Medical Terminology Arabic

Heart/vascular disease

Blood clots/DVT/Thrombophlebitis

Cholesterol or lipid problems

Congenital heart problem (born with)

High blood pressure or hypertension

Murmur or rheumatic fever

Family History of sudden cardiac death

Infections

Chickenpox (Varicella)

Hepatitis A B C Other

C B A

HIV

Malaria

Mono (infectious mononucleosis)

Periodontal Disease/Gingivitis

Sexually Transmitted Infections

Tuberculosis

Measles

Mumps

Rubella

Injuries

Fractures/broken bones

Head injury, serious with loss of consciousness

Orthopedic Problems (e.g. knee, back, joints)

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Respiratory problems

Asthma/ chronic cough/wheezing

Seasonal or environmental allergies/Hay fever

Allergy immunotherapy

Pneumonia

Sinusitis, chronic/surgery

Mental/Emotional Health

Abuse, history of physical, sexual, or other

Anxiety/Panic attacks/PTSD/Social Anxiety

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Attention Deficit Hyperactivity Disorder/ADD

Bipolar

Compulsive exercising

Depression

Drug/alcohol abuse or misuse (see back of sheet)

Food Issues: restriction or overeating

Insomnia (problems sleeping)

Obsessive compulsive

Suicide attempt

Anemia/bleeding disorder/hemophilia

Cancer

Dental surgery other than wisdom teeth Diabetes

Intestinal problems (colitis, Crohns, irritable bowel)

Kidney/bladder/recurrent UTI

Laxative use, habitual

Liver or gallbladder disease

Migraines

Passing out or loss of consciousness

Seizures or epilepsy

Skin diseases (e.g., eczema, psoriasis)

Hearing or Vision Problem (other than lenses)

Stomach problems (ulcer, reflux)

( )

Thyroid or other endocrine conditions

Transfusion of blood/blood product

Other

Family History

Alcoholism

Cancer

Diabetes

Heart Disease

Sudden Cardiac Death

Hepatitis or liver disease

High Blood Pressure

High Cholesterol

Kidney Disease

Other

Mental Illness/Suicide

Stroke/Blood clotting problems

Thyroid problems

Tuberculosis