Trilingual Tute Phase 1

CLINICAL MEDICINE LONG CASE
HISTORY TAKING IN NATIVE LANGUAGES
SHORTNESS OF BREATH
Personal History
Personal history (Q1)

EN What is your name?
සිං (ඔබගේ) නම ගමොකක්ද?
SI (Obage) nama mokakda?
த உங் களுடை஬ பப஬஭் ஋ன் ன?
TA Ungaludaya peyar enna?
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EN How old are you?
සිං වයස කීයද?
SI Vayasa keeyada?
த வ஬து ஋வ் வரவு ?
TA Vayathu evvalavu?
__________________________________________________________________________
EN What is your occupation?
සිං රැකියාව ගමොකක්ද?
SI Rakiyawa mokakda?
த ப ொழிய் ஋ன் ன ?
TA Tholil enna?
__________________________________________________________________________
EN Where are you from?
සිං ගම ගකොගහද?
SI Gama koheda?
த உங் களுடை஬ ஊ஭் ஋து ?
TA Ungaludaya oor ethu?
__________________________________________________________________________
EN Are you married?
සිං කසාද බැඳලද?
SI Kasaada bandalada?
த திரு஫ண஫் முடி து
் விை்டீ஭்கரொ ?
TA Thirumanam mudiththu vitteerkala?
-1-
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EN How many children do you have?
සිං ළමයි කීගදගනක් ඉන්නවද?
SI Lamai keedenek innawada?
த ஋ ் டன பிர் டரகர் ?
TA Eththanai pillaikal?
Presenting Complaint
__________________________________________________________________________
Presenting complaint (Q7)
EN Why did you come to hospital this time?
සිං ගේ පාර ඉස්පිරිතාගලට ආගේ ඇයි?
SI Me paara ispirithaaleta aawe ai?
த டவ ்தி஬சொடயக்கு வந் நநொக்க஫் ?
TA Vaiththiya salaikku vantha noakkam?
__________________________________________________________________________
History of Presenting Complaint

__________________________________________________________________________
(Q8)
EN For how long do you have difficulty in breathing?
සිං හතිය ගකොච්චර කාලයක් තිගයනවද?
SI Hathiya kochchara kaalayak thiyenawada?
த ஋வ் வரவு கொய஫ொ மூச்பசடுக்க கஷ்ை஫ொ இருக்கு ?
TA Evvalavu kaala maa moochchu edukka kashtamaa irukku?
__________________________________________________________________________
History of presenting complaint? (Q9)
EN How did this begin?
සිං ගකොගහොමද පටන්ගත්ගත්?
SI Kohomada patangaththe?
த ஋ப்படி ஆ஭஫் பிச்சது ?
TA eppidi aarampich chuthu ?
__________________________________________________________________________
EN How did this progressed ?
සිං ගකොගහොමද වැඩි උගන්?
SI Kohomada wadi une?
த ஋ப்படி கூடிச்சு ?
TA eppadi koodichchu?
-2-
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EN How long do you have to walk to get this shortness of breath?
සිං හතිය හැගදන්ගන් ගකොච්චර දුරක් ඇවිද්දම ද?
SI Hathiya hadenne kochchara durak awiddama da?
த ஋வ் வரவு தூ஭஫் நைந் ொ இந் பி஭ச்சிடன வரு஫் ?
TA evvalavu thooram nadanthaa intha pirach chinai varum?
__________________________________________________________________________
EN What are the activities that make you to have difficulty in breathing?
සිං හතිය හැගදන්ගන් ගමොනවා කරාම ද?
SI Hathiya hadenne monawa karaama da?
த ஋ன் ன ஋ன் ன பசஞ் சொ மூச்பசடுக்க கஷ்ை஫் வரு஫் ?
TA enna enna senjaa moochchedukka kashtam varum?
___________________________________________________________________________
Differential Diagnoses
__________________________________________________________________________
Heart failure (Q13)
EN Do you have undue exertional dyspnoea?
සිං වැඩ කරද්දී තරමට වඩා හතිය හැගදනවද?
SI Wada karaddi tharamata wadaa hathiya hadenawada?
த நவடய பச஬் யு஫் நபொது அரவுக்கு அதிக஫ொன மூச்சிட஭ ் ய்
TA Velai seyyum pothu alavukku athikamaka moochchiraiththal varukirathaa?
__________________________________________________________________________
Congestive heart failure (Q14)
EN Do you have difficulty in breathing and cough while sleeping?
සිං රෑට නිදාගගන ඉද්දි හතියයි කැස්සයි හැගදනවද?
SI Raata nidaagena iddi hathiyai kassai hadenawada?
த இ஭விய் தூங் கு஫் நபொது மூச்சு தி
் ணமய் ஌ம் படுகிம ொ?
TA Iravil thoongum pothu moochchuth thinaral etpadukirathaa?
__________________________________________________________________________
Congestive heart failure (Q15)
EN Do you have cough while lying down?
සිං හාන්සි උනාම කැස්ස හැගදනවද?
SI Haansi unaama kassa hadenawada?
த ச஭ிந்து தூங் கு஫் நபொது இரு஫ய் ஌ம் படுகிம ொ?
TA Sarinthu thoongum pothu irumal varukirathaa?
__________________________________________________________________________
Right Ventricular Failure (Q16)
EN Do you have swelling in your legs?
සිං කකුල් ඉදිගමනවද?
SI Kakul idimenawada?
த கொய் வீங் கி இருக்கொ ?
TA kaal veengi irukkaa ?
-3-
__________________________________________________________________________
EN Is this swelling get worse towards the evening?
සිං ඉදිමුම හවස් ගවද්දී වැඩි ගවනවද?
SI Idimuma hawas weddi wadiwenawada?
த ஫ொடயம௃ய் வீக்க஫் கூடுகின் ம ொ
TA Maalayil veekkam koodukinrathaa?
__________________________________________________________________________
EN Do you have pain in the right side of the abdomen?
සිං බගේ දකුණු පැත්ගත් කැක්කුමක් තිගයනවද?
SI Bade dakunu paththe kakkumak thiyenawada?
த வம௃ம் றின் வயப்பகுதிம௃ய் ஌ம் படு஫் வலி உர் ர ொ?
TA Vayitrin valathu pakkam vali ullathaa?
__________________________________________________________________________
EN Do you have severe loss of hunger?
සිං බඩගිනි නැති ගතියක් දරුණුවට තිගයනවද?
SI Badagini nathi gathiyak darunuwata thiyenawada?
த கடுட஫஬ொன பசிம௃ன் ட஫ உர் ர ொ?
TA Kadumayana pasiyinmai ullathaa?
__________________________________________________________________________
(Q20)
EN Have you had any heart attacks in the past?
සිං හෘදයාබාදය (heart attack) හැදිලා තිගයනවද?
SI Hrudayaabaadaya (heart attack) hadila thiyenawada?
த கைந் கொய ்திய் ஫ொ஭டைப்புகர் ஌ம் பை்ை ொ?
TA Kadantha kaalaththil maaradaippu aetpattadhaa?
__________________________________________________________________________
(Q21)
EN Were you diagnosed with any problems in the heart valves?
සිං හෘදවස්තුගේ (heart එගක්) valve වල ප්‍රශ්න තිබිල තිගයනවද?
SI Hrudawasthuwe (heart eke) valve wala prashna thibila thiyenawada?
த இ ஬ வொய் வுகரிய் பி஭ச்சடன உர் ர ொ?
TA Ithaya vaalvukalil pirachchanai ullathaa?
-4-
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(Q22)
EN Did anyone in your family died suddenly at younger age(<40 yrs) due to heart
disease?
සිං පවුගල් කවුරුහරි හෘදවස්තුගේ (heart එගක්) ගලඩ නිසා අඩු වයගස් නැතිගවලා
තිගයනවද?
SI Pawule kauruhari hrudawasthuwe (heart eke) leda nisa adu vayase nathiwela
thiyenawada?
த உங் களுடை஬ குடு஫் ப ்திய் ஬ொ஭ொவது இரவ஬திய் இரு ஬ நநொ஬் கர்
கொ஭ண஫ொக இமந்துர் ரொ஭்கரொ?
TA unkaluday kudum paththil yaaraa vathu ithaya noaikal kaaranamaaka ila vayathil
iranthu ullaar kalaa?
__________________________________________________________________________
COPD (Q23)
EN Are you smoking? (Quantify in packyears)
සිං දුේ ගබොනවද?
SI Dum bonawada?
த புடக பிடிப்பீ஭்கரொ ?
TA Pukai pidip peerkalaa?
__________________________________________________________________________
COPD (Q24)
EN How many cigarretes per day?
සිං දවසට කීයක් ගබොනවද?
SI Dawasata keeyak bonawada?
த ஒரு நொடரக்கு ஋வ் வரவு ?
TA oru naalaikku evvalavu?
__________________________________________________________________________
COPD (Q25)
EN For how many years are you taking cigarettes?
සිං අවුරුදු කීයක් ගබොනවද?
SI Awurudu keeyak bonawada?
த ஋வ் வரவு கொய஫ொக cigarette குடிக்கிறீங் க ?
TA evvalavu kaala maaka cigarette kudik kireenka?
__________________________________________________________________________
COPD (Q26)
EN Do you have cough for a long period of time?
සිං දිග කාලයක් කැස්ස තිබුනද?
SI Diga kaalayak kassa thibunada?
த நீ ண்ை கொய஫ொக இரு஫ய் இருந் ொ?
TA neenda kaalamaaka irumal irundha dhaa ?
-5-
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COPD (Q27)
EN Do you produce sputum?
සිං ගසම එනවද?
SI Sema enawada?
த சரி வரு ொ ?
TA sali varudhaa ?
__________________________________________________________________________
COPD (Q28)
EN Does that shortness of breath get worse intermittently with increased amount of
sputum production?
සිං ගසම ආවම හතිය නිතරම වැඩිගවනවාද?
SI Sema aawama hathiya nitharama wadiwenawada?
த அடிக்கடி சரி வந்து இந் பி஭ச்சடன இன் னு஫் கூடு ொ ?
TA Adikkadi sali vanthu intha pirach chanai kooduthaa ?
__________________________________________________________________________
COPD (Q29)
EN Does this shortness of breath get worse in the nights and the mornings?
සිං හතිය රෑටයි උගද්ටයි වැඩි ගවනවද?
SI Hathiya raatai udetai wadiwenawada?
த இ஭வியயு஫் கொடயயயு஫் மூச்பசடுக்க கஷ்ை஫் அதிக஫ொக இருக்கொ ?
TA iravilayum kaalai layum mooch chedukka kashtam athika maaka irukkaa ?
__________________________________________________________________________
COPD (Q30)
EN Is it releived by taking the inhalers?
සිං උරන ගබගහත් පාවිච්චි කලාට පස්ගස් හතිය අඩුගවනවද?
SI Urana beheth paawichchi kalaata passe hathiya aduwenawada?
த pump பொவிச்ச பிமகு பகொஞ் ச஫் சுக஫ொ இருக்கொ ?
TA Pump paavichcha piraku konjam sukama irukkaa ?
__________________________________________________________________________
Bronchial asthma (Q31)
EN Is it coming intermittently?
සිං හතිය නිතරම තිගයනවද ඉඳල හිටලා එනවද?
SI Hathiya nitharama thiyenawada indala hitala enawada?
த இது விை்டு விை்டு வரு ொ இய் ய ப ொை஭்ந்து இருக்கொ ?
TA ithu vittu vittu varu dhaa illa thodarnthu irukkaa ?
__________________________________________________________________________
EN Is it more in the mornings?
සිං උගද්ට වැඩිද?
SI Udeta wadida?
த கொடயய கூைவொ இருக்கொ?
TA kaalaila koodava irukkaa ?
-6-
__________________________________________________________________________
EN What increases the shortness of breath?
සිං ගමොනවා නිසාද හතිය වැඩිගවන්ගන්?
SI Monawa nisaada hathiya wadiwenne?
த ஋ன் ன ஋ன் ன ் ொய இது கூடுது ?
TA enna rnnath thaala ithu kooduthu ?
__________________________________________________________________________
EN does anyone in your family has asthma?
සිං ගගදර ගවන කාටවත් හතිය තිගයනවද?
SI Gedara wena kaatawath hathiya thiyenawada?
த குடு஫் ப தி
் ய நவம ஬ொருக்கொவது asthma/ இடரப்பு இருக்கொ ?
TA kudumpaththila vera yaaru kkaa vathu asthma allathu ilaippu irukkaa ?
__________________________________________________________________________
EN does anyone in your family has food or drug allergies?
සිං ගගදර කාටවත් කෑම, ගබගහත් විසගවන ගතියක් (allergy) තිගයනවද?
SI Gedara kaatawath kaama, beheth wisawena gathiyak (allergy) thiyenawada?
த குடு஫் ப தி
் ய ஬ொருக்கொவது சொப்பொை்டுக்கு அய் யது ஫ருந்து ஋துக்கு஫்
allergy இருக்கொ ?
TA kaudum paththiila yaarukka vathu saappat tukku allathu marunthu ethukkum allergy
irukkaa ?
__________________________________________________________________________
EN Did you have asthma in your childhood?
සිං ගපොඩි කාගල් හතිය තිබුනද?
SI Podi kaale hathiya thibunada?
த சின் ன வ஬சிய உங் களுக்கு இடரப்பு இருந் ொ?
TA sinna vayasila unkalukku ilaippu iruntha dhaa?
__________________________________________________________________________
EN Does this shortness of breath get worse in the nights and the mornings?
සිං හතිය රෑටයි උගද්ටයි වැඩි ගවනවද?
SI Hathiya udetai raatai wadiwenawada?
த இ஭வியயு஫் கொடயயயு஫் மூச்பசடுக்க கஷ்ை஫் அதிக஫ொக இருக்கொ ?
TA iravilayum kaalai layum mooch chedukka kashtam athika maaka irukkaa ?
__________________________________________________________________________
EN Have you ever used inhalers?
සිං උරන ගබගහත් පාවිච්චි කරලා තිගයනවද?
SI Urana beheth paawichchi karala thiyenawada?
த ஋ப்பவொவது Pump பொவிச்சீங் கரொ ?
TA eppavaa vathu pump paavich cheenkalaa ?
-7-
__________________________________________________________________________
Diffuse parenchymal lung disease (Q39)
EN Non productive cough with minimal sputum
සිං ගසම එනවද?
SI Sema enawada?
த சரி நபொகு ொ?
TA sali poguthaa?
__________________________________________________________________________
EN Is it become worse over the years?
සිං කාලයත් එක්ක දරුණු උනාද?
SI Kaalayath ekka darunu unaada?
த கொய஫் பசய் ய பசய் ய கஷ்ை஫் கூடிக் பகொண்நை நபொகு ொ ?
TA kaalam chella chella kashtam koodik konde poakudhaa?
__________________________________________________________________________
EN Were you working in any factories which produce lot of dust?
සිං ද෕විලි ගගොඩක් තිගයන තැන්වල වැඩ කරාද?
SI Duuwili godak thiyena thanwala wada karaada?
த கனக்க dust வொ஭ இை ்திய நவடய பச஬் றீங் கரொ ?
TA Kanakka dust vaara idath thila velai seireen kalaa?
__________________________________________________________________________
EN Are you taking any medications?
සිං ගබගහත් මුකුත් ගන්නවද?
SI Beheth mukuth gannawada?
த ஫ருந்து ஌து஫் பொவிக்கிறீங் கரொ ?
TA marunthu ethum paavikki reenkalaa ?
__________________________________________________________________________
Connective tissue disorders(esp SLE) (Q43)
EN Do you have joint pain?
සිං හන්දි රිගදනවද?
SI Handi ridenawada?
த joint வலி இருக்கு ொ ?
TA joint vali irukkudhaa ?
__________________________________________________________________________
EN Have you developped rashes on your skin?
සිං හගේ පලු හැදුනද?
SI Hame palu hadunada?
த ந ொலிய rash ஋து஫் வந் ொ?
TA thoalila rash ethum vanthadhaa ?
-8-
__________________________________________________________________________
EN Do oyu have wound inside your mouth?
සිං කට ඇතුගල් තුවාල උනාද?
SI Kata athule thuwaala unaada?
த வொயுக்குர் ர புண் இருக்கு ொ ?
TA vaayukkulla punn irukku dhaa ?
__________________________________________________________________________
EN Are you passing red coloured urine?
සිං මුත්‍රා රතු පාටට යනවද?
SI Muthraa rathu paatata yanawada?
த சிறுநீ ஭் சிவப்பொக நபொகு ொ ?
TA siru neer sivappaaka poakudhaa ?
__________________________________________________________________________
EN Do you see excess foam while you are urinating?
සිං මුත්‍රා කරද්දී ගගොඩක් ගපන එනවද?
SI Muthraa karaddi godak pena enawada?
த சிறுநீ ஭் பப஬் யு஫் நபொது த௃ட஭ அதிக஫் நபொகு ொ ?
TA siru neer peyyum poathu nurai athikam poakudhaa ?
__________________________________________________________________________
Pleural effusion (secondary to TB or bronchial carcinoma) (Q48)
සිං දිග කාලයක් කැස්ස තිබුනද?
த நீ ண்ை கொய஫ொக இரு஫ய் இருந் ொ?
__________________________________________________________________________
EN Are you coughing out blood with Sputum?
සිං කැහැලා ගසමත් එක්ක ගල් ගියාද?
SI Kahala semath ekka le giyada?
த சரியுைன் இ஭ ் ஫் வந் ொ?
TA saliyudan iraththam vantha dhaa ?
__________________________________________________________________________
EN past history of TB
සිං ක්‍ෂයගරෝගය හැදිලා තිගයනවද?
SI Kshayarogaya hadila thiyenawada?
த முன் ன஫் உங் களுக்கு கொச நநொ஬் வந்து இருக்கொ ?
TA munnam unkalukku kaasa noai vanthu irukkaa?
-9-
__________________________________________________________________________
EN Have you had any contact with people with long term cough and very sick?
සිං දිග කාලයක් කැස්ස තිබිල ගගොඩාක් ගලඩ ගවච්ච මිනිස්සු ආශ්‍රය කලාද?
SI Diga kaalayak kassa thibila godak leda wechcha minissu aashraya kalaada?
த ச஭ி஬ொன வரு ் மு஫் இரு஫லு஫் உர் ரவ஭்களுைன் இருந் தீ
் ங் கரொ ?
TA sariyaana varuththamum irumalum ullavar kaludan iruntheen kalaa ?
__________________________________________________________________________
Hematological disease (Q52)
Anaemia ( Refer the anaemia tute)
__________________________________________________________________________
Pancytopenia (Q53)
EN Are you blleeding a lot even for a small wound?
සිං ගපොඩි තුවාගල්කටත් ගල් ගගොඩක් යනවද?
SI Podi thuwalekatath le godak yanawada?
த சின் ன ஒரு கொ஬ ்துக்கு஫் கனக்க இ஭ ் ஫் நபொகு ொ ?
TA sinna kaayath thukkum kanakka iraththam poaku dhaa?
__________________________________________________________________________
Pancytopenia (Q54)
EN Did you see blood after brushing?
සිං දත් මැද්දට පස්ගස් ගල් එනවද?
SI Dath maddata passe le enawada?
த பய் லு மினுக்கின பிமகு வொம௃ய ஭ ் ஫் வந் ொ?
TA pallu minukkina piraku vaayila raththam vanth dhaa ?
__________________________________________________________________________
Pancytopenia (Q55)
EN Have you developped bluish discoloration of skin at the injection sites?
සිං එන්නත් විදපු තැන නිල් පාට ගවනවද?
SI Ennath widapu thana nil paata wenawada?
த ஊசி கு ்தின இை ்திய நீ ய஫ொ rash ஫ொதி஭ி வந்து இருக்கொ ?
TA Oosi kuththina idaththila irunthu neelama rash maathiri vanthu irukkaa ?
__________________________________________________________________________
Pancytopenia (Q56)
EN do you get itching or skin infection so frequently?
සිං නිතරම කසන ගතියක් හරි හගේ ගහොරි හරි හැගදනවද?
SI Nitharama kasana gathiyak hari hame hori hari hadenawada?
த உை஫் பிய ஋ங் நக஬ொவது கடி , பசொறி புண் ஌து஫் இருக்கொ ?
TA udampila enkeyaavathu kadi,sori , punn ethum irukkaa?
__________________________________________________________________________
Pancytopenia (Q57)
EN Do you get cold and diarrhoea very frequently?
සිං ගහේබිරිස්සාව, බඩ යාම නිතර හැගදනවද?
SI Hembirissaawa, bade yaama nithara hadenawada?
த அடிக்கடி டு஫லு஫் , வம௃ ் ொயயு஫் நபொகு ொ ?
TA adikkadi thadumalum vayiththaalayum poakudhaa ?
- 10 -
Complications
__________________________________________________________________________
Heart failure (Q58)
Heart failure - Refer above
__________________________________________________________________________
Acute renal failure (Q59)
EN Are you passing little amount of urine?
සිං මුත්‍රා අඩුගවන් යනවද?
SI Muthraa aduwen yanawada?
த சிறுநீ ஭் பகொஞ் ச஫ொக நபொக்கு ொ ?
TA Siru neer konja maaka poaku dhaa ?
__________________________________________________________________________
EN Do you have bitter taste in your mouth?/
සිං කගේ තිත්ත ගතියක් තිගයනවද?
SI Kate thiththa gathiyak thiyenawada?
த வொப஬ய் யொ஫் கசப்பொக இருக்கொ ?
TA vaayellaam kasappaa irukkaa?
__________________________________________________________________________
EN Have you noticed swelling of your body parts?
සිං ඇගේ ගකොගහහරි ඉදිමුනාද?
SI Ange kohe hari idimunada?
த உை஫் பிய ஋ங் நக஬ொவது வீங் கி இருக்கொ ?
TA Udampila enke yaavathu veenki irukkaa?
__________________________________________________________________________
Arrythmia (Q62)
EN do you feel increase in heart beating?
සිං පපුව ගැගහනවා වගේ දැගනනවද?
SI Papuwa gahenawa wage danenawada?
த பநஞ் சு பை பை ஋ன அடிக்கிம ொ ?
TA nenju pada pada vena adikkira dhaa?
__________________________________________________________________________
Treatment and Investigations upto now

