Systems review

Question 1

What would you ask about in a respiratory history?

Answer 1

• Cough +/- sputum
• Haemoptysis
• SOB
• Wheeze
• Sinusistis/blocked nose
• Nasal discharge
• Facial pain
• Reduced smell
• Earache
• Chest pain

Question 2

What would you ask about in a cardivascular history?

Answer 2

• Chest pain
• SOB - PND, orthopnoea, exertional
• Palpitations
• Varicose veins
• Ankle swelling
• Claudication

Question 3

What would you ask about in a GI history?

Answer 3

• Appetite/weight loss
• Mouth/teetch/tongue
• Dysphagia
• Dyspepsia/Heartburn
• Nausea/vomiting/haematemesis
• Fat intolerance
• Jaundicce
• Abdo pain
• Bloating/distention
• Bowel habit
• Perianal symptoms

Question 4

What would you ask about in a GU history?

Answer 4

• Frequency
• Urgency
• Dysuria
• Nocturia
• Volume
• Incontinence
• Haematuria
• Males - prostatic symptoms + ED

Question 5

What would you ask about in a neuro history?

Answer 5

• Fits/faints/LOC
• Headache
• Cognitive impairment
• Memory loss
• Dizziness/vertigo
• Balance
• HEaring
• Speech
• Vision - acuity/diplopia
• WEakness
• Numbness/tingling/paraesthesia

Question 6

What would you ask about in an obs/gynae systems review?

Answer 6

4 P’s

• PV bleeding
• PV discharge
• Pain
• Pregnancy

Question 7

If a woman was pregnant on systemic enquiry, what would you ask them?

Answer 7

• Foetal movements
• Contractions
• PV loss
• Pre-eclampsia symptoms - headache, visual disturbance, epigastric pain, oedema

Question 8

What would you ask as part of a rheumatological systems enquiry?

Answer 8

• Joint - pain, stiffness, swelling
• Skin - rashes, ulcers, raynauds
• Hair loss
• Eyes - red, dry
• Mouth - dry
• Chest - breathless
• GI - IBD symptoms
• GU - discharge

Question 9

What would you ask as part of an orthopaedic systems enquiry?

Answer 9

• Joint/bone/tissue - pain, stiffness, swelling, ROM, weight bearing
• Mechanical symptoms - locking, giving way
• Neuro symptoms distally - numbness, weakness, paraesthesia

Question 10

What would you ask about as part a systematic enquiry for a skin problem?

Answer 10

Use SOCRATES/temporal questions to explore each

• Pain
• Itch
• Bleeding
• Discharge
• Blistering
• Systemic symptoms – fever / malaise / weight loss / arthralgia
• Contact history/triggers
• Sun exposure (including sunbed use)

Question 11

What would you ask about as part of a systemic enquiry for an eye problem?