1. Hx & Ex introduction
Ghassan A. Barayan

2. What is the doctor work
Ghassan A. Barayan

3. Diagnosis
Ghassan A. Barayan

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

5. 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

6. 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

7. 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

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

9. Chief complaint + duration
In patient words
Ghassan A. Barayan

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

11. 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

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

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

14. Allergy
Food
Medication
Animals
Etc.
Ghassan A. Barayan

15. Drugs
Name
Dose
Frequency
Side effects
Ghassan A. Barayan

16. 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

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

18. Systemic Review CVS Respiratory GIT Genitourinary Hematology
Rheumatology
Endocrine
CNS

19. 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

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

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

22. (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

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

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

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

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

27. 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

28. 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

29. 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

30. 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

31. 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