__________________________________________________________________________
(Q63)
EN What are the medications you have been using so far?
සිං ගමච්චර කාගලට ගබගහත් ගමොනවද පාවිච්චි කගල්?
SI Mechchara kaaleta beheth monawada paawichchi kale?
த ஋ன் பனன் ன ஫ருந்துகர் நீ ங் கர் பொவிச்சீங் க ?
TA Ennenna marunthukal neenka paavich cheenka?
- 11 -
__________________________________________________________________________
(Q64)
EN Did you undergo Echo test?
සිං Echo පරීක්ෂණයක් කලාද?
SI Echo pareekshanayak kalaada?
த echo பசஞ் சொங் கரொ ?
TA echo senjaankalaa ?
__________________________________________________________________________
(Q65)
EN Have they taken any x ray of your chest?
සිං පපුගේ X-Ray ගත්තද?
SI Papuwe X-ray gaththada?
த X ray ஋டு ் ொங் கரொ ?
TA X ray eduththaankalaa ?
__________________________________________________________________________
(Q66)
EN Have you undergo any intravascular treatment procedure?
සිං ගල් නහරවල ප්‍රතිකාර මුකුත් කරලා තිගයනවද?
SI Le nahara wala prathikaara mukuth karala thiyenawada?
த ந஭஫் புகளுக்கு உர் ரொக சிகிச்டச அரிக்கப்பை்ை ொ ?
TA narambu kalukku ullaaka siki chchai alikka patta dhaa?
__________________________________________________________________________
(Q67)
EN Have they inserted any stents?
සිං stent දාල තිගයනවද?
SI Stent daala thiyenawada?
த stents நபொைப் பை்ை ொ ?
TA stents poada patta dhaa?
__________________________________________________________________________
(Q68)
EN Have you undergone any bypass operations?
සිං Bypass operation කරලා තිගයනවද?
SI Bypass operation karala thiyenawada?
த bypass operations பச஬் ஬ப் பை்ை ொ ?
TA bypass operations seyya patta dhaa?
__________________________________________________________________________
Social History
__________________________________________________________________________
(Q69)
EN How many people are there in your house?
සිං ගගදර කීගදගනක් ඉන්නවද?
SI Gedara keedenek innawada?
த உங் கர் வீை்டிய் ஋ ் டன நப஭் இருக்கிமொ஭்கர் ?
TA unkal veettil eththanai per irukki raarkal?
- 12 -
__________________________________________________________________________
(Q70)
EN What is your family's monthly income?
සිං පවුගල් මාසික ආදායම කීයද?
SI Pawule maasika aadaayama keeyada?
த உங் கரது குடு஫் ப வரு஫ொன஫் ஋வ் வரவு ?
TA unkalathu kudumpa varu maanam evvalavu?
__________________________________________________________________________
(Q71)
EN What your family members are doing?
සිං පවුගල් අය ගමොනවද කරන්ගන්?
SI Pawule aya monawada karanne?
த ஫ம் மவ஭்கர் ஋ன் ன பச஬் கிமொ஭்கர் ?
TA matra varkal enna seiki raarkal?
__________________________________________________________________________
(Q72)
EN Is your residence a town or a rural area?
සිං ගගදර තිගයන්ගන් ගේ පැත්තකද? ටවුමකද?
SI Gedara thiyenne gam paththakada, tawmakada?
த உங் கரது இை஫் கி஭ொ஫஫ொ ? அய் யது town ஆ ?
TA unkalathu idam kiraamamaa allathu townaa?
__________________________________________________________________________
(Q73)
EN Describe the structure of your house?
සිං ගගය ගැන කියන්න.
SI Geya gana kiyanna.
த வீை்டைப்பம் றி பசொய் லுங் கர் ?
TA veetai patri sollunkal?
__________________________________________________________________________
(Q74)
EN Is it a two story building?
සිං තේටු ගදගක් ගගයක්ද?
SI Thattu deke geyakda?
த நிய ப
் ொை஬ொ அய் யது ஫ொடி஬ொ ?
TA nilath thoadayaa allathu maadiyaa?
__________________________________________________________________________
(Q75)
EN Are there lot of dust in your house and the surrounding area?
සිං ගේ වගේ ද෕විලි ගගොඩක් තිගයනවද?
SI Ge wate duuwili godak thiyenawada?
த உங் கை வீை்ை சு ்தி dust கூை இருக்கொ ?
TA Ungada veetta suththi dust kooda irukka?
- 13 -
__________________________________________________________________________
(Q76)
EN Do you smoke?
SI Dum bonawada?
TA pukai pidip peerkalaa?
__________________________________________________________________________
(Q77)
EN Do you take alcohol?
සිං මත්පැන් ගබොනවද?
SI Mathpan bonawada?
த சொ஭ொ஬஫் குடிப்பீ஭்கரொ ?
TA saarayam kudip peerkala?
__________________________________________________________________________
(Q78)
EN Are you doing regular exercises?
සිං පිළිගවලකට ේ‍යායාේ කරනවද?
SI Piliwelakata wyaayaam karanawada>
த உைம் ை்பம௃ை்சி பச஬் கிறீ஭்கரொ ?
TA udat payit chi, sei ki reer kalaa?
__________________________________________________________________________
(Q79)
EN How often and how long do you do exercises?
සිං ගකොච්චර කාගලකට සැරයක් ගකොච්චර ේ‍යායාේ කරනවද?
SI Kocchara kaalekata sarayak kochchara wyaayam karanawada?
த ஒரு வொ஭ ்திம் கு ஋வ் வரவு ஭஫் ? ஋வ் வரவு நந஭஫்
TA oru vaarath thukku eththanai thadavaikal?
__________________________________________________________________________
(Q80)
EN What do you know about heart diseases?
සිං හෘදවස්තුගේ (heart එගක්) ගලඩ ගැන ගමොනවද දන්ගන්?
SI Hrudawasthuwe (heart eke) leda gana monawada danne?
த இ ஬ நநொ஬் கடர பம் றி உங் களுக்கு ஋ன் ன ப ஭ியு஫் ?
TA ithaya noaikalai patri unkalukku enna theriyum?
__________________________________________________________________________
(Q81)
EN what is the closest hospital to your house?
සිං ගගදරට ළඟම ඉස්පිරිතාගල ගකොගහද?
SI Gedarata langa ispirithaale koheda?
த வீை்டிம் கு அருகிய் உர் ர டவ தி
் ஬சொடய ஋து ?
TA veettukku arukil ulla vaiththiya saalai enna?
- 14 -
__________________________________________________________________________
(Q82)
EN Do you have vehicle at your home?
සිං ගගදර වාහනයක් තිගයනවද?
SI Gedara waahanayak thiyenawada?
த வீை்டிய் வொகன஫் உர் ர ொ ?
TA veettil vaakanam ulla dhaa?
__________________________________________________________________________
(Q83)
EN how long does it take to reach hospital?
සිං ඉස්පිරිතාගලට එන්න ගකොච්චර ගවලාවක් යනවද?
SI Ispiirthaaleta enna kochchara welawak yanawada?
த வீை்டிலிருந்து டவ தி
் ஬சொடய பசய் ய ஋வ் வரவு நந஭஫் ந டவ ?
TA veettil irunthu vaiththiya saalai sella evvalavu naeram thevai?
__________________________________________________________________________
- 15 -
ACUTE CHEST PAIN
Personal History

