Systematic enquiry questions

Question 1

Cardio

Answer 1

Chest pain
Palpitations
Dyspnoea - esp PND, Orthopnoea
Syncope/pre-syncope
Claudication
Varicose veins
Ankle oedema

N&Vs
Fever - pericarditis etc
Fatigue - Heart failure
Weight gain - Heart failure
Pain elsewhere 
(Night) sweats

Question 2

Resp

Answer 2

Cough
Haemoptysis
Sputum
Dyspnoea 
Wheeze
Chest pain

Sinusitis
Sore throat
Earache

Nausea
Fever 
Weight gain 
Weight loss 
(night) sweats
Pain elsewhere

Question 3

GI

Answer 3

Mouth/teeth/tongue
Dysphagia / odynophagia

Nausea & vomiting 
Haematemesis
Dyspepsia 
Appetite change
Jaundice
Abdominal pain
Abdominal distension

Bowel habit:

• Change
• Consitpation
• Diarrhoea
• Blood - malaena or fresh blood
• Mucus
• Steatorrhoea

Perianal symptoms

Systemic:
Weight loss
Fever 
Pruritis (cholestasis, liver problems)
Dizziness
Confusion (hepatic encephalopathy)
Urinary symptoms

Question 4

Neuro

Answer 4

Cognitive impairment (MSQ)
Headache
Dizziness, vertigo
Fits/faints/loss of consciousness 
Balance

Vision - acuity (blurred?), diplopia (double vision?)
Hearing
Speech disturbance

Weakness
Numbness/paraesthesia

SYSTEMIC:

• fever
• N&Vs
• palpitations
• chest pain
• trauma
• +/- aura (headaches)

Question 5

Female Urology

Answer 5

Urinary symptoms:

• frequency - esp nocturia
• dysuria (pain/difficulty)
• volume
• haematuria
• urgency & incontinence
• hesitancy
• flow

Sexual stuff:

• sexually active?
• sexual partners
• contraception
• vulval itching, skin changes, abnormal discharge
• LMP

Systemic:

• pain (pelvic + elsewhere)
• fever
• rigors
• N&Vs
• weight loss
• bowel habit
• +/- bleeding elsewhere

Question 6

Male urology

Answer 6

Urinary:

• frequency
• dysuria
• volume
• haematuria
• urgency & incontinence
• hesitancy
• flow

Sexual:

• sexually active?
• new partners
• contraception etc etc

Systemic:

• pain (pelvic + elsewhere)
• weight loss
• bowel habit
• fever
• rigors
• N&Vs
• +/- bleeding elsewhere

Question 7

Female reproductive

Answer 7

Periods:

• LMP
• cycle - duration, regularity, degree of bleeding, clots
• intermenstrual bleeding
• dysmenorrhagia
• PMB if post menopause

Gynae:

• are they?
• new sexual partners
• contraception
• STIs
• dyspareunia (painful sexy time)
• post-coital bleeds
• vaginal discharge
• vulval skin changes & itching
• last cervical smear

Obs & gynae history:

• gravidity & parity
• terminations
• delivery method (natural, c-section etc)
• any previous gynae disease (polyps etc)

Systematic:

• bowel & urinary symptoms!
• fever
• N&Vs
• weight loss
• pain

Question 8

Paeds

Answer 8

Feeding (food & fluids)
Urine - frequency, colour
Stool - frequency, appearance, blood, mucous
Vomiting
Abnormal weight change

Fever
Rash
Pain

Coryzal symptoms
Cough
Work of breathing - Dyspnoea, wheeze etc

Behaviour
Irritability / crying

Question 9

Psychiatry

Answer 9

Mood
Anxiety / panic symptoms
Confusion / memory problems
Hypochondriacal concerns

Abnormal thought content:

• odd ideas
• paranoia
• obsessions

Perceptual abnormalities / hallucinations

Risk to self (self harm & suicide)
Risk to others
Insight into problem

Question 10

Mental state exam (sections)

Answer 10

Appearance
Behaviour
Speech
Mood
Affect
Thought
Perception