausea, fever, night sweats, Wgt Ls, Pain, Sweating (2)), severity (1), painkillers (1)
Similar episodes (1)
VTE RF: long flights, immobilisation, AF, plaster cast, PHx, Ca, FHx clotting (2)
CV RF: DM, HTN, FHx, Cholesterol (2)
PMH: espc CV (2)
DHx (1), Allergies (1)
FHx (1)
SHx: Smoke, Alcohol, Drugs (2), Lifestyle/Occupation/House (1)
Closure (1)
DDx - ACS, IHD, Pericarditis, HF, PE, Pneumothorax, Anxiety
SOB
WIPER (5)
ICE (2)
PC: Onset (1), Duration (1), Triggers (2), Severity (2), Progression (2), Relieving (2), Associated CVR: Palp, Chest pain, heamoptysis, sputum, cough (2), Associated Systemic: nausea, Fever, Night sweats, Wgt lss, Nausea, Sweat (2),
Similar Episodes (1)
VTE RF: long flights, immobilisation, AF, plaster cast, PHx, Ca, FHx clotting (2)
CV RF: DM, HTN, FHx, Cholesterol (2)
PMH (2)
DHx/ Allergies (2)
FHx (1)
SHx: Smoke/Alcohol/Drug (2), Lifestyle/Occupation/House (1)
Closure (1)
DDx - PE, Pneumonia, Pneumo, Asthma, COPD, ACS, HF
Haematuria
WIPER (5)
ICE (2)
PC: Freq (1), Onset/Progression (2), Blood Loss (1), Smell (1), Abdo pain (2)
GU: frequency, dysuria, urgency, nocturia (2), hesitancy, dribbling, poor stream (2), Back pain (1)
Systemic: Wgt lss, Appetite, Fever (2)
PMH (1)
FHx (1)
DHx: espc anticoags (2)
SHx: Occupation (espc dye/chemical exposure) (2), Smoke/Alcohol (2)
Closure (1)
DDx - TCC, RCC, Renal Stones
Fatigue
WIPER (5)
ICE (2)
PC: Establish (1), Severity (1), Duration (1), Onset (1), constant (1), Associated; neuro/bowels/flu/preg (2)
Previous Episodes (1)
Blood loss: Menstruation, PR, Heamaturia, Heamoptysis (2)
Malignancy: Wgt ls, Fever, Sweats, Bony pain (2)
Depression/Life events (2)
PMH (2)
DHx & A (2)
FHx (1)
SHx: Smoke/Alcohol (2), Occupation/Home (2)
Closure (1)
DDx - Anaemia, Hypothyroid, DM, Depression
Joint Pain
WIPER (5)
ICE (2)
PC: SOCRATES (relieving heat/activity) (5), Stiffness (1), Swelling/Distribution (2), Diurnal Vary (2), Lumps/Swellings (2)
Previous Episodes (1)
Systemic: rashes, red eyes, dry MM, Wgt ls, Diarrhoea, Ulcers, PR Bleed
Neuro symptoms (1)
PMH (1)
DHx + A (2)
SHx: SMoke/Alcohol (2), House/Occupation (1), Effect ADLs (1)
Closure (1)
DDx - RA, OA, PA, SA, RA, Gout, SLE, Trauma
LUTS
WIPER (5)
ICE (2)
PC:Frequency (1), Nocturia (1), Dribbling (1), Incomplete (1), Strain (1), Hesitancy (1), Urgancy (1), Incontinence (1), Heamaturia (1), Dysuria (1), Abdo pain (1), Constipation (1), Fever (1), Back pain (1), Sexual problems (1)
Previous Urinary Retention (1), Previous GU interventions (1)
Systemic: Wgt ls, Appetite, Bony pain (2)
PMH (2)
DHx + A (2)
FHx (1)
SHx: Smoke/Alcohol (2), Occupation/Home (2)
Closure (1)
DDx - BPH, Ca, UTI, Stones, Prostatitis, DM (Polyuria)
Abdo Pain
WIPER (5)
ICE (2)
PC: SOCRATES (associated nausea/vom/urinary/bowels, better worse: strain/cough/lying) (8)
Severity & analgesia? (2)
Previous Episodes (1)
Systemic: Wgt, Appetite, Bone pain, Fevers (2)
PMH (1)
DHx + A (2)
FHx (1)
SHx: Smoking (1) Alcohol (1) Occupation/Home (1)
Closure (1)
DDx - Ulcer, Obstruction, Peritonitis, Renal Colic, Gallstones, Appendicitis, Mesenteric Ischeamia, Diverticulitis, Pancreatitis, Pyelonephritis, AAA, Ectopic Preg
Non-Specific
WIPER (5)
ICE (2)
PC: Circumstances (1) Consciousness (1) Onset (1) Duration (1) Warning Sx (1) Post Event Sx (1)
Associated CVR: SOB, Palp, Orthopnea, Heamoptysis, Sputum, Cough (2)