த உங் களுடை஬ பப஬஭் ஋ன் ன?
___________________________________________________________________________
EN How old are you?
SI Vayasa keeyada?
த ல஬து ஋ல் லரவு ?
__________________________________________________________________________
TA Tholil enna?
__________________________________________________________________________
සිං ගම ගකොගහද?
SI Gama koheda?
__________________________________________________________________________
EN Are you married?
සිං කසාද බැඳලද?
த திரு஫ண஫் முடி து
் விை்டீ஭்கரொ ?
1
__________________________________________________________________________
__________________________________________________________________________
සිං ගේ පාර ඉස්පිරිතාගලට ආගේ ඇයි?
த டல ்தி஬சொடயக்கு லந் நநொக்க஫் ?
__________________________________________________________________________

__________________________________________________________________________
(Q3)
EN How long do you have chest pain?
සිං පපුගේ කැක්කුම ගකොච්චර ගවලාවකට තිගයනවද?
SI papuwe kakkuma kochchara welaawakata thiyenawada?
த ஋ல் லரவு நந஭஫ொக பநஞ் சு லலி இருக்கிமது ?
TA evvalavu neramaka nenju vali irukkirathu?
__________________________________________________________________________
Ch – Character (Q5)
EN What kind of pain is this?
සිං ගමොන වගේ කැක්කුමක්ද?
SI Mona wage kakkumakda?
த ஋ன் ன ஫ொதி஭ி஬ொன பநஞ் சு லலி?
TA enna maathiriyaana nenju vali?
__________________________________________________________________________
Ch – Character (Q6)
EN Is it burning? or constricting?
සිං පිච්ගචනවා වගේද, හිරකරනවා වගේද?
SI Pichchenawa wageda, hirakaranawa wageda?
த திருகுலது ஫ொதி஭ி஬ொ அய் யது ஋஭ிலது ஫ொதி஭ி஬ொ ?
TA thiruku vathu maathi riyaa? allathu erivathu maathi riyaa?
2
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L – Location (Q8)
EN Show me the area where you have pain?
සිං රිගදන තැන ගපන්නන්න.
SI Ridena thana pennanna
த ஋ங் நக லலிக்கிமது ஋ன் று கொை்டுங் கர் ?
TA enke valik kirathu endru kaat tungal ?
__________________________________________________________________________
O- Onset (Q10)
EN Was it starting gradually or suddenly?
සිං ගහමින් පටන්ගත්තද එක පාර පටන්ගත්තද?
SI Hemin patangaththada eka paara patangaththada?
த ஒந஭ அடி஬ொகலொ அய் யது பகொஞ் ச஫் பகொஞ் ச஫ொகலொ லந் து ?
TA Ore adiyaa kawaa allathu konjam konja maaka vaa van thathu?
__________________________________________________________________________
R- Radiation (Q12)
EN Does this pain goes to other parts like left sided jaw, shoulder and medial border of
the left upper limb?
සිං කැක්කුම ගවන තැන්වලට විහිගදනවද? වේ පැත්ගත් හක්ක, උරහිස, වේ අත
පැත්තට?
SI Kakkuma wena thanwalata wihidenawada? wam paththe hakka, urahisa, wam atha
paththata?
த பநஞ் சுைன் கழு து
் , ந ொர் ஫ம் று஫் இைது டகயு஫் லலிக்கிம ொ ?
TA Nenjudan kalu tht thu, thoal matrum idathu kayyum valik kiradhaa?
__________________________________________________________________________
I- Intensity (Q15)
EN How severe is the chest pain? is it unbearable?
සිං පපුගේ කැක්කුම ගකොච්චර අමාරුද? දරාගන්න බැරි තරේද?
SI Papuwe kakkuma kochchara amaaruda? Daraaganna bari tharamda?
த ொங் க முடி஬ொ லலி஬ொக இருக்கிம ொ ?
TA thaanka mudi yaatha vali yaaka iruk kirathaa ?
__________________________________________________________________________
D- Duration (Q18)
EN How long does that pain last?
සිං කැක්කුම ගකොච්චර ගවලාවකට තිගයනවද?
SI Kakkuma kochchara welaawakata thiyenawada?
த லலி ஋ல் லரவு நந஭஫் இருக்கிமது?
TA vali evvalavu neram irukki rathu?
3
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E- Exacerbating factors (Q20)
EN What are the things which increase the pain?
සිං කැක්කුම වැඩිගවන්ගන් ගමොන වගේ අවස්ථා වලදී ද?
SI Kakkuma wadiwenne mona wage awastha waladi da?
த ஋ன் ன பச஬் யு஫் நபொது லலி கூடுகிமது ?
TA enna seyyum poathu vali koodu kinrathu?
__________________________________________________________________________
R- Relieving factors (Q22)
EN What are the things reduce the pain?
සිං කැක්කුම අඩුගවන්ගන් ගමොන වගේ අවස්ථා වලදී ද?
SI Kakkuma aduwenne mona wage awastha waladi da?
த ஋ன் ன பச஬் யு஫் நபொது லலி குடமகிமது ?
TA enna seyyum poathu vali kurai kinrathu?
__________________________________________________________________________
Associated Autonomic features (Q24)
EN Did you have increased sweating?
සිං වැඩිගයන් දහදිය දැේමද?
SI Wadiyen dahadiya dammada?
த அதிக஫ொக வி஬஭்க்கிம ொ ?
TA Athi ka maaka viyark kinra thaa?
__________________________________________________________________________
Associated Autonomic features (Q25)
EN Do you feel vomitish or have you vomitted?
සිං ඔක්කාරයට වගේ ආවද? වමගන ගියාද?
SI Okkaarayata wage aawada? Wamane giyaada?
த லொந்தி லந் ொ ? அய் யது லருலது நபொய இருக்கிம ொ ?
TA vaanthi vantha dhaa? allathu varu vathu poala iruk kira dhaa?
___________________________________________________________________________
__________________________________________________________________________
Myocardial infarction (Q28)
Acute onset tightening type central chest pain, lasts for more than 30 minutes
associated with autonomic symptoms such as sweating (Refer above)
__________________________________________________________________________
Unstable angina? (Q31)
EN Not relieved by rest or GTN?
සිං දිව යට තිගයන ගපත්ත තිබ්බද? ඒකට කැක්කුම අඩු උගන් නැද්ද?
SI Diva yata thiyana peththa thibbada? Ekata kakkuma adu une nadda?
த ஫ருந்ட நொக்கிம் கு கீற் டல ்து஫் லலி குடம஬விய் டய஬ொ ?
TA marun thai naakkitku keel vaith thum vali kuraya villa yaa?
4
__________________________________________________________________________
Unstable angina? (Q33)
Similar to the above but duration may be less
__________________________________________________________________________
Aortic dissection (Q35)
EN Was the pain very severe at the onset and subsided with time?
සිං කැක්කුම මුලින් වැඩිගයන් තිබිල පස්ගස් අඩු උනාද?
SI Kakkuma mulin wadiyen thibila passe adu unada?
த லலி ஆ஭஫் ப தி
் ய் மிக அதிக஫ொக இருந்து பின் பு குடமந் ொ?
TA vali aaram paththil mika athika maaka irun thu pinpu kuraintha dhaa?
__________________________________________________________________________
EN Was it a kind of shearing type of pain?.
සිං ඉරනවා වගේ කැක්කුමක්ද ආගේ?
SI Iranawa wage kakkumakda aawe?
த கு ்திக் கிழிப்பது நபொன் ம லலி஬ொ?
TA
__________________________________________________________________________
EN Do you have uncontrolled hypertension or Marfan syndrome ?
සිං ප්‍ගරෂර් වැඩිගවලා නැත්තේ Marfan syndrome කියන ගලඩක් තිබුනද?
SI Pressure wadiwela, naththam Marfan syndrome kiyana ledak thibunada?
த pressure அதிக஫ொக இருந் ொ ? marfan syndrome இருந் ொ?
TA pressure marfan syndrome athika maaka iruntha dhaa?
__________________________________________________________________________
Acute percarditis (Q39)
Central chest pain
(Refer above)
__________________________________________________________________________
Referred to neck arm or left shoulder
(Refer above)
__________________________________________________________________________
EN Does it decrease with inspiration and lying supine?
සිං හුස්ම ඇතුලට ගනිද්දී සහ උඩ අත බලලා හාන්සි ගවලා ඉද්දි කැක්කුම
වැඩිගවනවාද?
SI Husma athulata ganiddi saha uda atha balala haansi weddi kakkuma
wadiwenawada?
த மூச்சிழுக்கு஫் நபொது஫் சொ஬் ந்து படுக்கு஫் நபொது஫் லலி கூடுகின் ம ொ ?
TA moochchu ilukkum poathum, saainthu padukkum poathum vali koodu kira dhaa?
5
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EN Does it decrease on bending forwards?
සිං ඉස්සරහ පැත්තට නැගමද්දී කැක්කුම අඩුගවනවද?
SI Issaraha patthata nameddi kakkuma adu wenawada?
த குனியு஫் நபொது லலி குடமகிம ொ ?
TA kuni yum poathu vali kurai kinra dhaa?
__________________________________________________________________________
Pulmonary embolism (Q44)
EN Do you have difficulty in breathing?
සිං හුස්ම ගන්න අපහසු ද?
SI Husma ganna apahasu da?
த மூச்பசடுக்க சி஭஫஫ொக இருக்கிம ொ ?
TA Moochchu edukka sirama maaka irukki ra dhaa?
__________________________________________________________________________
EN Have you coughed out blood?
සිං කැහැල ගසම වගේ ගේ ගියාද?
SI Kahala sema wage le giyada?
த சரியுைன் இ஭ ் ஫் லருகிம ொ ?
TA sali yudan iraththam varu kira dhaa?
__________________________________________________________________________
EN Have you experienced clotting of blood inside the vessels?
සිං ගේ නහර වල ගේ කැටි ගැහැල තිගයනවද?
SI Le nahara wala le kati gahala thiyenawada?
த முன் ன஭் நொடிகரிய் இ஭ ் ஫் உடமந் து உர் ர ொ ?
TA munnar naadi kalil iraththam urainththu ulla dhaa?
__________________________________________________________________________
Pneumothorax (Q48)
EN Was that the chest pain involved mainly the peripheral part of the chest?
සිං කැක්කුම පපුව වගටද තිබුගන්?
SI Kakkuma papuwa wateda thibune?
த லலி பநஞ் டச சும் றி உர் ர ொ ?
TA vali nenjai sutri ulla dhaa?
__________________________________________________________________________
Oesophageal pain (Q50)
EN Do you have chest burning? or regurgitation?
සිං පපුව දැවිේල වගේ, උගුරට එනවා වගේ තිගයනවද?
SI Papuwa dawilla wage, ugurata enawa wage thiyenawada?
த பநஞ் பச஭ிவு உர் ர ொ ?
TA nenju erivu ulla dhaa?
6
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Peptic ulcer disease (Q52)
EN Have you ever had bloody vomiting or passage of black colour stools ?
සිං කවද හරි ගේ වමගන, නැත්තේ මලපහ කළු පාටට ගියාද?
SI Kawada hari le wamane, nattham malapaha kalu paatata giyada?
த லொந்தியுைன் இ஭ ் ஫் நபொன ொ ? ஫ய஫் கருப்பு நிம஫ொக நபொன ொ ?
TA vaanthiyudan iraththam poanadhaa? malam karuppu niramaaka poana dhaa?
__________________________________________________________________________
Acute pancreatitis (Q54)
EN Was that pain radiates through back?
සිං කැක්කුම පිටගකොන්ද පැත්තට විහිගදනවද?
SI Kakkuma pitakonda patthata wihidenawada?
த லலி லம௃ம் றின் ஊைொக முதுகிம் கு பசன் ம ொ ?
TA vali vayit rin oodaka muthu kitku senra dhaa?
__________________________________________________________________________
Acute pancreatitis (Q55)
EN And relieved by bending forwards?
සිං ඉස්සරහට නැගමද්දී කැක්කුම අඩු ගවනවද?
SI Issarahata nameddi kakkuma adu wenawada?
த குனியு஫் நபொது லலி குடமகிம ொ ?
TA kuniyum poathu vali kuraikira dhaa?
__________________________________________________________________________
Complications
__________________________________________________________________________
Heart failure (Q58)
Ask the questions for heart failure (Refer oedema notes)
__________________________________________________________________________
Arrythmia (Q60)
EN Do you feel increase in heart beating?
සිං පපුව ගැගහනවා වගේ දැගනනවද?
த பநஞ் சு பை பை ஋ன அடிக்கிம ொ ?
TA nenju pada pada vena adikkira dhaa?
__________________________________________________________________________
Management and Investigations upto now

