symptom

confusion / memory loss

dizziness

ask about
abnormal movements
depression
gait disturbances
head trauma
help for daily activities
bathing / dressing
going to the toilet
cooking / feeding yourself
doing laundry
shopping
managing money
incontinence
weakness
head trauma
hearing loss
lightheaded / pass out
positional
spinning around
tinnitus

fatigue / sleepiness

apnea
exercise
refreshed after a nap
snoring
stress
wake up choking / gasping

headache

lacrimation
nasal discharge
muscle tightness
stress
visual disturbances
weakness

loss of consciousness

abnormal movements
context
exercise
pain
postural
trauma
incontinence
lightheadedness
palpitations
postictal
sweating
tongue biting
family history
gait abnormalities
nystagmus
palpitations
relation
movement / resting
OH
abnormal movements
loss of consciousness
numbness
pain
headache / neck / back
speech
tingling
trauma

tremor

weakness

differential
alzheimer
HIV
hypothyroidism
NPH
syphilis
vascular dementia
vitamin deficiencies B1,3,12

work up
CBC
HIV
MRI
THS
VDRL

acoustic neuroma
arrhythmia
BPPV
DHT
labyrinthitis
meniere
seizure
valvular disease
vestibular neuronitis
adjustment disorder
anemia
depression
hypothyroidism
PTSD
sleep apnea
withdrawal
cluster headache
migraine
tension headache
sinusitis / meningitis / vasculitis
SAH
pseudotumor / neoplasia
caffeine withdrawal
trigeminal neuralgia
arrhythmia
orthostasis
neuropathy
dehydration
PE
seizure
valvular disease
vasovagal

audiogram
CBC
EKG / holter
MRI
orthostatic VS
tilt table test
US
VDRL

cerebellar
essential tremor
hyperthyroidism
neoplasia
parkinson
side effect
wilson
CVA
hematoma
migraine
MS
neoplasia
neuropathy
seizure Todds paralysis
TIA

CBC
MRI
TSH
urine toxicology

CBC
glucose
sleep study
TSH
urine toxicology
CBC / ESR
CT
lumbar puncture
MRI

blood gases
CBC
CT
EEG
EKG / holter
electrolytes
glucose
orthostatic VS
tilt table test
US

carotid US
CBC
CK
CT
EKG / holter
EMG
glucose / HbA1c
Ig anti AChR
lumbar puncture
PT / PTT
US

symptom
sore throat

ask about
ear pain
nasal discharge
rash

differential
HIV
infectious mononucleosis
streptococcal pharyngitis
viral pharyngitis

palpitations

anemia / bleeding
context
anxiety
coffee
exercise
DM
heart disease
lightheadedness
sweating
tremor
epistaxis
nasal deformity
wheezing

arrhythmia
hyperthyroidism
hypoglycemia
panic attack
side effect
coffee

cough

asthma
bronchitis
foreign body aspiration
GERD
lung abscess
lung cancer
pneumonia
postinfectious cough
postnasal drip
TB

work up
CBC
HIV
monospot test
rapid strep test
throat culture
CBC
EKG / holter
glucose
TSH
US

CBC
CT
methacholine challenge
PFTs
PPD
serology for Mycoplasma
sputum gram & culture
U Ag for Legionella
X rays

symptom
dysphagia

ask about
fatigue / ice craving
liquids vs solids
heartburn
pain
regurgitation
skin tightness
food poisoning
chicken
hamburger
mayonnaise
rice
LMP
vertigo
eating habits
fiber /fat
jaundice
urine color
stool color

differential
achalasia
DES
scleroderma
neoplasia
peptic stricture

upper GI bleeding

coffee ground ?
context
nosebleed
OH
vomiting

lower GI bleeding

hematemesis ?
dark stool (melena) ?
bright blood ?
eating habits

coagulopathy
esophageal varices
gastritis
NSAIDs
PUD
stress ulcers
angiodysplasia
diverticulosis
meckel
neoplasia

constipation

eating habits

diarrhea

describe
blood / mucus / water
bloating
relieved by defecating / sleep

N&V

ABD pain

cholecystitis
gastroenteritis
food poisoning
hepatitis
pancreatitis
pregnancy
vertigo
appendicitis
cholecystitis
hepatitis
neoplasia
pancreatitis
urolithiasis
side effect

depression
diverticulitis
hemorrhoids
hypothyroidism
low fiber diet
neoplasia
dysentery
food poisoning
gastroenteritis, viral
giardiasis
IBD / IBS
pseudomembranous colitis
travelers diarrhea

work up
barium swallow
+2
CBC / Fe / ferritin / TIBC
CT
endoscopy
manometry
X rays
ALT / AST
amylase / lipase
CBC
electrolytes
hCG
stool culture
US
ALT / AST
amylase / lipase
bb
CT
EKG
ERCP
pelvic exam / rectal exam
US
X rays chest & ABD
ALT / AST
CBC
endoscopy
orthostatic VS
PT / PTT
rectal exam
CBC
rectal exam
NGT
colonoscopy
bleeding scan
angiography
CBC
electrolytes
rectal exam
TSH
X rays
stool
culture
C. difficile toxin
giardia Ag
RBC / WBC
TSH

symptom
hematuria

ask about
initial / terminal / total ?
context
exercise
trauma

discharge

color / odor
itching / pain
tampons / douches

dyspareunia

abuse sexual / domestic

discharge
libido
lubrication
painful menses

erectile dysfunction

libido
nocturnal erections

amenorrhea

nipple discharge
facial hair
hot flashes / vaginal dryness

differential
neoplasia
renal
ureteral
bladder
trauma
urolithiasis
UTI
candida
bacterial vaginosis
physiologic
gonorrhea / chlamydia
trichomona
atrophic vaginitis (menopause)
endometriosis
PID
psychogenic
abuse
depression
organic
atherosclerosis
DM
psychogenic
side effect
blockers
OH
trauma
pregnancy
hypothyroidism
prolactinoma
menopause

work up
BUN / creatinine
CBC / PT / PTT
Urinalysis / UC
IVP
US / CT
cystoscopy
pelvic exam
wet prep
gram & culture
chlamydia LCR
pelvic exam
US
FSH
laparoscopy
CBC
glucose
genital & rectal exam

hCG
TSH
prolactin
pelvic exam

Symptom
limb pain

ask about
redness / warmth / swelling
other joints involved
other symptoms
red eye
mouth ulcers
genital ulcers

differential
migratory
gout / pseudogout / infectious
connective tissue diseases
PMR
seronegative arthropaties
viral arthralgia

back pain

context
exercise
rest
incontinence
numbness
tingling
weakness
body image
palpitations
tremor

disk herniation
muscle strain
neoplasia
spinal stenosis

weight loss

weight gain

abuse

anorexia
HIV
hyperthyroidism
malabsorption
neoplasia
cushing
depression
DM
hypothyroidism

dry skin
edema
hair loss
menses
smoking
does anyone treat you in a way that hurts you ?
is there any threat to your safety at home or anywhere else ?
would you like to tell me about the bruises on your arms ?

work up
CBC
ESR
arthrocentesis
auto Ig
ANA / RF / dsDNA / Sm
uric acid
X rays
EMG
MRI
X rays

CBC
electrolytes
HIV
TSH
urine toxicology
CBC
dexa suppression test
glucose
TSH
urinary cortisol
CBC
cervical culture
CT
hCG
HIV
PT / PTT
skeletal survey
VDRL
wet prep