General symptom systemic inquiry

Holistic Hormone Balance

Natural Menopause Relief Secrets

Get Instant Access

It is inconceivable that any patient will require to be asked all the questions that may be important on some occasions. For example, enquiry about contact with birds may be critical in a patient with atypical pneumonia but is a waste of time in many situations. It follows that the choice of questions selected to ensure that the history, as obtained, is sufficiently comprehensive is a matter of clinical judgement. As a general principle, it is important for the clinician to pay particular attention to those diagnostic options which require specific treatment.

During training experience can he obtained from undertaking a thorough general symptom inquiry, asking the patient the 'cardinal' symptoms relevant to each system (see Table LI I), Otherwise, ii is useful to start with an open inquiry such as 'what olher symptoms have you noticed?" or 'tell me about your health in general' (i.e. not "have you any other symptoms'?'). A positive response prccipitatcs an examination of the system cluster - and its layers - as undertaken for the presenting complaint, but usually in less detail.

There are other cues to checking cardinal symptoms in one or more systems:

• when the putative diagnosis for the presenting complaint raises possibilities of disease or disorder in other systems, e.g. a patient presenting with palpitations due to atrial fibrillation may have hyperthyroidism


Alcoholic Myopathy Symptoms

Fig. 1,9 Alcohol-related disorders,


Alcoholic dementia (cortical atrophy)

Subdural haematoma (falls)

Withdrawal convulsions

Delirium tremens



Alcoholic hepatic cirrhosis

Portal hypertension Pancreatitis

Dupuytrens contracture Proximal myopathy Peripheral neuropathy

TABLE 1.11 The general symptom inquiry: cardinal' symptoms if

Genera/ health

If appropriate, mental attitude to sex (libido), morning erections, frequency

General wel-being

of intercourse, ability to maintain erections, ejaculation, urethral





Weight change

If premenopausal, age of onset of periods (menarche). regularity of periods


(e,g, 28-day cycle), length ol period, blood loss (e.g, clots, flooding), date

of last period, contraception if relevant, presence of vaginal discharge

Cardiovascular system

If post-menopausal, bleeding

Ankle swelling

Stress and/or urge incontinence


If appropriate, libido, pain during intercourse (dyspareunia)

Brealhlessness when lying flat (orthopnoea)

Attacks of nocturnal brealhlessness (paroxysmal nocturnal dyspnoea)

Central nervous system

Chest pain or exertion


Pain in legs on exertion


Faints and blackouts

Respiratory system

Tingling (paraesthesiae)

Shortness of breath: exercise tolerance



Muscle weakness


Hearing symptoms (e.g. deafness, tinnitus)

Sputum production (colour, amount)

Chest pain reiated to respiration or coughing


Blood in spulum (haemoptysis)

Appearance of eyes Pain


Disturbance of vision, Including dyplopia

Condition of mouth

Difficulty with swallowing (dysphagia)


Nausea and vomiting

Joint pain or stiffness


Muscle pain or weakness


Abdominal pain


Wetght loss

Heat intolerance

Change in bowel habit

Cold intolerance

Colour of motion (e.g pale, dark, black, fresh blood)

Change in sweating

Prominence of eyes


Swelling in neck

Pain on passing urine (dysuria)

Excessive thirst

Frequency of passing urine by day or night (nocturia)

Abnormal colour of urine (e.g. blood)

Number ot sexual partners


If appropriate age, prostatic symptoms such as difficulty in starting to pass

urine, poor stream, terminal dribbling

Was this article helpful?

0 0
Natural Cures For Menopause

Natural Cures For Menopause

Are Menopause Symptoms Playing Havoc With Your Health and Relationships? Are you tired of the mood swings, dryness, hair loss and wrinkles that come with the change of life? Do you want to do something about it but are wary of taking the estrogen or antidepressants usually prescribed for menopause symptoms?

Get My Free Ebook

Post a comment