__________________________________________________________________________
Angiography (Q63)
EN Have you undergo any intravascular treatment procedure?
සිං ගේ නහරවල ප්‍රතිකාර මුකුත් කරලා තිගයනවද?
SI Le nahara wala prathikaara mukuth karala thiyenawada?
த ந஭஫் புகளுக்கு உர் ரொக சிகிச்டச அரிக்கப்பை்ை ொ ?
TA narambu kalukku ullaaka siki chchai alikka patta dhaa?
7
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Stenting (Q64)
EN Have they inserted any stents?
සිං stent දාල තිගයනවද?
SI Stent daala thiyenawada?
த stents நபொைப் பை்ை ொ ?
TA stents poada patta dhaa?
__________________________________________________________________________
Bypass (Q65)
EN Have you undergone any bypass operations?
සිං Bypass operation කරලා තිගයනවද?
SI Bypass operation karala thiyenawada?
த bypass operations பச஬் ஬ப் பை்ை ொ ?
TA bypass operations seyya patta dhaa?
__________________________________________________________________________
Other Components of the History

__________________________________________________________________________
Past medical history (Q67)
EN Have you had this kind of pain in the past?
සිං ගේ වගේ කැක්කුම කලින් තිබිල තිගයනවද?
SI Me wage kakkuma kalin thibila thiyenawada?
த முன் னரு஫் இது நபொன் ம லலி ஌ம் பை்ை ொ ?
TA munnarum ithu ponra vali et patta dhaa?
__________________________________________________________________________
EN Do you have diabetes, pressure and cholesterol?
සිං දියවැඩියාව, pressure, cholesterol තිගයනවද?
SI Diyawadiyaawa, pressure, cholesterol thiyenawada?
த diabetes , pressure and cholesterol இருந் ொ?
TA diabetes , pressure and cholesterol iruntha dhaa?
__________________________________________________________________________
EN Do you have any other illnesses?
සිං ගවන ගලඩ මුකුත් තිගයනවද?
SI Wena leda mukuth thiyenawada?
த நலறு ஌ ொலது நநொ஬் கர் உர் ர ொ ?
TA veru ethaa vathu noaikal ulla dhaa?
8
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Family history (Q71)
EN Does anyone in your family have heart diseases?
සිං පවුගේ කාටහරි හෘදවස්තුගේ (heart එගක්) ගලඩ තිගයනවද?
SI Pawule kaatahari hrudawasthuwe (heart eke) leda thiyenawada?
த உங் களுடை஬ குடு஫் ப தி
் ய் ஬ொருக்கொலது இ ஬ நநொ஬் கர் உர் ர ொ ?
TA unkaludaya kudumpaththil yaarukkaavathu ithaya noaikal ulla dhaa?
__________________________________________________________________________
EN Did anyone in your family died suddenly at younger age (<40 yrs) due to heart
disease?
සිං පවුගේ කවුරුහරි හෘදවස්තුගේ (heart එගක්) ගලඩ නිසා නැතිගවලා තිගයනවද?
SI Pawule kauruhari hrudawasthuwe (heart eke) leda nisa nathiwela thiyenawada?
த உங் களுடை஬ குடு஫் ப ்திய் ஬ொ஭ொலது இரல஬திய் இரு ஬ நநொ஬் கர்
கொ஭ண஫ொக இமந்துர் ரொ஭்கரொ?
TA unkaluday kudum paththil yaaraa vathu ithaya noaikal kaaranamaaka ila vayathil
iranthu ullaar kalaa?
__________________________________________________________________________
EN Does anyone in your family have DM,HT or cholesterol?
සිං පවුගේ කාටහරි දියවැඩියාව, pressure, cholesterol තිගයනවද?
SI Pawule kaatahari diyawadiyaawa, pressure, cholesterol thiyenawada?
த உங் களுடை஬ குடு஫் ப தி
் ய் ஬ொருக்கொலது diabetes , pressure and cholesterol
உர் ர ொ ?
TA unkaludaya kudumpaththil yaarukkaavathu diabetes , pressure and cholesterol
iruntha dhaa?
__________________________________________________________________________
Social history (Q75)
EN Do you smoke?
SI Dum bonawada?
__________________________________________________________________________
සිං මත්පැන් ගබොනවද?
த சொ஭ொ஬஫் குடிப்பீ஭்கரொ ?
9
__________________________________________________________________________
EN Are you doing regular exercises?
සිං පිළිගවලකට ේ‍යායාේ කරනවද?
SI Piliwelakata wyaayaam karanawada?
த உைம் ை்பம௃ை்சி பச஬் கிறீ஭்கரொ ?
TA udat payit chi, sei ki reer kalaa?
__________________________________________________________________________
EN How often and how long do you do exercises?
සිං ගකොච්චර කාගලකට සැරයක් ගකොච්චර ේ‍යායාේ කරනවද?
SI Kocchara kaalekata sarayak kochchara wyaayam karanawada?
த ஒரு லொ஭ ்திம் கு ஋ல் லரவு ஭஫் ? ஋ல் லரவு நந஭஫்
TA oru vaarath thukku eththanai thadavaikal?
__________________________________________________________________________
SI Rakiyaawa mokakda?
TA tholil enna?
__________________________________________________________________________
EN Do you take oily and salty foods?
සිං ගතේ වැඩි / ලුණු වැඩි කෑම කනවද?
SI Thel wadi / lunu wadi kaama kanawada?
த பகொழுப்பு ஫ம் று஫் உப்பு அதிக ஫ொன உணவுகடர உண்கிறீ஭்கரொ?
TA koluppu matrum uppu athika maana unavukalai unkireer kalaa?
__________________________________________________________________________
EN What do you know about heart diseases?
සිං හෘදවස්තුගේ (heart එගක්) ගලඩ ගැන ගමොනවද දන්ගන්?
SI Hrudawasthuwe (heart eke) leda gana monawada danne?
த இ ஬ நநொ஬் கடர பம் றி உங் களுக்கு ஋ன் ன ப ஭ியு஫் ?
TA ithaya noaikalai patri unkalukku enna theriyum?
__________________________________________________________________________
EN What is the closest hospital to your house?
සිං ගගදරට ළඟම ඉස්පිරිතාගල ගකොගහද?
த வீை்டிம் கு அருகிய் உர் ர டல தி
் ஬சொடய ஋து ?
10
__________________________________________________________________________
සිං ගගදර වාහනයක් තිගයනවද?
த வீை்டிய் லொகன஫் உர் ர ொ ?
__________________________________________________________________________
EN How long does it take to reach hospital?
සිං ඉස්පිරිතාගලට එන්න ගකොච්චර ගවලාවක් යනවද?
SI Ispiirthaaleta enna kochchara welawak yanawada?
த வீை்டிலிருந்து டல தி
் ஬சொடய பசய் ய ஋ல் லரவு நந஭஫் ந டல ?
__________________________________________________________________________
EN Are there any vehicle close to your home at any time to go to hospital?
සිං ඕන ගවලාවක ඉස්පිරිතාගලට යන්න ගගදර ළඟ වාහනයක් තිගයනවද?
SI Ona welawaka ispiithaaleta yanna gedara langa gedara langa wahanayak
thiyenawada?0
த ஋ந் நந஭மு஫் லொகன லசதி உர் ர ொ ?
TA en neramum vaakana vasathi ulla dhaa?
__________________________________________________________________________
11
GENERALISED OEDEMA
Personal History

த உங் களுடை஬ பப஬஭் ஋ன்ன?
___________________________________________________________________________
EN How old are you?
SI Vayasa keeyada?
த ல஬து ஋ல் லரவு ?
__________________________________________________________________________
த ப ொழிய் ஋ன்ன ?
TA Tholil enna?
__________________________________________________________________________
සිං ගම ගකොගෙද?
SI Gama koheda?
__________________________________________________________________________
EN Are you married?
සිං කසාද බැ඲ලද?
த திரு஫ண஫் முடி ்து விை்டீ஭்கரொ ?
1
__________________________________________________________________________
__________________________________________________________________________
සිං ගේ ඳාර ඉස්පිරිතාගලට ආගේ ඇයි?
த டல ்தி஬சொடயக்கு லந் நநொக்க஫் ?
__________________________________________________________________________

