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Case Taking Proforma Respiratory System
Case Taking Proforma Respiratory System
Presenting Complaints:
Duration
Mode of onset
Paroxysmal
Dry / productive
Postural / diurnal
Aggravating / reliving factors
Associated factors - chest pain, syncope
Sputum:
Hemoptysis:
Duration
Episodes
Fresh or altered blood
Associated with purulent sputum or food particles
Breathlessness:
Duration
Onset
Grade
Progression
Aggravating/relieving factors
PND/orthopnea
Chest pain:
Duration
Site
Mode of onset
Nature - pricking/stabbing
Severity
Radiation
Postural variation
Aggravating or relieving factors
Associated with food intake
Associated with nausea, vomiting
Negative History:
Past History: