A patient presents to ED with chest pain and this trace. What would you do?
Interpretation management
A full systems review is not necessary for every patient. You should only review systems relevant to the presenting complaint with the aim of identifying/excluding significant associated features. For example, for left iliac fossa pain, a complete history will include questions about gastrointestinal, urological and, if female, obstetric and gynaecological systems. In addition, some questions within each system review will be more or less relevant depending on the presenting complaint, and you do not have to ask them all. You must also go on to ask further symptom-specific questions for each positive symptom (see exploring symptoms).
The 4 P’s:
You are taking a history from a patient with breathlessness. What system review questions would you ask?
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What would be in your differential diagnosis for breathlessness? Ensure you structure your answer!
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A patient who is 30 weeks pregnant presented with lower abdominal pain. You are taking the history. Which systems review questions would you ask?
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