__________________________________________________________________________
Symptom analysis (Q8)
EN How long do you have body swelling?
සිං ඇඟ ඉදිගමන එක ගකොච්චර කාලයක් තිගයනවද?
SI Anga idimena eka kochchara kaalayak thiyenawada?
த ஋ல் லரவு கொய஫ொக உைய் வீக்க஫் உர் ரது ?
TA Evvalavu kaalamaka udal veekkam ullathu?
__________________________________________________________________________
EN How did it begin, suddenly or gradually?
සිං ටික ටික ඳටන්ගත්තද නැත්තේ එක ඳාර ඳටන්ගත්තද?
SI Tika tika patangaththada naththam eka paara patangaththada?
த சிறிது சிறி ொகலொ அய் யது சடுதி஬ொகலொ ஆ஭஫் பி ் து?
TA Sirithu sirithakava allathu saduthiyakavaa aarampiththathu?
__________________________________________________________________________
EN Is this swelling involves the whole body or some parts of the body like abdomen?
සිං මුළු ඇඟම ඉදිගමනවද නැත්තේ බඩ වගේ සමෙර තැන් විතරක් ඉදිගමනවද?
SI Mulu angama idimenawada naththam bada wage samahara than witharak
idimenawada?
த உைய் முழுலது஫ொ அய் யது ஒருசிய பகுதிகரிய் ஫ை்டு஫ொ
கொணப் படுகிமது?.
TA Udal muluvathuma allathu oru sila pakuthikalil mattuma kaanappadukirathu?
2
__________________________________________________________________________
Diurnal variation (Q11)
EN Is this swelling getting worse towards the evening?
සිං ඉදිමුම ෙවසට වැඩි ගවනවද?
SI Idimuma hawasata wadi wenawada?
த ஫ொடயம௃ய் வீக்க஫் கூடுகின்ம ொ?
__________________________________________________________________________
Diurnal variation (Q12)
EN Is this swelling worse in the mornings?
සිං ඉදිමුම උගේට වැඩියිද?
SI Idimuma udeta wadiyida?
த அய் யது கொடயம௃ய் வீக்க஫் அதிக஫ொக கொணப் படுகிம ொ?
TA Allathu kaalayil veekkam athikamaka kaanappadukirathaa?
___________________________________________________________________________
__________________________________________________________________________
Left heart failure (Q13)
EN Do you have undue exertional dyspnoea?
සිං වැඩ කරේදී තරමට වඩා ෙතිය ෙැගදනවද?
SI Wada karaddi tharamata wada hathiya hadenawada?
த நலடய பச஬் யு஫் நபொது அரவுக்கு அதிக஫ொன மூச்சிட஭ ் ய்
஌ம் படுகிம ொ?
TA Velai seyyum pothu alavukku athikamaka moochchiraiththal varukirathaa?
__________________________________________________________________________
EN Do you have difficulty in breathing and cough while sleeping?
සිං රෑ නිදාගගන ඉන්නගකොට ෙතිය ෙැගදනවද?
SI Raa nidagena innakota hathiya hadenawada?
த இ஭விய் தூங் கு஫் நபொது மூச்சு ்திணமய் ஌ம் படுகிம ொ?
TA Iravil thoongum pothu moochchuth thinaral etpadukirathaa?
__________________________________________________________________________
EN Do you have cough while lying down?
සිං ොන්සිගවලා ඉන්නගකොට කැස්ස ෙැගදනවද?
SI Haansiwela innakota kassa hadenawada?
த ச஭ிந்து தூங் கு஫் நபொது இரு஫ய் ஌ம் படுகிம ொ?
TA Sarinthu thoongum pothu irumal varukirathaa?
3
__________________________________________________________________________
Right heart failure (Q16)
EN Is this swelling get worse towards the evening?
සිං ඉදිමුම ෙවසට වැඩි ගවනවද?
SI Idimuma hawasata wadi wenawada?
த ஫ொடயம௃ய் வீக்க஫் கூடுகின்ம ொ?
__________________________________________________________________________
සිං බගේ දකුණු ඳැත්ගත් කැක්කුම ෙැගදනවද?
SI Bade dakunu paththe kakkuma hadenawada?
த லம௃ம் றின் லயப் பகுதிம௃ய் ஌ம் படு஫் லலி உர் ர ொ?
TA Vayitrin valathu pakkam vali ullathaa?
__________________________________________________________________________
EN Do you have severe loss of appetite?
සිං බඩගින්න නැත්තටම නැති ගතියක් තිගයනවද?
SI Badaginna naththatama nathi gathiyak thiyenawada?
த கடுட஫஬ொன பசிம௃ன்ட஫ உர் ர ொ?
TA Kadumayana pasiyinmai ullathaa?
__________________________________________________________________________
EN Have you had any heart attacks in the past?
සිං ඳහුගිය කාගේ ෙෘදයාබාධය (ොට් ඇටැක්) ෙැදිලා තිගයනවද?
SI Pahugiya kale hrdayabaadaya (heart attack) hadila thiyenawada?
த கைந் கொய ்திய் ஫ொ஭டைப் புகர் ஌ம் பை்ை ொ?
TA Kadantha kaalaththil maaradaippu aetpattadhaa?
__________________________________________________________________________
EN Were you diagnosed with any problems in the heart valves?
සිං ෙෘදවස්තුගේ කඳාටවල (ොට් එගක් වෑේේ වල) ප්‍රශ්න තිබිල තිගයනවද?
SI Hrdawasthuwe kapaatawala (heart eke valve wala) prashna thibila thiyenawada?
த இ ஬ லொய் வுகரிய் பி஭ச்சடன உர் ர ொ?
TA Ithaya vaalvukalil pirachchanai ullathaa?
__________________________________________________________________________
Respiratory causes (COPD) (Q21)
EN Do you have chronic with large amount of sputum production for a long time?
සිං දිග කාලයක් තිගයන, ගගොඩක් ගසම යන කැස්සක් තිගයනවද?
SI Diga kaalayak thiyena, godak sema yana kassak thiyenawada?
த நீ ண்ை கொய஫ொக கடுட஫஬ொன இரு஫ய் சரி பி஭ச்சடன உர் ர ொ?
TA Neenda kaalamaaka kadumayaana irumal Sali pirachchanai ulladhaa?
4
__________________________________________________________________________
Respiratory causes (COPD) (Q22)
EN Do you have the habit of smoking? For how long?
සිං දුේ ගබොනවද? ගකොච්චර කාලයක්ද?
SI Dum bonawada? Kochchara kaalayakda?
த புடகப் பறக்க஫் இருக்கிம ொ? ஋ல் லரவு கொய஫ொக ?
TA Pukaip palakkam ulladhaa? Evvalavu kaalamaka?
__________________________________________________________________________
Chronic liver disease (Q23)
EN Is that abdominal swelling is more than the leg swelling?
සිං කකුේවල ඉදිමුමට වඩා බගේ ඉදිමුම වැඩිද?
SI Kakulwala idimumata wadaa bade idimuma wadida?
த கொய் வீக்க ்திலு஫் லம௃ம் று வீக்க஫் கூடு யொக இருக்கிம ொ ?
TA Kaal veekkath thilum paarkka vayitru veekkam koodudhalaka ulladhaa?
__________________________________________________________________________
EN Have your eyes turn into yellow?
සිං ඇස් කෙ ඳාට උනාද?
SI As kaha paata unaada?
த கண் ஫ஞ் சரொக இருக்கிம ொ?
TA Kann manjalaaka irukkirathaa?
__________________________________________________________________________
EN Have you had bloody vomiting?
සිං ගේ වමගන ගියාද?
SI Le wamane giyaada?
த இ஭ ் லொந்தி லந் ொ?
TA Iraththa vaanthi vanthadhaa?
__________________________________________________________________________
EN Were you passing black coloured stools?
සිං මලඳෙ (ගටොයිලට්) කළු ඳාටට යනවද?
SI Malapaha (toilet) kalu paatata yanawada?
த ஫ய஫் கருப் பு நிம஫ொக நபொகின்ம ொ?
TA Malam karuppu niramaaka poginradhaa?
__________________________________________________________________________
Hepatic enchephalopathy (Q27)
EN Do you have any abnormal behaviuor?
සිං ෙැසිරීගේ අමුත්තක් තිගයනවද?
SI Hasireeme amuththak thiyenawada?
த விநனொ ஫ொன நைலடிக்டககர் கொணப் படுகிம ொ?
TA Vinotha maana nada vadik kaikal kaanap padukira dhaa?
5
__________________________________________________________________________
EN Do you have reversal of sleeping pattern?
සිං නිදාගන්න ගවලාව උඩ යට මාරුගවලා තිගයනවද?
SI Nidaganna welaawa uda yata maaruwela thiyenawada?
த தூங் கு஫் நந஭஫் ஫ொறியுர் ர ொ ?
TA Thoongum naeram maari ulladhaa?
__________________________________________________________________________
EN Do you have Confusion?
සිං හිගතන ගේවේ අවුේ ගවලා තිගයනවද?
SI Hithena dewal awul wela thiyenawada?
த ஫னக்குறப் ப஫் உர் ர ொ ?
TA Manak kulap pam ulladhaa?
__________________________________________________________________________
EN Do you have easy bleeding tendency?
සිං ගේ වැඩිගයන් යන ගතියක් තිගයනවද?
SI Le wadiyen yana gathiyak thiyenawada?
த அதிக஫ொன இ஭ ் க்கசிவு உர் ர ொ ?
TA Athika maana iraththa kasivu ulla dhaa?
__________________________________________________________________________
Hepatorenal syndrome (Q31)
EN Do you pass less amount of urine?
සිං මුත්‍රා අඩුගවලා තිගයනවද?
SI Muthraa aduwela thiyenawada?
த சிறுநீ ஭ின் அரவு குடமலொக உர் ர ொ ?
TA Siru neerin alavu kurai vaka ulla dhaa?
__________________________________________________________________________
EN Do you have metallic taste in your tonque?
සිං දිගේ යකඩ රෙක් දැගනනවද?
SI Dive yakada rahak danenawada?
த நொக்கிய் கசப் பு ் ன்ட஫ உர் ர ொ ?
TA Naakkil kasappu thanmai ulla dhaa?
__________________________________________________________________________
EN Do you have itching? Is it involving the whole body?
සිං කසන ගතියක් තිගයනවද? මුළු ඇඟම කසනවද?
SI Kasana gathiyak thiyenawada? Mulu angama kasanawada?
த உைய் முழுலது஫் பசொறிச்சய் உர் ர ொ ?
TA Udal mulu vathum sorich chal irukki radhaa?
6
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EN Have you noticed any change in your skin colour?
සිං ෙගේ ඳැෙැය ගවනස් ගවලා තිගයනවද?
SI Hame pahaya wenas wela thiyenawada?
த ந ொலின் நிம஫் ஫ொம் ம஫டைந்து உர் ர ொ ?
TA Thoal in niram matra madainthu ulladhaa?
__________________________________________________________________________
EN Have you ever experienced sudden abdominal enlargement with associated pain and
fever?
සිං කවද ෙරි එක ඳාරට බඩ ඉදිමිලා, බගේ කැක්කුමයි උණයි ෙැදිලා තිගයනවද?
SI Kawada hari eka paarata bada idimila bade kakkumai unai hadila thiyenawada?
த உங் களுக்கு ஋ப் நபொ ொலது சடுதி஬ொன லம௃ம் று வீக்க து
் ைன் லம௃ம் று
லலி ஫ம் று஫் கொ஬் ச்சய் ஌ம் பை்டுர் ர ொ ?
TA Eppoathu aavathu sadu thiyaana vayitru veekka thudan vayitru vali matrum kaaich
chal vantha dhaa?
__________________________________________________________________________
Hypoglycaemia (Q36)
EN Have you had an episode like hunger,sweating,palpitations and giddiness
සිං බඩගින්න එක්ක දෙදිය, ඳපුගේ ගැහිේල, කලන්තය ෙැදිලා තිගයනවද?
SI Badaginna ekka dahadiya, papuwe gahilla, kalanthaya hadila thiyenawda?
த ஫஬க்கநிடய,வி஬஭்டல, ஫ொ஭்பு பை பைபலன அடி ் ய் நபொன்மடல
கடுட஫஬ொன பசியுைன் ஌ம் பை்டுர் ர ொ?
TA Mayakkam, viyar vai ,maarpu pada pada ena adith thal pontra vai kadumai yaana
pasi yudan vantha dhaa?
__________________________________________________________________________
Hypogonadism (Q37)
EN Are you having lack of interest in sexualm activities?
සිං ලිංගික කටයුතුවල කැමැත්තක් නැති ගතියක් තිගයනවද?
SI Lingika katayuthuwala kamaththak nathi gathiyak thiyenawada?
த உைலுமவிய் நொை்ைமின்ட஫ கொணப் படுகிம ொ ?
TA Udal uravil naat tam illaa mal irukki radhaa?
__________________________________________________________________________
Hypogonadism (Q38)
EN Do you take alcohol ? for how long?
සිං මත්ඳැන් ගබොනවද? ගකොච්චර කාලයක්ද?
SI Mathpan bonawada? Kochchara kaalayakda?
த சொ஭ொ஬஫் குடிப் பீ஭்கரொ? ஋ல் லரவு கொய஫ொக?
TA Saarayam kudip peer kalaa? Evva lavu kaala maaka?
7