Associated Systemic: Fever, Wgt, Sweats, Vom, Pain, Bowels (2)
CV RF: DM, HTN, FHx, Cholesterol (2)
Previous Episodes (1)
PMH (1) DM Control (1)
DHx (1) + A (1)
FHx (1)
SHx: Smoke/Alcohol/Drugs (2), Lifestyle/Occupation (1)
Closure (1)
Swollen Legs
WIPER (5)
ICE (2)
PC: SOCRATES (5)
Previous Episodes/Tx (2)
Orthopnea? (1) Nocturnal Dyspnoea (1)
CVR Sx: SOB, Palp, Heamoptysis, Sputum (2)
Systemic Sx: Fever, Sweats, Wgt Ls, Pain, Vom (2)
VTE RF: Previous VTE, Immobile, FHx clotting disorders, Hx of Ca
CVD RF: Cholesterol, FHx, HTN, DM
PMH (2)
DHx (1) + A (1)
FHx (1)
SHx: Smoke/Alcohol/Drugs (2), lifestyle/occupation (1)
Closure (1)
DDx - DVT, Cellulitis, HF, Hypothyroid (Pretibial), Renal Failure, Nephrotic Syndrome
Vomiting
WIPER (5)
ICE (2)
PC: Freq (1), Content (1), Bile (1), Blood (1), Severity (1), Meds to help? (1), Triggers; Food/Travel (1)
Previous Episodes (1)
Associated Sx: Abdo pain, Bowels, PR bleed, fainting, retching (2)
Systemic Sx: Wgt, Fevers, Preg, Appetite, Urinary, Sweats (2)
PMH (1)
DHx (1) + A (1)
FHx (1)
SHx: Smoke (1) Alcohol (1) Occupation/Home (1)
Closure (1)
DDx - Obstruction, Gastroenteritis, Pancreatitis, Appendicitis, Peptic Ulcer
Dysphagia
WIPER (5)
ICE (2)
PC: Establish (1) Onset (1) Solids/Liquids (1) Progressive (1) Cough/Aspiration (1) Oral intake (1)
Similar Episodes (1)
Associated Sx: Vom, Abdo pain, Bowels, Haematemesis
Systemic Sx: Sweat, Wgt, Appetite, Fever (2)
PMH (1)
DHx (1) + A (1)
FHx (1)
SHx: Alcohol (1) Smoke (1) Home/Occupation (1)
Closure (1)
DDx - Ca, Oesophagitis, Achalasia
PR Bleeding
WIPER (5)
ICE (2)
PC: Onset (1) Freq (1) Colour (1) Volume (1) Where (1)
Previous Episodes (1)
Normal Bowel Habits (1) Straining? (1)
Associated Sx: Abdo pain, Vom, Urinary, Bowels (2)
Systemic Sx: Appetite, Wgt, Fevers, Sweats, Bone pain (2)
PMH Appetite, Wgt
DHx (1) + A (1)
FHx (1)
SHx: Smoke (1) Alcohol (1) Home/Occupation (1)
Closure (1)
DDx - Ca, Fissure, Fistula, GI Bleed, Hemorrhoids, Diverticular heamorrhage, Peptic Ulcer
Diarrhoea
WIPER (5)
ICE (2)
PC: Normal (1) Freq (1) Consistancy (1) COlour (1) PR bleed (1) Melaena (1) New food (1) Travel (1)
Previous Episodes (1)
Associated Sx: Vom, Abdo pain, Tired, Dizzy, Urinary (1)
Systemic Sx: Wgt, Appetite, Fevers, Sweats, Bloating, Reflux (1)
PMH (1)
DHx (1) + A (1)
FHx (1)
SHx: Smoking (1) Alcohol (1) Home/Job (1)
Closure (1)
DDx - Gastroenteritis, IBD, IBS, Diverticulitis, Coeliac, Food Intolerence
Headaches
WIPER (5) ICE (2) PC: Character (1) Location (1) Onset (1) Duration (1) Severity (1) Meds (1) Worsen (1) Improve (1) Previous Episodes (1) Associated Sx: Dizzy, Nausea, Rash, Vom, Aura, Neck stiffness (2) Systemic Sx: Wgt, Appetite, Fever (2) PMH (1) DHx (1) + A (1) FHx (1) SHx: Smoke (1) Alcohol (1) Home/Job (1) Closure (1) DDx - Migraine, Tension, Cluster, Heamorrhage, Meningitis, Temporal Arteritis
Collapse/Falls
WIPER (5) ICE (2) PC: Establish (1) Witness (1) Doing (1) Conciousness (1) Duration (1) Pre-Ictal (1) Post-Ictal (1) Seizures/Fits (1) Tongue biting/Incontinence (1) Injuries from collapse (1) Previous Episodes (1) Systemic Sx: Fever, Wgt, Appetite (2) PMH (1) DHx (1) + A (1) FHx (1) SHx: Smoke (1) Alcohol (1) Home/Job (1) Closure (1) DDx - Vasovagal, Epilepsy, Postural Hypotension, Arrythmias, CVA, Aortic Stenosis, Mechanical, Drug/Alcohol induced
Memory Loss
WIPER (5)
ICE (2)
