Review of Systems

Question 1

General

Answer 1

Fever, chills, weight change, weakness, fatigue

Question 2

Skin

Answer 2

Rashes, lumps, sores, itching, dryness, CIC, change in hair/nails

Question 3

Vision

Answer 3

tearing, double, blurred, spots

Question 4

Hearing

Answer 4

tinnitus, vertigo, infection, discharge

Question 5

Nose

Answer 5

Colds, stuffiness, discharge, nosebleed, itching

Question 6

Throat

Answer 6

Teeth/gums, sore tongue, dry mouth, sore throat

Question 7

Neck

Answer 7

Goiter, pain, stiffness, CIV

Question 8

Pulmonary

Answer 8

Cough, SOB, wheezing, dbp, sputum

Question 9

CV

Answer 9

Palpitations, chest pain, swelling, syncope, murmur

Question 10

GI

Answer 10

Dysphagia, Nausea, COB, stool color, constipation

Question 11

GU

Answer 11

Frequency, Polyuria, Nocturia, Pain, Flank pain

Question 12

MSK

Answer 12

Cramps, stiffness, arthritis, limitation, trauma

Question 13

Neuro

Answer 13

Change in mood, attention, speech, tingling, dizziness

Question 14

Hem

Answer 14

Anemia, bruising, bleeding, slow healing, clots

Question 15

Endo

Answer 15

Hot/cold interolerance, sweating, hunger, thirst, hair growth