__________________________________________________________________________
Hypogonadism (Q39)
EN Do you have any unsafe sexual practices and intravenous substance abuse
සිං අනාරක්ෂිත ලිංගික කටයුතු කරනවද? මත්ේ‍රේ‍ය එන්නත් කරනවද?
SI Anaarakshitha lingika katayuthu karanawada? Mathdhrawya ennath
karagannawada?
த லமொன நை ்ட கரிய் ஈடுபடுலதுண்ைொ ? நபொட ப் பபொருர்
ஊசிகடர பொவிப் பதுண்ைொ ?
TA Thava raana nada ththai kalil eedu paduva thundaa? Poathai oosi kalai paavi ppa
thundaa?
__________________________________________________________________________
Hypogonadism (Q40)
EN Did you take any Ayurvedic or any other medications for a long time?
සිං ආයුර්ගේද, ගවනත් ගබගෙත් ගගොඩක් කේ ඳාවිච්චි කලාද?
SI Ayurveda, wenath beheth godak kal paawichchi kalaada?
த ஆயு஭்நல ஫ம் று஫் ஌டன஬ ஫ருந்துகடர நீ ண்ைகொய஫்
பொவி ் துண்ைொ ?
TA Aayur veda matrum aenaya marunthu kalai neenda kaalam paavi ththa thundaa?
__________________________________________________________________________
Autoimmune (Q41)
EN Have you ever had the collection of symptoms like joint pain and skin rashes?
සිං ෙන්දි ගේදනාව, ෙගේ ඳලු එකට ෙැදිලා තිගයනවද?
SI Handi wedanaawa, hame palu ekata hadila thiyenawada?
த மூை்டுலலி, ப ொலிய் ழு஫் புகர் நபொன்மடல ஒன்மொக லந்துர் ர ொ ?
TA Moottu vali ,thoalil thadippu kal pontravai onraaka vanthu ulladhaa?
__________________________________________________________________________
Autoimmune (Q42)
EN Do you find any recent onset difficulty in movements?
සිං ඇවිදින්න, අතඳය ගෙොලවන්න අමාරුවක් ආවද?
SI Awidinna, athapaya holawanna amaaruwak aawada?
த நை஫ொடுலதிய் புதி ொக சி஭஫ங் கர் ஋துவு஫் ஌ம் பை்டுர் ர ொ ?
TA Nada maadu vathil puthi thaaka sira mankal vanthu ulla dhaa?
__________________________________________________________________________
Autoimmune (Q43)
EN Does anyone in your family has liver disease?
සිං ඳවුගේ කාට ෙරි අක්මාගේ ගලඩ තිගයනවද?
SI Pawule kaatahari akmaawe leda thiyenawada?
த உங் களுடை஬ குடு஫் ப ்திய் ஬ொருக்கு஫் ஈ஭ய் நநொ஬் கர் உர் ர ொ ?
TA Unkal udaya , kudum pathil , yaaru kkum eeral noaikal ulla dhaa?
8
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Autoimmune (Q44)
EN Have you had any kind of biliary disease in the past?
සිං පිත්තාශගේ ගලඩ ෙැදිලා තිගයනවද?
SI Piththaashaye leda hadila thiyenawada?
த உங் களுக்கு பி ் ப்டப நநொ஬் கர் ஌ம் பை்டுர் ர ொ ?
TA Unga lukku piththa pai noai kal ulla dhaa?
__________________________________________________________________________
Renal disease (Glomerulonephritis) (Q45)
EN Do you find any swelling around the eyes?
සිං ඇස් වගට් ඉදිමුනාද?
SI As wate idimunaada?
த கண்கடர சும் றி வீக்க஫் உர் ர ொ ?
TA Kankalai sutri veekkam ulla dhaa?
__________________________________________________________________________
EN Do you find any froth formatioon in the urine?
සිං මුත්‍රා එක්ක ගඳන ගගොඩක් යනවද?
SI Muthraa ekka pena godak yanawada?
த சிறுநீ ஭ிய் அதிகரலொன த௃ட஭ ந ொன்றுகின்ம ொ ?
TA Siru neeril athika alavu nurai thoandru kira dhaa?
__________________________________________________________________________
EN Do you pass red coloured urine?
සිං මුත්‍රා රතු ඳාටට යනවද?
த சிறுநீ ஭் சிலப் பொக நபொகின்ம ொ ?
TA Siru neer sivappu aaka poa kinra dhaa?
__________________________________________________________________________
(Q48)
EN Have you ever had fever associated with yellowish discoloration of the eyes in the
past?
සිං උණත් එක්ක ඇස් කෙ ඳාට ගවලා තිගයනවද?
SI Unath ekka as kaha paata wela thiyenawada?
த ஋ப் பபொழு ொலது கொ஬் ச்சலுைன் உைய் ஫ஞ் சரொக ஫ொறி உர் ர ொ ?
TA Eppodhaa vadhu kaach chaludan udal manjalaaka maari ulla dhaa?
__________________________________________________________________________
(Q49)
EN Have you ever had blood cancer?
සිං ගේ පිළිකා ෙැදිලා තිගයනවද?
SI Le pilikaa hadila thiyenawada?
த குருதிப் பும் று நநொ஬் லந்து உர் ர ொ ?
TA Kuruthi putru noai vanthu ulla dhaa?
9
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(Q50)
EN Have you ever had malaria?
සිං මැගේරියා ෙැදිලා තිගයනවද?
SI Malaria hadila thiyenawada?
த ஫நய஭ி஬ொ லந்து உர் ர ொ?
TA Malaria vanthu ulla dhaa?
__________________________________________________________________________
(Q51)
EN Do you have DM or Hypertension?
සිං දියවැඩියාව, Pressure තිගයනවද?
SI Diyawadiyaawa, pressure thiyenawada?
த Diabetes, pressure உர் ர ொ?
TA Diabetes, pressure ulladhaa?
__________________________________________________________________________
Complications of nephrotic syndrome (Q52)
EN DVT – Painfull swelling of the legs associated with fever
සිං කකුේ කැක්කුමත් එක්ක ඉදිමිලා උණ ෙැදිලා තිගයනවද?
SI Kakul kakkumak ekka idimila una hadila thiyenawada?
த கொ஬் ச்சலுைன் சடுதி஬ொன கொய் வீக்க஫் ,லலி ஫ம் று஫் சில ் ய் லந்து
உர் ர ொ ?
TA Kaaichal udan saduthiyaana kaal veekkam,vali matrum sivath thal vanthu ulla dhaa?
__________________________________________________________________________
Complications of nephrotic syndrome (Q53)
EN Hypovolemia – postural dizziness
සිං ොන්සි ගවලා ඉ඲ල නැගිටිනගකොට කලන්තයට වගේ එනවද?
SI Haansiwela indala nagitinakota kalanthayata wage enawada?
த இருந்து ஋ழு஫் பு஫் பபொது ஌ம் படு஫் டய சும் மய் ?
TA Elumbum poathu thalai sutru kira dhaa?
__________________________________________________________________________
Chronic kidney disease (Q54)
EN Decrease in urine output
සිං මුත්‍රා අඩුගවන් යනවද?
SI Muthraa aduwen yanawada?
த சிறுநீ ஭் குடமலொக நபொகின்ம ொ?
TA Siruneer kuraivaaga pogindradhaa?
__________________________________________________________________________
Uraemic features (Q55)
EN Do you have nausea or vomiting?
සිං වමගන ගියාද? ඔක්කාරයට එනවද?
SI Wamane giyaada? Okkaarayata enawada?
த லொந்தி லந் ொ? கு஫ை்ைய் லந் ொ?
TA Vaandhi vandhadhaa? Kumattal vandhadhaa?
10
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EN Do you have loss of hunger?
සිං බඩගින්න නැතිගවලාද?
SI Badaginna nathiwelaada?
த பசி இய் டய஬ொ?
TA Pasi illayaa?
__________________________________________________________________________
EN Do you have weight loss?
සිං ඇඟ ගකට්ටු ගවලාද?
SI Anga kettu welaada?
த உைய் ப஫லிந் ொ?
TA Udal melindhadhaa?
__________________________________________________________________________
EN Do you get muscle cramps?
සිං මස්පිඩු ගකොරගවනවද?
SI Maspidu korawenawada?
த டசப் பிடிப் பு லருகின்ம ொ?
TA Thasaippidippu varugindhradhaa?
__________________________________________________________________________
EN Do you have itching? Is it involving the whole body?
සිං කසන ගතියක් තිගයනවද? මුළු ඇඟම කසනවද?
SI Kasana gathiyak thiyenawada? Mulu angama kasanawada?
த உைய் முழுலது஫் பசொறிச்சய் உர் ர ொ ?
TA Udal mulu vathum sorich chal irukki radhaa?
__________________________________________________________________________
Malabsorption (Q60)
EN Do you have bulky, pale, foul and sticky stools?
සිං මලඳෙ සුදු ඳාටට, දුර්ගන්දයට, ඇගලනවා වගේ යනවද?
SI Malapaha sudu paatata, durgandayata, alenawa wage yanawada?
த ஫ய஫் பலர் டர நிம஫ொ. ஫ண ந
் ொை ஓை்டும ஫ொதி஭ி நபொகு ொ?
TA Malam vellai niramaa, manaththoda, ottura maadhiri pogudhaa?
__________________________________________________________________________
Malabsorption (Q61)
EN Do you have weight loss? (Refer above)
__________________________________________________________________________
Malabsorption (Q62)
EN Anaemic features (Refer anaemia tute)
11
Investigations and Treatment so far
__________________________________________________________________________
(Q63)
EN How many times have you been admitted?
සිං කී ඳාරක් ඉස්පිරිතාගල නැවතුනාද?
SI Kee paarak ispirithaale nawathunaada?
த டல ்தி஬ சொடயம௃ய் நிறு ் ப் பை்ை ைடலகர் ஋ ் டன?
TA vaiththiya saalayil niruththap patta thadavaikal eththanai?
__________________________________________________________________________
UGIE (Q64)
EN Did they insert a camera through your mouth?
සිං කටින් බටයක් දාල බැලුවද?
SI Katin batayak daala baluwada?
த லொ஬ொய Camera நபொை்டு பொ஭் ் ொ?
TA Vaayaala camera pottu paarthadhaa?
__________________________________________________________________________
(Q65)
EN Did they give you blood?
සිං ගේ විේදද?
SI Le widdada?
த இ஭ ் ஫் ஌ம் மப் பை்ை ொ?
TA Iraththam etra padda dhaa?
__________________________________________________________________________
(Q66)
EN Were you adviced to do a liver transplant?
සිං අක්මාවක් බේද කරගන්න කිේවද?
SI Akmaawak baddha karaganna kiwwada?
த ஈ஭ய் ஫ொம் ம operation பச஬் ஬ பசொன்னொங் கரொ?
TA Eeral maatra operation seyya sonnaangalaa?
__________________________________________________________________________
Social History
__________________________________________________________________________
(Q67)
த உங் கர் வீை்டிய் ஋ ் டன நப஭் இருக்கிமொ஭்கர் ?
12
__________________________________________________________________________
(Q68)
සිං ඳවුගේ මාසික ආදායම කීයද?
த உங் கரது குடு஫் ப லரு஫ொன஫் ஋ல் லரவு ?
__________________________________________________________________________
(Q69)
EN What do your family members do?
සිං ඳවුගේ අය ගමොනවද කරන්ගන්?
த ஫ம் மல஭்கர் ஋ன்ன பச஬் கிமொ஭்கர் ?
__________________________________________________________________________
(Q70)
සිං ගගදර තිගයන්ගන් ගේ ඳැත්තකද? ටවුමකද?
த உங் கரது இை஫் கி஭ொ஫஫ொ ? அய் யது town ஆ ?
__________________________________________________________________________
(Q71)
EN Are you smoking?
SI Dum bonawada?
த புடக பிடிப் பீ஭்கரொ ?
__________________________________________________________________________
(Q72)
සිං මත්ඳැන් ගබොනවද?
த சொ஭ொ஬஫் குடிப் பீ஭்கரொ ?
__________________________________________________________________________
(Q73)
EN Are there any one at home to help you?
සිං ගගදර උදේවට කවුරුත් ඉන්නවද?
SI Gedara udawwata kauruth innawada?
த வீை்டிய உங் களுக்கு help பண்ண ஬ொரு஫் இருக்கிமொ஭்கரொ ?
TA veettil unkalukku help panna yaarum irukki raar kalaa?
13
__________________________________________________________________________
(Q74)
EN Do you get any support from the organizations?
සිං ආයතන වලන් උදේ ලැගබනවද?
SI Aayathana walin udaw labenawada?
த உங் களுக்கு நிறுலன஫் ஌து஫் உ வி பச஬் கிம ொ ?
TA unkalukku niruvanam ethum uthavi sei kira dhaa?
__________________________________________________________________________
(Q75)
EN what is the closest hospital to your house?
සිං ගගදරට ළඟම ඉස්පිරිතාගල ගකොගෙද?
த வீை்டிம் கு அருகிய் உர் ர டல ்தி஬சொடய ஋து ?
14
STROKE
Personal History