PC: Establish (1) Ante/Retrograde (1) Onset (1) Duration (1)
Previous Episodes (1)
Triggers (1)
Preceding Head Trauma (1)
Associated Neuro: Parasthesia/Weakness/Speech/Visual/Headache (2)
Mental Health (1) Depression (1)
Other Psych: Hallucinations/Delusions (1)
Caused danger? (1)
Systemic Sx: Fever, Wgt, Appetite, infections (2)
PMH (1)
DHx (1) + A (1)
FHx (1) Dementia? (1)
SHx: Alcohol (1) Smoke (1) Home/Job (1)
Vascular RF: Cholesterol/HTN/DM (1)
Closure (1)
DDx - Dementia: Az, Vascular, Ley-body. Delirium: Infection, CVA, Dehydration, Thiamine deficiency, MI, Hypoxia
Weakness
WIPER (5) ICE (2) PC: Establish (1) Distribution (1), Altered sensation (1) Onset (1) Duration (1) Previous episodes (1) Associated Sx: Speech, Visual, Headache, Hearing (2) Systemic Sx: Wgt, Appetite, Fevers (2) PMH (1) DHx (1) + A (1) FHx (1) SHx: Smoke (1) Alcohol (1) Home/Job (1) CVA RF: DM/HTN/Cholesterol/Hx/AF (3) Closure (1) DDx - CVA, MS, Trauma, GBS, MS, Thiamine Deficiency, SLE, MND, MG
Groin Lump
WIPER (5)
ICE (2)
PC: Site (1) Onset (1) Pain (1) Varies? (1) Size (1) Unilateral? (1) Irreducible? (1)
Associated w/ phys activity? (1)
Sx of Obstruction: Pain/Vom/Constipation (1)
Hx of previous lumps (1)
Systemic Sx: Wgt, Appetite, Fever, Bone pain (2)
PMH (1)
DHx (1) + A (1)
FHx (1)
SHx: Smoke (1) Alcohol (1) Home/Job (1)
CVA RF: DM/HTN/Cholesterol/Hx/AF (3)
Hernia RFs: Obesity/Cough/Lifting/Constipation (2)
Closure (1)
DDx - Hernia, LN, Lipoma, Abscess
Epistaxis
WIPER (5)
ICE (2)
PC: Freq (1) Both Nostrils? (1) Volume/Duration (1) A&E? (1)
Trauma/Blocked/Anaemia (2)
RF: Anticoags, Bleeding disorders, nasal sprays (2)
Previous surgery/Nose interventions (1)
PMH (1)
DHx (1) + A (1)
FHx (1)
SHx: Smoke (1) Alcohol (1) Drugs; Cocaine (1) Home/Job (1)
Closure (1)
DDx - Trauma, Mucosal Irritation, Septal abnorm, Clotting disorders, Ca
Dizziness
WIPER (5) ICE (2) PC: Spinning/Faint/Fall (1) Freq (1) Severity (1) Duration (1) Triggers: Head movement, Stress, Trauma, Viral (1) Associated Sx: Headache, Vom, Hearing loss, Tinnitus, Ear pain (5) Head injury? (1) Meningitis; Stiff neck/Photophobia (1) PMH (1) DHx (1) + A (1) FHx (1) SHx: Smoke (1) Alcohol (1) Home/Job (1) Closure (1) DDx - Vertigo, BBPV, Vestibular Neuritis
Red Eye
WIPER (5)
ICE (2)
PC: Onset (1) Duration/Progression (1) Triggers (1) unilateral (1), Visual disturbance? (1) Pain (1)
Glasses/Contacts? (1)
Infective contacts (1)
Hx of eye trauma? (1)
Associated Sx: redness, gritty, d/c, rhinnorhoea, sneezing (2)
Previous Episodes (1)
Systemic Sx: Fever, Vom, Ulcers, STIs, Dysuria, Skin changes (2)
PMH (1) Surgical Hx (1)
DHx (1) + A (1)
FHx (1)
SHx: Smoke (1) Alcohol (1) Home/Job (1)
Closure (1)
DDx - Scleritis, Uveitis, Corneal abrasion/ulcer, Subconjunctival heamorrhage, Conjunctivitis
Visual Disturbance
WIPER (5)
ICE (2)
PC: Onset (1) Duration (1) Character (1) Uni/Bilateral (1)
Triggers (1)
Pain (1)
Difficulty adapting to Darkness (1)
Glasses/Contacts (1)
? CVA: headache, neuro, weakness, dysphagia (1)
? GCA: scalp tenderness, jaw cramp (1)
? Retinal detachment: flashes of ligt, floaters, straight lines look curved (1)
? Pituitary lesion: XS growth, wgt, palp (1)
PMH (1) Surgical Hx (1)
DHx (1) + A (1)
FHx (1) (espc glaucoma, DM, vascular disease, CVA, Heart disease, Retinal detachment)
SHx: Smoke (1) Alcohol (1) Home/Job (1)
Closure (1)
DDx - CVA, Pituitary Tumour, Glaucoma, DM
