WEIGHT LOSS

ANY OTHER CONCERN: ANY THING THAT IS WORRYING YOU MIGHT BE CAUSING IT

NATURE OF WT LOSS: AMOUNT, DURATION, INTENTIONAL, APPETITE, CONCORDANCE WITH CHNGE IN

DIET+PHYSICAL ACTIVTY OR LIFESTYLE

ALARM SYMPTOMS: EARLY SATIETY, DYSPHAGIA, TUMMY PAIN, CHANGE IN BOWL HABIT
(DIARRHEACONSTIPATION,PALE STOOLS),BLOOD IN STOOL,COUGH WITH HEMOPTYSIS ,BONY
PAINS,ENDOCRINE (THYROID+ADDISON )

NUTRITIONAL STATUS: NO OF MEALS+SNACK/24 HOURS, DIET CONTAIN MEAT+DAIRY PRODCT, WHO COOK
,WETHER FINISH PORTION OR NOT,ANY NUTRITIONAL +VITAMIN SUPPLMNT,ANY DIETRY CONSULTXX

PSYCOLOGICAL ISSUES: HOW HAS YOUR MOOD BEEN OVER RECENT WEEKS, ANY FLUCTUTATION IN WT

PAST MEDICAL: CHRONIC MED CONDITIONS: CCF,CRF,T2DM,COPD,PUD,PANC COND,CROHN,PERIPHERAL

VAS DISEASE
PAST SRGICAL +FAMILY HX: GUT SURGERIES + FAMILY HX OF CANCERS

MEDICATIONS: EFFECT ON APPETITE (SSRI+LEVADOPA+METFORMIN+DIGOXIN, THEOPHYLLIN), EFFECT ON

GIT =DRY MOUTH (ANT CHOLINERGICS,DIURETICS),DYSPHAGIA ( BISPHOPHONATES,NSIADS),NAUSEA
(DIGOXIN ,METFORMIN+IRON ),PANCREATITIS (AZTHIPRINE,HIV DRUGS,THAIZIDE ,FLAGYL),RECREATIONAL
DRUGS ( COAIN+AMPHETAMINES )

SOCIAL ISSUES: DRINK+ALCOHAL +TRAVEL (HIV+GAIRDIA+TB)

ABDOMINAL PAIN .DYSPEPSIA

LOCATION : EPIG.APUD+PANCREATIC/RUQ-BIIALRY/LLQ-COLONIC
QUALITY AND INTENSITY: COLICKY VS OTHER
RADIATION : TO BACK -PANCREATIC,R SHOULDER-GALL BLADDER
AGG FACTR /ALLEVAITING FACTROS : FOOD /EMPTY SOTMACH/BOWL MOVEMENTS/RX
ASSOCIATED : REFLUX SYMPX(RETROSTERNAL BURNING ,ACID BRASH ,WORSE ON LYING FLAT –GERD
),EXERTIONAL DYSPNEA ,OR CHEDT PSIN
EXXCLUDE CARDIAC VS GERD VS PANCREASE VS BILIARY VS COLONIC
 NOCTURNAL SYMPTOMS (SLEEP POSTURE, LATE DAY EATING )

EXXLUDE `ALARM FEATURS:

DEWJAV PREVIOUS: DYSPHAGIA, EARLY SATIETY,WT LOSS,JAUNDICE,ANEMIA,VOMITING,PREVIOUS GSTRIC
ISSUES

PAST MEDICAL: GASTRIC ,PANCREATC,BIILIARY ,COLONIC ISSUES/CANCERS/HXX OF

ANEMIA,HYPERLIPIDEMIA,

MEDICATIONS: ANY PPI USE BEFORE ,COMPLIANCE,DRUGS CAUSING GERD

(NITRAT,CCB,BISPHOSPHONATES,THEOPHYLLIN ) ,DRUGS CAUSING GSTRIC ISSUE
(NSAIDS,STEROIDS,BISPHOPHTS) ,DRUGS CAUSING PACNREATITIS ( AZATHIOPRINE,HIV DRUGS,LOOP AND
THIAZIDE DIURETICS )

SOCIAL ISSUES : ALCOHAL ,SMOKING ,LIFESTYLE ,OBESITY

IMPACT OF SYMPTOMS ON LIFE,JOB ETC

Change in bowl habit : what is the trouble with your bowl habits -diarrhea ( >200 GM/DAY STOOL/VERY
LOOSE STOOL ) /constipation(<3 BM /WEEK)  can you tell me exactly what do u mean by
constipation/diarrhea/loose stool --how is diff. from your normal bowl habits WHAT IS YOUR NORML
BOWL HABIT ( HOW OFTEN YOU OPEN YOUR BOWL IN AVG WEEK

CONSTIPATION:WHAT DO U PASSSTOOL HARD /SOFT DOES IT HURT WHEN U PASS IT ANY BLOOD IN
STOOL /TOILET AFTER FINISH,STILL HABE THE FEELING TO OPEN BOWLS -ARE YOU STILL PASSING WIND
DO YOU EVER LOOS CONTROL OF YOUR BOWLS. R/O DEFECATORY DISORDER :SENSITIVE QS1.DO YOU
EVER HAD DIFF PASSING SOFT AS WELL AS HARD STOOLS 2.DO YOU EVER FIND IT DIFF TO RELAX IN ORDER TO
PASS STOOLS 3.DO YOU EVER NEED TO PUT FINGER IN YOUR back passage TO HELP YOU PASS STOOL

DIARRHEA:
OCDPAE
QUALITY :WATERY : LARGE VOLUME ( SECRETORY),MOD VOLUME ( OSMOTICM)
BLOOD DIARRHA+ TUMMY PAIN :INFLAMMATORY
PALE GREASY STOOL ;WT LOSS- MALABSORPTION
URGENCY :PROCTITIS
ANY NIGHT SYMPTOMS
IMPACT ON JOB AND TRAVEL(ANY PAD DURING TRAVEL)
RELIEVING FACTR:AGGROVTING FACTRS ( FOOD : CELIAC VS LACTOSE )
ASSOCIATED SYMPTOMS:1.ABDOMINAL SYMPTOMS ( N,V,DYSPHAGIA,REFLUX,TUMMY PAIN,WT LOSS),2.
EXTRAINESTINAL SYMPTOMS ( JOINT PAIN ,RASH ,EYE ,ORAL ULCERS),SYSTEMIC ( FEVER
,FATIGUE,LUMPS+BUMPS)
 ANY RECENT RX ( ANTIBIOTIC WITHIN 2 MONTHS ) ,ANY RECENT CONTACT WITH ILL,RECENT FOOD FROM
OUTSIDE ,TIME B/W FOOD AND SYMPTOMS ( <6HR STAPH,8-14 HR  CLOS PERFRINGS,>14 HR VIRAL)

PAST MEDICAL: CONSTIPATION : HYPOTHY+INC CA+PREVIOUS SPINALCARD SURGERY +DIVERTICULOSIS,,

DIARRHEA : T2DM,CHR PANCREATITIS,HYPERTHYROID,CELIAC ( AA FOR GRAVE ),SYSTMC SCLEORIS,CAFCINOID

MEDICATIONS ; DIARRHEA (AB+ACE INH+DIGOX+SSRI+STATIN+PPI+LAXA+MG)

SOCIAL ISSUES :ALCOHAL(PANCREASE ) /SMOKING ( CROHN FLARE )/DIETRY /HIV R/F/ANAL INTERCOURSE