த உங்களுடைய பெயர் என்ன?
___________________________________________________________________________
EN How old are you?
SI Vayasa keeyada?
த வயது எவ்வளவு ?
__________________________________________________________________________
සිං රැකියොව ගමොකක්ද?
த ப ொழில் என்ன ?
TA Tholil enna?
__________________________________________________________________________
SI Gama koheda?
த உங்களுடைய ஊர் எது ?
__________________________________________________________________________
EN Are you married?
සිං කසොද බැඳලද?
த ிருமணம் முடித்து விட்டீர்களொ ?
1
__________________________________________________________________________
த எத் டன ெிள்டளகள் ?
__________________________________________________________________________
සිං ගේ පොර ඉසපිරිතොගලට ආගේ ඇයි?
த டவத் ியசொடைக்கு வந் ந ொக்கம் ?
__________________________________________________________________________

__________________________________________________________________________
History of presenting complaint (Q8)
EN was it sudden or gradual?
සිං එක පොරටම ආවද ගෙමින් ආවද?
SI Eka paaratama aawada hemin aawada?
த ஒநே அடியொகவொ அல்ைது பகொஞ்சம் பகொஞ்சமொகவொ ஆேம்ெித் து
TA Ore adiyaakavaa allathu konjam konjam aakavaa aarampith thathu
__________________________________________________________________________
EN Do you have one sided facial weakness?
සිං මුහුගේ එක පැත්තක් පණ නැතුව ගියොද?
SI Muhune eka patthak pana nathuwa giyaada?
த முகம் ஒரு ெக்கமொக இழுத்துக் பகொண்ை ொ?
TA mukam oru pakka maaka iluththu konda dhaa?
__________________________________________________________________________
EN Do you have arm or leg weakness?
සිං අත්, කකුල් පණ නැතුව ගියොද?
SI Ath, kakul pana nathuwa giyaada?
த கொல் டக ெைமில்ைொமல் இருக்கிற ொ ?
TA kaal , kai palam illamal irukkira dhaa?
2
__________________________________________________________________________
EN Which side?
සිං ගමොන පැත්ගත් ද?
SI Mona pattheda?
த எந் ெக்கம் ?
TA entha pakkam?
__________________________________________________________________________
EN Did you lose consciousness?
සිං සිහි නැති උනොද?
SI Sihi nathi unada?
த மயக்கம் வந் ொ ?
TA mayakkam vantha dhaa?
__________________________________________________________________________
EN Do you see things in double?
සිං ඇසප වලට ගදක ගදක වගේ ගපනුනද?
SI As walata deka deka wage penunada?
த எல்ைொநம இேண்டு இேண்ைொக ப ரிகிற ொ ?
TA ellame irandu irandaaka theriyuthaa?
__________________________________________________________________________
EN do you have sensory loss in one side of the face?
සිං මුහුගේ එක පැත්තක හිරි වැටුනද?
SI Muhune eka patthaka hiri watunada?
த முகத் ில் ஒரு ெக்கமொக உணர்ச்சி இல்ைொமல் இருக்கிற ொ ?
TA mukaththil oru pakkam unarchchi illamal irukkira dhaa?
__________________________________________________________________________
EN Is it difficult to talk?
සිං කතො කරන්න අමොරුද?
SI Katha karanna amaaruda?
த நெச கஷ்ைமொக இருக்கிற ொ ?
TA Pesa kasta maaka irukkira dhaa?
__________________________________________________________________________
EN Is it difficult to swallow?
සිං ගිලින්න අමොරුද?
SI Gilinna amaaruda?
த விழுங்க கஷ்ைமொக இருக்கிற ொ ?
TA vilunka kasta maaka irukkuthaa ?
3
__________________________________________________________________________
EN Are the food particles coming through the mouth?
සිං කන කෑම කටින් එලියට වැගටනවද?
SI Kana kaama katin eliyata watenawada?
த சொப்ெிடும் நெொது புடேக்நகருகின்ற ொ?
TA saappidum pothu puraik kerukinra dhaa?
__________________________________________________________________________
EN Do you have difficulty in walking?
සිං ඇවිදින්න අමොරුද?
SI Awidinna amaaruda?
த ைக்க கஷ்ைமொக இருக்கிற ொ ?
TA nadakka kasta maaka irukki radhaa?
__________________________________________________________________________
EN Do you tend to fall while walking?
සිං ඇවිදිනගකොට වැගටන්න යනවද?
SI Awidinakota watenna yanawada?
த ைக்கும் நெொது விழ ெொர்க்கிறீர்களொ ?
TA nadakkum poathu vila paarkki reerkala?
__________________________________________________________________________
EN For How long do you have these symptoms?
සිං ගකොච්චර කොලයක් ගමගෙම තිගයනවද?
SI Kochchara kaalayak mehema thiyenawada?
த எவ்வளவு ந ேமொக இந் ெிேச்சிடன உள்ளது ?
TA evvalavu nera maaka intha pirachchanai ulladhu?
__________________________________________________________________________
EN What were you doing at the time of stroke?
සිං අංශබොගය ෙැගදන ගවලොගේ ගමොකක්ද කර කර හිටිගේ?
SI Anshabaagaya hadena welaawe mokakda kara kara hitiye?
த ெக்கவொ ம் வரும் நெொது என்ன பசய்து பகொண்டு இருந் ீர்கள் ?
TA pakka vaadham varum poathu enna sithu kondu irun theerkal?
__________________________________________________________________________
Type of weakness (Face / Arm / Leg / Speech
(Refer above)
__________________________________________________________________________
Loss of consciousness
(Refer above)
4
__________________________________________________________________________
EN What is more weaker, the arm or the legs?
සිං වැඩිගයන් පණ නැත්ගත් අත්වලද කකුල්වලද?
SI Wadiyen pana natthe athwalada kakulwalada?
த டகயொ அல்ைது கொைொ அ ிகமொக வக்
ீ ஆக உள்ளது ?
TA kaiyaa allathu kaala athikamaaaka week aka ulladhu?
__________________________________________________________________________
Progression of symptoms (Q25)
EN are these symptoms still persist?
සිං අමොරුව තවම තිගයනවද?
SI Amaaruwa thawama thiyenawada?
த இன்னும் வக்
ீ அகவொ உள்ளது ?
TA innum week akavaa ulladhu?
__________________________________________________________________________
Progression of symptoms (Q26)
EN Same severity or getting worse ?
සිං ඒ ගොනටම තිගයනවද තවත් වැඩිගවලොද?
SI E gaanatama thiyenawada thawath wadiwelaada?
த அந அளவொகவொ அல்ைது அ ிகமொகிற ொ ?
TA athey alavaa kavaa illai athika maakira dhaa?
__________________________________________________________________________
Associated symptoms (Q27)
EN Do you have severe headache?
සිං දරුණු ඔලුගේ කැක්කුමක් තිගයනවද?
SI Darunu oluwe kakkumak thiyenawada?
த கடுடமயொன டை வைி உள்ள ொ ?
TA kadu mayana thalai vali ulla dhaa?
__________________________________________________________________________
EN Do you have vomitish feeling or have you vomitted?
සිං ඔක්කොරයට එනවද? වමගන් ගියොද?
SI Okkaarayata enawada? Wamane giyaada?
த வொந் ி வருவது நெொை உள்ள ொ ? அல்ைது வொந் ி வந் ொ ?
TA vaanthi varuvathu pola ulladhaa allathu vaanthi vantha dhaa?
__________________________________________________________________________
EN Have you had fits?
සිං වලිප්පුව ෙැදිලො තිගයනවොද?
SI Walippuwa hadila thiyenawada?
த fit வந் ொ ?
TA fit vantha dhaa?
5
___________________________________________________________________________
Clinical Pattern of Stroke

__________________________________________________________________________
Anterior circulation (Q30)
Face arm and leg weakness
(Refer above)
__________________________________________________________________________
EN Do you find it difficult to remember words and Names?
සිං වචන, නේ මතක් කරන්න අමොරුද?
SI Wachana, nam mathak karanna amaaruda?
த வொர்த்ட கள் மற்றும் பெயர்கடள ஞொெகம் இல்டையொ?
TA vaarththaikal matrum peyarkalai gnabakam illayaa?
__________________________________________________________________________
EN Have you lost memory of the past?
සිං අතීතගේ ගවච්ච ගේවල් අමතක ගවලො ගියොද?
SI Atheethaye wechcha dewal amathaka wela giyaada?
த ெடழய ஞொெகங்கள் எல்ைொம் மறந்து விட்ை ொ ?
TA palaya gnabakankal ellam maranthu vitta dhaa?
__________________________________________________________________________
EN Please say what is 5 into 5?
සිං පසපවරක් පෙ කීයද කියන්න?
SI Paswarak paha keeyada kiyanna?
த ஐந்ட ஐந் ொல் பெருக்கினொல் எவ்வளவு ?
TA ainthai ainthal perukkinaal evvalavu?
__________________________________________________________________________
Posterior circulation (Q34)
EN Do you see things in double?
සිං ගදක ගදක ගප්පනවද?
SI Deka deka penawada?
த இேண்டு இேண்ைொ ப ரியு ொ?
TA Irandu irandaa theriyudhaa?
__________________________________________________________________________
EN Do you have vertigo?
සිං කැරකිල්ල වගේ තිගයනවද?
SI Karakilla wage thiyenawada?
த டை சுற்றுகிற ொ ?
TA thalai sutru kira dhaa?
6
__________________________________________________________________________
Facial numbness and weakness
Refer above
__________________________________________________________________________
Dysphagia and nasal regurgitation
Refer above
__________________________________________________________________________
Slurring of speech
Note it as you talk to the patient
__________________________________________________________________________
Imbalance and unsteadiness (examination finding, but can say it in the history)
Refer above
__________________________________________________________________________
Lacunar circulation (Q40)
No specific symptoms
__________________________________________________________________________
EN Do you pass stools or urine?
සිං මලපෙ, මුත්රො යනවද?
SI Malapaha, muthra yanawada?
த மைம் சிறு ீர் நெொகின்ற ொ ?
TA malam , siru neer pokinra dhaa?
__________________________________________________________________________
EN Do you have involentary passage of stools?
සිං පොලනය කරගන්න බැරුව මලපෙ යනවද?
SI Paalanaya karaganna baruwa malapaha yanawada?
த மைம் கட்டுப் ெொடு இன்றி நெொகின்ற ொ ?
TA malam kattup paadu illamal pokinra dhaa?
__________________________________________________________________________
EN Do you have involentary passage of urine?
සිං පොලනය කරගන්න බැරුව මුත්රො යනවද?
SI Paalanaya karaganna baruwa muthra yanawada?
த சிறு ீர் கட்டுப் ெொடு இன்றி நெொகின்ற ொ ?
TA siru neer kattup paadu illamal pokinra dhaa?
7
__________________________________________________________________________
Aetiology
__________________________________________________________________________
Atherosclerosis (Q44)
EN Ask for past history of DM, HT and ischaemic heart disease( refer to chest pain note)
සිං දියවැඩියොව, pressure, heart එගක් ගලඩ තිගයනවද?
SI Diyawadiyaawa, pressure, heart eke leda thiyenawada?
த diabetes , pressure, cholesterol இருந் ொ ?
TA diabetes , pressure, cholesterol iruntha dhaa?
__________________________________________________________________________
EN Do you smoke?
SI Dum bonawada?
த புடக ெிடிப்ெீர்களொ ?
TA Pukai pidippeerkalaa?
__________________________________________________________________________
EN Do you have cholesterol?
සිං Cholesterol තිගයනවද?
SI Cholesterol thiyenawada?
த Cholesterol இருக்கிற ொ ?
TA Cholesterol irukkira dhaa?
__________________________________________________________________________
EN Did you have chest pain before?
සිං පුගේ කැක්කුමක් තිබුනද?
SI Papuwe kakkumak thibunada?
த முன்னர் உங்களுக்கு ப ஞ்சு வைி இருந் ொ ?
TA munnam unkalukku nenju vali vantha dhaa?
__________________________________________________________________________
EN Do you have cramping like pain from the calfs after walking some distance?
සිං ටික දුරක් ඇවිදිනගකොට ගකන්ඩ ගකොරගවනවො වගේ රිගදනවද?
SI Tika durak awidinakota kenda korawenawa wage ridenawada?
த பகொஞ்ச தூேம் ைந் ெிறகு கொல்களில் ெிடிப்ெது நெொன்ற வைி வந் ொ ?
TA konja thooram nadantha piraku kaalkalil pidippathu pola vali varu dhaa?
8
__________________________________________________________________________
EN Have you had thses kind of transient weakness of the body parts before?
සිං මීට කලින් ඇගේ ගකොටසපවල ගේ වගේ ටික ගවලොවකට පණ නැතිගවලො තිගයනවද?
SI Meeta kalin ange kotaswala me wage tika welawakata pana nathiwela thiyenawada?
த இ ற்கு முன்னர் இது நெொை டக கொல் வக்
ீ அவது நெொன்று வந்து சரியொகி
உள்ள ொ ?
TA ithatku munnam ithu pola kai kaal week aavathu pola vanthu sari aaki ulla dhaa?
__________________________________________________________________________
Cardioembolism (Q50)
EN Have you been diagnosed with any heart valve problems?
සිං Heart එගක් valve වල ප්පරශපන තිගයනවද?
SI Heart eke valve wala prashna thiyenawada?
த heart valve களில் எ ொவது ெிேச்சடன உள்ள ொ ?
TA heart valve kalil ethum pirach chanai ulla dhaa?
__________________________________________________________________________
EN Did you have Heart attack in the recent past?
සිං ලඟදි heart attack ෙැදුනද?
SI Langadi heart attack hadunada?
த முன்னர் heart attack வந்து உள்ள ொ ?
TA munnam heart attack vanthu ulla dhaa?
__________________________________________________________________________
EN Are you feeling increasesd heart beatings?
සිං පුව ගැගෙනවො වගේ දැගනනවද?
த ப ஞ்சு துடிப்பு ெைமொக உள்ள ொ ?
TA nenju thudippu palamaaka ulla dhaa?
__________________________________________________________________________
EN Do you have frequent faintish feelings?
සිං නිතරම කලන්තය වගේ දැගනනවද?
SI Nitharama kalanthaya wage danenawada?
த அடிக்கடி மயக்கம் வருவது நெொன்று உள்ள ொ ?
TA adik kadi mayakkam varuvathu pola ulla dhaa?
__________________________________________________________________________
EN Were you having prolonged fever for in the recent past?
සිං ළඟදී දිග කොලයක් උණ තිබුනද?
SI Langadi diga kaalayak una thibunada?
த ீண்ை கொைமொக கொச்சல் இருந் ொ ?
TA neenda kaalamaaka kaachchal iruntha dhaa?
9
__________________________________________________________________________
Vasculitis (infective) (Q55)
EN Have you practiced high risk sexual practices?
සිං අනොරක්ිත ලිංගික ඇසුරු තිබුනද?
SI Anaarakshitha lingika asuru thibunada?
த ெொதுகொப்ெற்ற உைல் உறவில் ஈடு ெட்டீர்களொ ?
TA paathu kaappatra udal uravil eedu patteer kalaa?
__________________________________________________________________________
EN Have you had any blood transfusions?
සිං ගල් විදලො තිගයනවද?
SI Le widala thiyenawada?
த உங்களுக்கு இேத் ம் ஏற்ற ெட்ை ொ ?
TA unkalukku iraththam etra patta dhaa?
__________________________________________________________________________
EN Were you using heroin injections?
සිං ගෙගරොයින් එන්නත් පොවිච්ි කරලො තිගයනවද?
SI Heroin ennath paawichchi karala thiyenawada?
த Heroin ஊசி ெொவித் ீர்கள ?
TA Heroin oosi paavith theer kalaa?
__________________________________________________________________________
Vasculitis (autoimmune disease) (Q58)
සිං ෙන්දි වල ගේදනොවක් තිගයනවද?
SI Handi wala wedanawak thiyenawada?
த joint களில் வைி இருக்கிற ொ ?
TA joint il vali ulla dhaa?
__________________________________________________________________________
EN Do you have skin rashes?
සිං ෙගේ පලු ෙැදිලො තිගයනවද?
SI Hame palu hadila thiyenawada?
த ந ொைில் rash உள்ள ொ ?
TA tholil rash ulla dhaa?
__________________________________________________________________________
EN Do you have wounds in the mouth?
සිං කගේ තුවොලගවලො තිගයනවද?
SI Kate thuwalawela thiyenawada?
த வொயில் புண் உள்ள ொ ?
TA vaaayil pun ulla dhaa?
10
__________________________________________________________________________
EN Are you passing blood in the urine?
සිං මුත්රො වල ගල් යනවද?
SI Muthra wala le yanawada?
த சிறு ீரில் இேத் ம் நெொகிற ொ ?
TA siru neeril iraththam pokira dhaa?
__________________________________________________________________________
EN Were you having prolonged fever for in the recent past?
සිං ළඟදී දිග කොලයක් උණ තිබුනද?
SI Langadi diga kaalayak una thibunada?
த ீண்ை கொைமொக கொச்சல் இருந் ொ ?
TA neenda kaalamaaka kaachchal iruntha dhaa?
__________________________________________________________________________
Thrombophilias (Q63)
EN Are there anyone in your family had similar symptoms?
සිං පවුගල් ගවන කොටෙරි ගේ වගේ ෙැදිලො තිගයනවද?
SI Pawule wena kaatahari mehema hadila thiyenawada?
த உங்கள் குடும்ெத் ில் நவறு யொருக்கும் இது நெொன்ற ெிேச்சடன வந் ொ ?
TA unkal kudumpaththil veru yaarukkum ithu ponra pirachchanai ulla dhaa?
__________________________________________________________________________
Thrombophilias (Q64)
EN Are there anyone in your family who had recurrent abortions?
සිං පවුගල් කොටෙරි එක පොරකට වඩො ගබ්සො ගවලො තිගයනවද?
SI Pawule kaatahari eka paarakata wadaa gabsaa wela thiyenawada?
த உங்கள் குடும்ெத் ில் யொருக்கொவது ிரும்ெத் ிரும்ெ கருச்சிட வு வந் ொ
?
TA unkal kudumpaththil yaarukka vadhu thirumpa thirumpa karuch chithaivu vantha
dhaa?
___________________________________________________________________________
Other stroke-like events

