Symptoms Flashcards
Tiredness causes and associated sx
- Anaemia - SOBOE, dizzy, HA
- Hypothyroidism - constipation, weight gain, cold, menorrhagia
- Depression - mood, early wakening
- Diabetes - polydipsia, polyuria
Headache red flags
- Intracranial bleed - thunderclap, trauma
- Raised ICP - posture / valsalva
- SOL - immunosuppression, focal neuro, >50y
- GCA - scalp tenderness, jaw claudication, visual change
- Glaucoma - visual blur, red eye, halos around lights
- Meningitis - fever, neck stiffness, photophobia, rash
Fit/Fall/Syncope questions
Before - warning, circumstance
During - duration, LOC, movements, incontinence, complexion
After - amnesia, muscle pain, confusion, sleepy, injuries
BGD - prev. episodes, frequency, QoL
Driving
Chest sx
SOB - current vs normal, orthopnoea, PND Cough - productive, trigger, nocturnal Sputum - colour, volume Blood - fresh or in sputum Palpitations - speed, rhythm, ass. sx (dizzy, LOC, SOB)
Abdo sx
Diarrhoea / constipation / vomiting
- how much, often, at night?
- colour, consistency, blood
Weight loss / food intake
Dysphagia - solids/liquids (incl order)
Odynophagia
Reflux
Dyspepsia Red Flags
ALARMS
- anaemia
- loss of weight
- anorexia
- recent onset progressive symptoms
- melaena / haematemesis
- swallowing difficulty
Also - >55y, >4 weeks/relapsing sx, persistent vomiting
Gynae
Discharge - quantity, colour
Bleeding
- type - menstrual, post-coital, intermenstrual, post-menopause
- quantity - pads/tampons, clots/flooding
- pain with blood loss
- anaemia - tired, SOBOE
- thyroid
- pregnant?
2o amenorrhoea (work down body)
- general - WL, stress, diet and exercise
- head - visual problems, headaches
- thyroid - heat intolerance, tremor, palpitations
- torso - hirsutism, acne
- abdomen - pregnancy?
MOSC
- menstrual, obstetric, sexual and contraception / cervical
Orthopaedics / rheum
Back pain
- early am stiffness
- sciatica
- urinary incontinence / retention
- faecal incontinence / constipation
- power / sensation in LL
Joint pain / stiffness / swelling
- worse in am, for how long? - >30m = inflammatory
- better with exercise (inflammatory) or worse (OA)
- sleep disturbance
- loss of function
Bone / tissue / joint injury
- stiffness/swelling
- movement restriction / weight-bearing?
- locking / giving way
- distal weakness, numbness, paraesthesia
Back pain red flags
Cauda equina
- urinary incontinence/retention
- faecal incontinence / constipation
- bilateral leg pain
- severe/progressive neuro deficit
- decreased anal tone / saddle anaesthesia
Infection or cancer
- age <20 or >50y
- weight loss
- fever / night sweats
- recent infection
- cancer history
- injection drugs
- immunosuppression
Fracture
- trauma
- severe central spinal pain
- structural spine abnormality
- spinal tenderness
Spondyloarthropathy
- early am stiffness
- night pain
- worse with rest
Psych
Depression
- core - mood, anhedonia
- bio - sleep, energy, appetite
- future - hopeless, suicidal thoughts / plans
- other - hx of mania
Anxiety
- timing - onset/duration, episodic/constant, triggers, QoL
- somatic sx - palpitations, SOB, chest tight, sweat, dizzy
- Ass. psych - depression, stress, avoidance
- Obsessions / compulsions
- flashbacks, trauma, hyperarousal
- bio - hyperthyroidism, ACS sx
Auditory hallucinations
- voice - who, familiar/unfamiliar, same/different, when
- real / pseudo - i.e. out or inside head
- 2nd/3rd person - to you / about you
- what they say and commands
- risk to self / others
Delusions
- expand and challenge
- risk to self and others
Memory loss (collateral hx)
- short / long-term
- insight and concerns
- functional level
- MMSE
Eating
- BMI
- Sx - avoidance of weight gain, obsessions with appearance, binging / purging
- food diary
- results - menstrual cycle, dental hygiene
- depression, diabetes and thyroid screen
Paediatrics
Diarrhoea and vomiting - inc nappies, fluids, drowsy
Soiling / enuresis
- 1o/2o (2o ?UTI, GE, SCC)
- toilet training
- protest behaviour: stressful life
- soiling - consistency, painful anus
FTT / WL
- growth chart
- input - diet, hunger
- use - energy, activities
- output - wet nappies, stools
- other - chronic cough (CF), recurrent infection (CF PCD, immune), sweating/SOB when feeding (cardiac), behaviour, general health, happiness, parents health
Weight gain
- growth chart, input, use, output
- hypothyroid - growth impaired, delayed puberty, mental slow
- cushings - growth impaired, proximal weak, central obesity
- syndromic - Laurence-Moon (extra digits, intellectually impaired), Prader-Willi (poor muscle tone, distinct facial features, lack of eye co-ordination)
Walking / sitting delay
- age of milestones
- mobility
- hand dominance
- balance or behavioural problems
- neuro sx
Speech delay
- age of milestones
- senses - voice, hearing, vision
- communication - comprehension (follows commands, responds to voice), non-verbal communication (pointing, gestures, facies), social (tantrums, playing)
Puberty - early/late, 1o amennorrhoea, short stature
- testes, breasts, axilla/pubic hair, menarche, height, acne, mood changes
- ICP - visual change, headache
- family puberty / stature history
- sx of other disease - CF, thyroid, anorexia, Crohn’s
Behavioural disorder
- ADHD - poor concentration, hyperactivity
- conduct disorder - hostile, aggressive, cruel
- autism - poor socially, restricted interests, repetitive behaviours, difficulty with emotions
Allergies
- pattern, frequency, duration, persistent/intermittent
- reaction - wheeze, rash, sneezing, itchy eyes, abdomen pain/ diarrhoea, swollen eyes/tongue
- Triggers
- FH of atopy
- home - heating, dampness, pets, smokers, pollutant exposure
Rash sx
Duration, progression, frequency
Site, size, shape
Description - appearance, blisters, blanching
Secondary - itchy/painful, crusting
Better/worse - heat, sunlight, cold, treatment, allergies
Rheum sx
