Taking a History - general

Question 1

What are the components of a history?

Answer 1

history of presenting complaint
chunk and check
past medical history
drug and allergy history
family history 
social history
chunk and check
systemic enquiry
summarise

Question 2

What is involved in the HPC?

Answer 2

start with an open question, allow them to speak
facilitate expansion
onset - (if they fell make sure you find out how and why)
duration/course
severity
intermittent or continuous
precipitating factors
relieving factors
previous episodes
pain
ICE

Question 3

what is involved in the PMH?

Answer 3

present complaint specific
other medical conditions
surgical history
acute hospital admissions

Question 4

what is involved in the drug history?

Answer 4

pc specific medications
regular medication
contraception
over the counter/herbal remedies
allergies

Question 5

what is involved in the family history?

Answer 5

PC specific
contact with people who are unwell
parents in good health? - what did they die of?
hereditary/significant conditions?

Question 6

what is involved in the social history?

Answer 6

smoking - how long, how many
alcohol - type, volume, frequency
recreational drugs
diet
exercise
daily activities
living situation
occupation
hobbies
travel

Question 7

what is involved in the systemic enquiry?

Answer 7

CV - chest pain, palpitations, dyspnoea, syncope, orthopnoea, oedema
Resp - dyspnoea, cough, sputum, wheeze, haemoptysis, chest pain
GI - appetite, nausea, vomiting, indigestion, dysphagia, weight loss, abdominal pain, bowel habit
Urinary - volume, frequency, dysuria, urgency, incontinence
CNS - vision, headache, motor/sensory, LOC, confusion
MSK - pain
Dermatology - rashes, skin breaks, ulcers, lesions