Review of The Systems.pptx

Review of thesystems

Dr. Made Ratna Saraswati, SpPD

Wednesday, 13 Oct 2010

Review of the system mayuncover problems that thepatient has overlooked,particularly in areas unrelated topresent illness.

Review of the systems questionoften challenin!

askin a series of question

from head to toe.

"ome clinicians do the review ofthe systems durin the physicale#amination, askin about ears,for e#ample as they e#aminethem.

"tandard series of review$of$systemquestions

%eneral

"kin

&ead, eyes, ears, nose, throat '&(()*+!

)eck

reast

Respiratory

-ardiovascular

%astrointestinal

eripheral vascular/rinary

%enital

usculoskeletal

sychiatric

)euroloic

&ematoloic

(ndocrine

General!

/sual weiht, recent weihtchane, any clothes that fit moretihtly or loosely than before.

eakness, fatiue, or

ever

Skin!

rashes, lumps, sores, itchin,dryness, chanes in color

chanes in hair or nails

chanes in sie or color of moles

Head, eyes, ears, nose, throat(HEE!"!&ead! headache, head in4ury, diiness, lihtheadedness

(yes! vision, lasses or contact lenses, last e#amination, pain,redness, e#cessive tearin, double or blurred vision, spots,specks, flashin lihts, laucoma, cataracts.

(ars!hearin, tinnitus, vertio, earaches, infection, dischare.5f hearin is decreased, use or nonuse of hearin aids.

)ose and sinuses! frequent colds, nasal stuffiness, dischare,or itchin, hay fever, nosebleeds, sinus trouble

 *hroat 'or mouth and pharyn#+! condition of teeth and ums,bleedin ums, dentures, if any, and how they fit, last dentale#amination, sore tonue, dry mouth, frequent sore throats,hoarseness.

e#k !

swollen lands, oiter, lumps,pain, or stiffness in the neck

$reast!

lumps, pain, or discomfort, nippledischare, self e#aminationpractices

Respiratory!

-ouh

"putum 'color, quantity+

&emoptysis,

6yspnea

heein,

leurisy

7ast chest #$ray.

 8ou may wish to include asthma, bronchitis,emphysema, pneumonia, and tuberculosis

%ardiovas#&lar!heart trouble

hih blood pressure

rheumatic fever

heart murmurs

chest pain or discomfort

alpitations

dyspnea, orthopnea, paro#ysmal nocturnaldyspnea

(dema

result of past electrocardiorams or othercardiovascular test.

Gastrointestinal!trouble swallowin, heartburn, appetite, nausea.

owel movements, stool color and sie, chane inbowel habits, pain with defecation, rectal bleedinor black or tarry stool, hemorrhoids, constipation,diarrhea.

9bdominal pain, food intolerance, e#cessivebelchin or passin of as.

 :aundice , liver, or allbladder trouble, hepatitis.

Peripheral vas#&lar!

intermittent claudication, lecramps, varicose veins, past clotsin the veins, swellin in calves,les, or feet,

color chane in finertips or toesdurin cold weather,

swellin with redness ortenderness.

'rinary!frequency of urination

polyuria

nocturia

urency

burnin or pain durin urination

hematuria

urinary infections

kidney or flank pain

kidney stones

ureteral colic

suprapubic pain, incontinence

in males! reduced caliber or force of the urinary stream,hesitancy, dribblin

Genital!

ale!

&ernias

dischare from or sores on the penis

testicular pain or masses

scrotal pain or swellin

history of se#ually transmitted disease and theirtreatment.

"e#ual habits, interest, function, satisfaction

birth control methods, condom use and problems

-oncerns about &5; infection

emale!

ae at menarche, reularity, frequency, and duration ofperiods, amount of bleedin, bleedin between periodsor after intercourse, last menstrual period,dysmenorrhea, premenstrual tension

9e at menopause, menopausal symptoms, postmenopausal bleedin.

5f the patient was born before 1<=1, e#posure todiethylstilbestrol '6("+ from maternal use durinprenancy 'linked to cervical carcinoma+.

;ainal dischare, itchin, sores, lumps, se#uallytransmitted diseases and treatments.

)umber of prenancies, number and type of deliveries,number of abortion 'spontaneous and induced+,complications of prenancy, birth$control methods.

"e#ual preference, interest, function, satisfaction, anyproblems, includin dyspareunia. -oncerns about &5;infection.

M&s#&loskeletal!muscle or 4oint pain, stiffness, arthritis, out,

backache.

5f present, describe location of affected 4oints or muscles,any swellin, redness, pain, tenderness,

stiffness, weakness, or limitation of motion or activity,include timin of symptoms 'e.. mornin or evenin+,duration, any history of trauma.

)eck or low back pain.

 :oint pain with systemic features such as fever, chills,rash, anore#ia, weiht loss, or weakness.

Psy#hiatri#!

nervousness, tension, mood,includin depression, memorychane, suicide attempts, ifrelevant.

e&roloi#!

-hanes in mood, attention, orspeech, chanes in orientation,memory, insiht, or 4udment,headache, diiness, vertio,faintin, blackouts, seiures,weakness, paralysis, numbness orloss of sensation, tinlin or >pinsand needles?, tremors or otherinvoluntary movements, seiures.

Hematoloi#!

anemia, easy bruisin orbleedin, past transfusions,transfusion reactions.

Endo#rine!

thyroid trouble, heat or coldintolerance, e#cessive sweatin,e#cessive thirst or huner,polyuria, chane in love of shoesie.