SYMPTOMS causes What to cover in hx Examination INVESTIGATIONS MANAGEMENT

Associated RISK FACTORS TESTS RESULTS EMERGENCY longterm ADVICE ALARMING FOLLOW
symptoms UP
RADIATING MI - SWEATING P MED.HX ECG NORMAL ASPIRIN -BB SMOKING
TO LT - SOB LIFESTYLE TROPONIN WAITING GTN SPRAY (REDUCE EXERCISE
SHOULDER - LIGHTHEADEDNESS FAMILY.HX ROUTINE BLOODS WAITING O2 THE STRAIN ON DIET
OR JAW - NAUSEA, VOMITING -REPEAT TROPONIN HEART) STRESS
- TIREDNESS AFTER 6 AND 12 -ACEI
ANGINA
HOURS BEFORE (REDUCE
DISCHARGE REMODELING)
CHEST PAIN

ON LEANING PERICARDITIS OF FEVER OR NOT -KEEP IN HOSPITAL COLCHICINE →

FORWARD FLU LIKE AVAILABLE TILL RESULTS NSAIDS
SYMPTOMS
Dx of MSK Trauma BRIEF: CHEST INSPECTION, CXR REST,
exclusion Fever, flu like $ PALPATION (PAIN CHEST PAINKILLER
EXPANSION), PERCUSSION,
AUSCALTATION
HEMOTHORAX Trauma CXR
PE
PNEUMONIA
GORD
RT Hepatitis a -TUMMY PAIN FECOORAL Lft, serology, U/S Symptomatic LOOSE CLOTH
HYPOCHOND -NAUSEA, VOMITING ROUTE FOR ↑GGT Pcm SIMPLE FOOD
RIAL PAIN -ITCHING HEP. A.: EATING Stop alcohol
RETCHING -JAUNDICE OUT?, FAMILY
-DIARRHEA HAS THE SAME?

Hepatitis B SEXUAL HX,

HEPATITIS

BLOOD TRANS.,
WORK (nurse)
DRUG ABUSE
Tattoo piercing
Gall stones -surgery hx :gall
bladder surgery
Alcoholic H. -ALCOHOL hx
Hepatocellular -anemia symptoms
carcinoma -weight loss (not
specific)
MI - SWEATING -routine blood -O2 DIET
- SOB -cxr - ACE
- LIGHTHEADEDNESS -ecg -BETABLOCKER
- NAUSEA, VOMITING -cardiac enzymes - DIURETICS
-echocardiogram
MIness postBreathless

PE
COPD
KIDNEY INJURY
PUL. FIBROSIS
Heart faliure ANKLE SWELLING CVD -cxr:
SOB HTN cardiomegaly
COUGH ARRYTHMIA -ecg: Q wave
CHEST PAIN SMOKING
OBLIQUE TIGHTNESS SALTY DIET
DIZZINESS OBESITY
TIREDNESS -medications
HEART RACING compliance
 Night sweats TB Met a friend with the Travel hx -routine blood -ADMISSION: SYMPTOMATIC
CHRONIC Cough old age WT LOSS same symptoms HOMELESS -cxr CURB 65
Travel hx -ECG SCORE
WT loss LUNG CANCER Anaemia symptoms -Smoking -SPUTUM - O2 SYMPTOMATIC
Appetite loss -profession CULTURE -ANTIBIOTIC
hemoptysis (asbestos) (AFTER SALINE
ASTHMA Worse with allergy NEB. OR SYMPTOMATIC
gardening BRONCHO-
PNEUMONIA Fever, URINA ALVEOLAR SYMPTOMATIC
OUTPUT LAVAGE
Heart faliure Cough,SOB lying - SYMPTOMATIC
down
ADDICT PCP (HIV) WT LOSS SEXUAL Low spo2 -routine blood - O2
ORAL THRUSH RECREATIONAL -cxr - ANTIBIOTIC
Tatoo, needle -ABG COTRIMOXAZOLE
-sputum culture - HIV?
COUGH,SOB YOUNG

Night sweats TB WT LOSS CONTACT Rifampicin, No need for

WT LOSS TRAVEL -offer HIV TEST isoniazide, 6 isolation
(NEVER FORCE) months -cover mouth
pyrimidazole, while cough
ethambutol 2 -no sleep
months same room
-no work
LUNG CANCER
ASTHMA
PNEUMONIA FEVER
Wt loss Bronchogenic Cough smoking Routine blood CXR: ROUND HOW TO DISCLOSE CANCER:
Appetite loss carcinoma SOB CXR OPACITY BREAKING BAD NEWS TECHNIQUES:
Weight loss Sputum culture use ICE
Loa Spirometry SUMMERISE EVERYTHING AND THEN ASK SO WHAT DO YOU THINK? ABOUT
Chest pain CT scan WHAT IT CAN BE?
Chest tightness Bronchoscopy? IS IT CANCER?
tiredness WE ARE ALSO SUSPECTING CANCER BUT WE NEED TO DO OTHER INV.
(BRONCHOSCOPY, BIOPSY, CT GUIDED BIOPSY)
Management: 1- in GP and stable→ 2 weeks urgent referral.(multidisciplinary
Hemoptysis old age

team) 2- in Hospital→ admission and investigations

Ask about social history and manage him socially
If he ask about the management: it depends if it’s confirmed where is the cancer
and in what stage so we need to go through all the investigations plan first then
we can decide the management plan
Wt loss mesothelioma Work (asbestos)
Appetite loss
PE
TB
Bronchiectasis
pneumonia
Blood thinner
Resent
instrumentation