IMPORTANT QS IN HX TAKING

Asthma

Site
Onset
Character
Radiation
Association
Timing
Exacerbating/Relieving factors
Severity

Onset – when first started? Condition before the onset?

Character – Wheezing?
Pallor?
Association – Fever?
Cough?
Runny nose?
Atopy/eczema?
Exacerbating – Dust?
Cold weather?
Other allergens? Smoke? Perfume? Pets?
Exercise
Drugs; NSAIDS?
Relieving – Relieved by medication?
Treatment history – type of MDI
Who prescribed?
Compliance?
Technique?
Severity – can speak? any cyanosis? Lethargy?
Frequency of attack
How many times visiting the GP / ED?
Any previous admissions?
Nebs

FHx of Asthma

For a known case of asthma

- When was given the dx?
- Who gave the dx?
- Where?
- Any MDI?
- Type of inhaler/steroid dose in microgram (not in puffs)
- Frequency of inhaler
- Effectiveness, any change/progress?
- Who follow-up?
- In between attacks, what happened?

Fits
- Who witnessed?
- Describe the fits
o Limbs erking/spasm
o Uprolling eyes
 o Frothing
o Bowel/bladder incontinence
- What was he doing?
- Duration
- Post-ictal drowsiness
- Any recurrence
- Ever happened before
- FHx of fits

Fever
- Onset
- Intermittent
- Temperature – what thermometer? Technique?
- High-grade/low?
- Tx
- GP visits
- Chills/rigors
* Dengue-prone area?

Vomiting
- When started?
- Volume?
- Vomitus? Blood? Food particle? Water?
- Colour – bile-stained? [green]
- Frequency
- Nausea

Diarrhea
- Onset
- Frequency
- Stool – watery? Colour? Blood? Fresh blood? Clots? Colour?

Cough
- + wheezy  asthma (at night)
- + syncope  increased intrathoracic pressure (+pain +stridor)
- + bovine cough w/ hoarseness  laryngeal inflammation/infection/tumor (croup)
 Neuromuscular disorder (respiratory muscle weakness)
- + moist  chronic bronchitis
- + dry cough  asthma after viral infection
 Interstitial lung disease (eg: idiopathic pulmonary fibrosis)
- + non-productive, centrally painful  pneumonia
- + nocturnal  asthma