Hx & Ex introduction Ghassan A. Barayan

What is the doctor work Ghassan A. Barayan

Diagnosis Ghassan A. Barayan

Role in hospital الإعتناء بالمظهر حسن الخلق الأمانة احترام الزملاء احترام الاكبر التعامل مع الزميلات والممرضات المحافظة على مرافق المستشفى Ghassan A. Barayan

dealing with patients احترام سرية المريض التعاطف مع المرضى أجر عيادة المريض الدعاء له ابداء الاهتمام بمشاكل المرضى وهمومهم الروح الإنسانية في التعامل التواضع الاستئذان و الشكر Ghassan A. Barayan

Breaking the fear الاستعداد الجيد والتحضير لست الوحيد الذي سيخطأ هي الخطوة الأولى كل دقه بتعليمة لا تخجل من الخطأ عالم جديد تعامل ببساطه وبدون تكلف خذها ببساطة Ghassan A. Barayan

Hx components Personal data Chief complaints History of presenting illness Systemic review Past history Drugs Allergy Blood transfusion Social Hx Family Hx summery Ghassan A. Barayan

Personal data Name Nationality Sex ( M - F ) Age Occupation ?? Admission : ( ER - OPD ) Duration Ghassan A. Barayan

Chief complaint + duration In patient words Ghassan A. Barayan

History of presenting illness Chronic illness Analysis of chief complaint Associated symptoms Related systemic review Previous episodes Ghassan A. Barayan

Pain analysis SDN OPERA S: site & severity D: duration N: nature O: onset P: precipitating factor & Progression E: end R: reliving factor , radiation & referred pain A: aggravating factor & associated symptom Ghassan A. Barayan

Past Hx Past medical: ( DM, HTN, IHD, TB, Asthma ) Previous admissions. Previous important investigations Past surgical: Any previous surgery Ghassan A. Barayan

Blood transfusion Where When Why Complications of transfusion. Amount Ghassan A. Barayan

Allergy Food Medication Animals Etc. Ghassan A. Barayan

Drugs Name Dose Frequency Side effects Ghassan A. Barayan

Social Hx Smoking : “pack year= no. of cigarettes per day × years of smoking “ Alcohols Drugs abuse Marriage & any sexual contacts. Occupation Education Financial Living : place & type Travel Animal contacts Ghassan A. Barayan

Family Hx Similar disease Other disease : cancer - IHD Death in young age relative Ghassan A. Barayan

Systemic Review CVS Respiratory GIT Genitourinary Hematology Rheumatology Endocrine CNS

CVS Chest pain or heaviness Dyspnea ( extertional – orthopnea - PND) Palpitation ( rate-regularity-time) Syncope Fatigue Intermittent claudication Cyanosis Cold extremities Ankle swelling Ghassan A. Barayan

Respiratory sys. Chest pain Cough Sputum Hemoptesis Dyspnea Wheezing Strider Night sweat Fever Hoarseness Sore throat Nasal discharge Ghassan A. Barayan

GIT Appetite Weight change Lethargy Water brash Heart burn Acid regurgitation Dysphagia Odinophagia Nausea Vomiting hematemesis Ghassan A. Barayan

(constipation , diarrhea, alternative) stool: color, consistency, bulk Jaundice Pruritis Color of stool & urine Abdominal pain Abdominal swelling Bowel habit change (constipation , diarrhea, alternative) stool: color, consistency, bulk Bleeding (melena, hematochezia) Anal pain or hemorrhoid Ghassan A. Barayan

Urinary Upper UT: High fever Chills Mass Hematuria Pain ( flank – lion –groin) Nausea Ghassan A. Barayan

Irritative symptoms “FUNDUS” Frequency Urgency Noctoria Dysuria Lower tact : Irritative symptoms “FUNDUS” Frequency Urgency Noctoria Dysuria Urge incontinence Small void volume Ghassan A. Barayan

overload incontinence anuria Obstructive symptoms Hesitancy straining Disrupted stream terminal Dribbling Incomplete empty overload incontinence anuria Ghassan A. Barayan

Genital Male: Impotance Female: Menses Amount - frequency -regularity -duration- pain - LMP Both: Discharge Rash Ghassan A. Barayan

Hematology Symptoms of anemia Fatigue –palpitation – dizziness -sweating Bleeding tendency bleeding through any orifice (nose- mouth-anus-urethra) Easy bruising Puerpera Thrompotic tendency Infection Fever L.N. enlargement Bone pain Skin rash Weight loss Ghassan A. Barayan

Rheumatology local : joint pain joint swelling morning stiffness loss of function Instability weakness change in sensation deformity myalgia neck pain back pain Ghassan A. Barayan

Rheanoid phenomena “white-red-blue” Dry eye Dry mouth Redness Systemic: rash fever fatigue weight loss diarrhea mucosal ulcer Photosensitivity Rheanoid phenomena “white-red-blue” Dry eye Dry mouth Redness Ghassan A. Barayan

Endocrine Appetite Weight change Change bowel habit Sweating Hair distribution Lethargy Skin change Pigmentation Stature Erectile dysfunction Polyuria Polydepsia Lump in neck ( goiter ) Weather sensitivity Tremor Psychogenic change Menstruation Ghassan A. Barayan

CNS Headache Dizziness Vertigo Vision ( visual failed – acquit) Hearing Smell Speech Taste Swallowing Gait Loss of sensation Motor function Tremor Involuntary movement Sphincter control fits Ghassan A. Barayan