ASSOCIATED SYMPTOMS abd

ABDOMINAL, GI, GU, OBGYN

Description sudden or gradual, Cab Cod

L I Q ODPRTC C/I R, AGG, ALL, ASSOCIATED, RAMP HIS FOSS (NIC GUS
WADESST.

CASES
ABDOMINAL GENERAL ASSOCIATED:
COLOR, FREQUENCY, AMOUNT, VOLUME, AB PAIN, BLOATING, WEIGHT,
APPETITE, DIET, EXERCISE, PALPITATIONS, COLD INTOLERANCE, FIBER,
FLUIDS, ANTIBIOTICS, TRAVEL, CAMPING, HIV, AB SURGERY, DM,
PANCREATITIS, ETOH, DRUGS, COLON CANCER FAMILY HISTORY, BOWEL
OR BLADDER CHANGES. FEVER, INFECTIONS, PAIN ELSEWHERE WITH OR
WITHOUT FOOD, N, V, D, C, CHEST PAIN, FATIGUE, YELLOW
DISCOLORATION. WHAT HAPPENS BEFORE, DURING AND AFTER.
RELATIONSHIP TO MENSES, LPS, LMP, GRAVA, PARA, AND GO OBGYN
ROUTE.

Blood in stool: color, dark or red, amount, in table spoons, duration, ab pain, rectal pain,
spasm, c, d, trauma, history of colonoscopy, warfarin use, easy bruising, or vascular
disease, straining on defecation.

CONSTIPATION: DIARRHEA, NAS, VOMIT. GENERAL ASSOCIATED

DIARRHEA: CONSTIPATION, NAS, VOMIT. PLUS THE ASSOCIATED LISTED

DYSPHAGIA: ONSET, DURATION, PROGRESSION, DROOLING, WEIGHT LOSS,

SOLIDS LIQUIDS, WHAT COME FIRST, HEARTBURN, REGURGITATION,
HOARSENESS, DRY COUGH, SORE THROAT, CHEST PAIN, SOUR TASTE,
CHEST BURNING, PAIN WITH SWALLOW, NUMBNESS, TINGINGLING, COLD
INTOLERANCE, FATIGUE, FOOD CRAVINGS, SMOKING HISTORY.
WORK UP: CBC, CXR, ENDOSCOPY WITH BIOPSY, BARIUM SWALLOW, CT
CHEST
PHYSICAL EXAM: HEENT, HEAD AND NECK, AB, SKIN

HEMATURIA: amount, duration, blood clots, pain in hips, pain in groin, kidney stones,
pain with urination, vigorous exercise, trauma, smoking, hx of stones, easy bleed, abd
pain, weight, appetite, fever, if a male also include the above questions
NAUSEA: VOMIT, DIARRHEA, CONSTIPATION. ABD PAIN, w/or w/o food, preg,
headache, stiff neck, vertigo, numb weakness, chest pain, weight appetite, fatigue,
describe the vomit “ “

VOMITING: DIARRHEA, CONSTIPATION. “ ‘

URINARY SYMPTOMS male: duration, hesitancy, stream, incomplete bladder,

straining, post void dribble, urgency, frequency, nocturia bone pain, uti, meds, urethral
stricture, burning, weight loss, fatigue, discharge,

Weight gain: onset, amount, cold intolerance, skin/hair changes, voice changes,
constipation, appetite, fatigue, depression, sleep cycle (fall, stay, multiple awakening,
early rising) fever, chills, chest pain, sob, ab pain, diarrhea, lmp, frequency, changes,
pads, menarche, lps, pregnancies, births,

Weight loss: amount, duration, intentional, diet history, body image, anxiety, sexual
history, depression, palpitations, tremor, d, c, n, v, appetite, thyroid disease, hiv risk,
etoh, drugs, meds, history of cancer, any pain anywhere

OBGYN

Work up: OBGYN cbc urine analysis, pelvic exam, breast exam, urine hcg, tsh,
prolactin, lh/fsh mri brain, cervical cultures, us pelvis, glucose, biopsy, electrolytes, hiv
antibody
Pain with sex: duration, timing, vaginal discharge, rash, painful period, ab pain, n, v, d,
c, hot flashes, lubrication, libido, trauma, violence, hx of pid, endometriosis, lmp, lps,
menarche, menses cycle, pregnancies, live birth, birth control, sexual protection,

Bleed: all the above plus: urinary symptoms, pre or post mena pause, trauma, warfarin,
ocp, bleeds, bruises, lps, lmp, amount of blood, how many pads or tampons, now versus
then, clots, back pain, leg pain,

Amenorrhea: durations, preg, headache, vision, hair loss or hair growth, facial hair
growth, deep voice, acne, increased muscle strength, vaginal dryness, weight, appetite,
palpitations, weakness, numbness, hot cold intolerance, fatigue, tremor, hot flashes

PHYSICAL EXAM: ALL ABOVE CASES

1. heent (ent) perrla, eomi
2. neck thyroid and lymph nodes
3. cv
4. pul
 5. inspect extremeties,reflexs
6. abd- inspect, aus, palpate, murphys, rovings, rebound, psoas, obturator, cva
tenderness

WORK UP ABD: DIGITAL RECTAL, CBC, STOOL FOR O+P, FOBT AND WBC,
tsh, electrolytes, b12, vit d, ct ab and pelvis, UA, URINE culture, ast, alt, u/s pelvis, tsh,
colonsoscopy, bun/cr, urethral culture, psa, u/s renal,