__________________________________________________________________________
Trauma (Q65)
EN Have you had any trauma to the head?
සිං ඔලුවට පෙරක් මුකුත් වැදුනද?
SI Oluwata paharak mukuth wadunada?
த டையில் அடி ெட்ை ொ ?
TA thalayil adi patta dhaa?
11
__________________________________________________________________________
Tumour (Q66)
EN Were you having early morning headache which is relieved by vomiting?
සිං උගේ පොන්දර ඔලුගේ කැක්කුම ෙැදිලො වමගන ගියොම ෙරියනවද?
SI Ude paandara oluwe kakkuma hadila wamane giyaama hariyanawada?
த ீண்ை கொைமொக கொடையில் டை வைி வொந் ி நெொனவுைன் குடறவது
நெொை இருந் ொ ?
TA neenda kaala maaka kaalayil thalai vali vaanthi ponavudan kuraivathu pola ulla
dhaa?
__________________________________________________________________________
Hemiplegic migraine (Q67)
EN Were you having severe throbbing like headache in one side of the head?
සිං ඔලුගේ එක පැත්තක, ඇගනනවො වගේ දරුණු කැක්කුමක් තිබුනද?
SI Oluwe eka patthaka anenawa wage darunu kakkumak thibunada?
த டையின் ஒற்டற ெக்கத் ில் குத்துவது நெொன்ற டை வைி இருந் ொ ?
TA thalayin oru pakkath thil kuththu vathu pola thalai valikku dhaa?
__________________________________________________________________________
Post-ictal Todd’s paresis (Q68)
EN Did you have a fit before the onset of these symptoms?
සිං ගේ ගලගේ ෙැගදන්න කලින් වලිප්පුවක් ෙැදුනද?
SI Me lede hadenna kalin walippuwak hadunada?
த இந் ெிேச்சிடன ப ொைங்க முன்னர் fit வந் ொ ?
TA intha pirach chinai thodanka munnar fit vantha dhaa?
__________________________________________________________________________
CNS infection (Q69)
EN Do you have fever and associated abnormal behaviuor?
සිං උණත් එක්ක ෙැසිරීගේ ගවනසක් ඇතිවුනොද?
SI Unath ekka hasireeme wenasak athiwunaada?
த உங்களுக்கு கொச்சலுைன் வித் ியொசமொன குணொ ிசயங்கள் வந்துள்ள ொ ?
TA unkalukku kaachchal udan viththi yaasa maana palak kangal vanthu ulla dhaa?
__________________________________________________________________________
metabolic encephalopathy (Q70)
EN Do you have any diseases in your kidneys or liver?
සිං වකුගඩුවල, අක්මොගේ ගලඩ මුකුත් තිගයනවද?
SI Wakugaduwala, akmaawe leda mukuth thiyenawada?
த உங்களுக்கு kidney இநைொ அல்ைது ஈேைிநைொ ந ொய்கள் ஏதும் இருக்கிற ொ ?
TA unkalukku kidney ilo allathu eeral ilo noaikal ethum irukkira dhaa?
__________________________________________________________________________
Hemorrhagic stroke (Q71)
EN Are you on any medications like warfarin?
සිං Warfarin වගේ ගබගෙත් මුකුත් පොවිච්ි කරනවද?
SI Warfarin wage beheth mukuth paawichchi karanawada?
த warfarin என்ற மருந்ட ெொவிக்கிறீர்களொ?
TA warfarin enkira marunthai paavikkireerkalaa?
12
__________________________________________________________________________
Complications
__________________________________________________________________________
Complications (Q72)
EN Infections such as respiratory tract infections and UTI
සිං ගසම, නැත්තේ මුත්රො දැවිල්ලක් ෙැදුනද?
SI Sema, nattham muthraa dawillak hadunada?
த ப ஞ்சில் சளி அல்ைது சைக்கடுப்பு நெொன்றடவ இருக்கிே ொ?
TA nenjil sali alladhu salak kaduppu poanravai iruk kira dhaa?
__________________________________________________________________________
Complications (Q73)
EN Associated neurological problems - seizures
සිං වලිප්පුව ෙැදුනද?
SI Walippuwa hadunada?
த வைிப்பு வந் ொ?
TA Walippu wandhadhaa?
__________________________________________________________________________
Complications (Q74)
EN Have you developped wounds in your back and buttocks?
සිං ිගේ ෙරි තේටේවල ෙරි තුවොල ගවලොද?
SI Pite hari thattamwala hari thuwaala welaada?
த முதுகில் அல்ைது ெின் ெகு ியில் புண்கள் உள்ள ொ ?
TA muthukil allathu pin pakiuthiyil punkal ulla dhaa?
__________________________________________________________________________
Complications (Q75)
EN Have you felt sudden onset pain in the limbs?
සිං අත්වල කකුල්වල එක පොරට දරුණු කැක්කුමක් ආවද?
SI Athwala kakulwala eka paarata darunu kakkumak aawada?
த கொல்களில் கடுடமயொன வைி உள்ள ொ ?
TA kaaal kalil kadu mayaana vali ulla dhaa?
__________________________________________________________________________
Level of functioning and other parts of the history

__________________________________________________________________________
Level of functioning of the patient - Barthel index (Q76)
EN Do you need help for ?
සිං උදේ අවශපය ගවනවද?
SI Udaw avashya wenawada?
த உங்களுக்கு உ வி ந டவப்ெடுகிற ொ ?
TA unkalukku uthavi thevaip padu kira dhaa?
13
__________________________________________________________________________
EN Bathing?
සිං නොන්න?
SI Naanna?
த குளிப்ெ ற்கு ?
TA kulippa thatku?
__________________________________________________________________________
EN Use of toilet
සිං වැසිකිලිය (toilet එක) පොවිච්ි කරන්න?
SI Wasikiliya (toilet eka) paawichchi karanna?
த மைசைகூைத்ட ெொவிக்க ?
TA mala sala kooda ththai paavippa thatku?
__________________________________________________________________________
EN Dressing
සිං ඇඳුේ අඳින්න?
SI Andum andinna?
த உடுப்பு நெொை?
TA uduppu poda
__________________________________________________________________________
EN Personal hygiene and cleanliness
සිං ිරිසිදුවට ඉන්න?
SI Pirisiduwata inna?
த சுத் மொக இருக்க
TA suththa maaka irukka?
__________________________________________________________________________
EN Grooming – i.e. combing hair
සිං ගකොන්ගේ පීරන්න?
SI Konde peeranna?
த முடி இழுக்க ?
TA thala mudi ilukka?
__________________________________________________________________________
EN Eating
සිං කෑම කන්න?
SI Kaama kanna?
த சொப்ெிை
TA saappida?
14
__________________________________________________________________________
Level of mobility
(See below)
__________________________________________________________________________
EN Transferring
සිං ගකොගෙවත් යන්න ඕගන් උනොම?
SI Kohewath yanna one unaama?
த எங்நகயொவது நெொக?
TA enke yaavathu poaka?
__________________________________________________________________________
EN Recreational activities
සිං විගනෝද ක්රියො කරන්න?
SI Winoda kriyaa karanna?
த பெொழுதுநெொக்குகளுக்கு ?
TA poluthu poakku kalukku?
__________________________________________________________________________
EN Speech and higher functional abilities of the patient
සිං කතොකරන්න?
SI Kathaakaranna?
த நெச?
TA pesa?
__________________________________________________________________________
EN Have you undergone any physiotherapy or occupational therapy
සිං ේයොයොේ කරන්න යැේවද?
SI Wyaayaam karanna yawwada?
த Exercise பசய்ய அனுப்ெினொர்களொ?
TA exercise seyya anuppi naar kalaa?
__________________________________________________________________________
Drug Hx (Q88)
EN Anticoagulants , Antiplatelets
සිං <Name of the drug> පොවිච්ි කරනවද?
SI <Name of the drug> paawichchi karanawada?
த <Name of the drug> ெொவிக்கிறீங்களொ?
TA <Name of the drug> pavikkireen kalaa?
15
__________________________________________________________________________
Family Hx (Q89)
EN DM, HT, Young onset stroke
සිං පවුගල් කොටෙරි දියවැඩියොව, Pressure, අඩු වයගසප අංශභොගය ෙැදිලො තිගයනවද?
SI Pawule kaatahari diyawadiyaawa, pressure, adu wayase anshabaagaya hadila
thiyenawada?
த குடும்ெத் ில் யொருக்கொவது diabetes, pressure, குடறஞ்ச வயசிை ெொரிசவொ ம்
வந் ிருக்கொ?
TA Kudumpaththil yaarukka vadhu diabetes, pressure, kurainja vayasila paarisa
vaadham vandhirukkaa?
__________________________________________________________________________
த உங்கள் வட்டில்
ீ எத் டன நெர் இருக்கிறொர்கள் ?
__________________________________________________________________________
සිං පවුගල් මොසික ආදොයම කීයද?
த உங்களது குடும்ெ வருமொனம் எவ்வளவு ?
__________________________________________________________________________
EN What your family members are doing?
සිං පවුගල් අය ගමොනවද කරන්ගන්?
த மற்றவர்கள் என்ன பசய்கிறொர்கள் ?
__________________________________________________________________________
සිං ගගදර තිගයන්ගන් ගේ පැත්තකද? ටවුමකද?
த உங்களது இைம் கிேொமமொ ? அல்ைது town ஆ ?
16
__________________________________________________________________________
EN Describe the structure of your house?
සිං ගගය ගැන කියන්න.
SI Geya gana kiyanna.
த வட்டைப்ெற்றி
ீ பசொல்லுங்கள் ?
TA veetai patri sollunkal?
__________________________________________________________________________
EN Is it a two story building?
සිං තේටු ගදගක් ගගයක්ද?
SI Thattu deke geyakda?
த ிைத்ப ொையொ அல்ைது மொடியொ ?
TA nilath thoadayaa allathu maadiyaa?
__________________________________________________________________________
EN Are there any staircases in your house?
සිං ගගදර පඩිගපල් තිගයනවද?
SI Gedara padipel thiyenawada?
த ெடிக்கட்டு ஏதும் உள்ள ொ ?
TA padi kattu ethum ulla dhaa?
__________________________________________________________________________
EN Are there any open well or pit nearby to your house?
සිං ගේ වගේට ලිං, වලවල් තිගයනවද?
SI Ge wateta ling, walawal thiyenawada?
த வட்டை
ீ சுற்றி குழி அல்ைது கிணறு ஏதும் உள்ள ொ ?
TA veettai sutri kuli allathu kinaru ethum ulla dhaa?
__________________________________________________________________________
EN Does your house have sufficient light in every areas?
සිං ගගදර ෙැමතැනම ගෙොඳට එලිය තිගයනවද?
SI Gedara hamathanama hondata eliya thiyenawada?
த வட்டில்
ீ எல்ைொப் ெக்கமும் பவளிச்சம் ன்றொக உள்ள ொ ?
TA veettil ellaap pakkamum velichcham nanraaka ulla dhaa?
__________________________________________________________________________
EN Are the floors slippery in the toilet and bathrooms?
සිං Toilet, bathroom වල බිම ලිසපසනවද?
SI Toilet, bathroom wala bima lissanawada?
த toilet,bathroom டே எல்ைொம் வழுக்கு ொ?
TA toilet ,bath room il tharai valukku dhaa?
17
__________________________________________________________________________
EN Are there any one at home to help you?
සිං ගගදර උදේවට කවුරුත් ඉන්නවද?
SI Gedara udawwata kauruth innawada?
த வட்டிை
ீ உங்களுக்கு help ெண்ண யொரும் இருக்கிறொர்களொ ?
TA veettil unkalukku help panna yaarum irukki raar kalaa?
__________________________________________________________________________
EN Do you get any support from the organizations?
සිං ආයතන වලින් උදේ ලැගබනවද?
SI Aayathana walin udaw labenawada?
த உங்களுக்கு ிறுவனம் ஏதும் உ வி பசய்கிற ொ ?
TA unkalukku niruvanam ethum uthavi sei kira dhaa?
__________________________________________________________________________
EN What is the nearest hospital wih rehabilitation facilities?
සිං ගගදරට ළඟම ගලොකු ඉසපිරිතොගල ගකොගෙද?
SI Gedarata langama loku ispirithaale koheda?
த வட்டுக்கு
ீ கிட்ை உள்ள பெரியொஸ்ெத் ிரி எது?
TA veettukku kitta ulla periya aaspathiri ethu?
__________________________________________________________________________
සිං ගගදර වොෙනයක් තිගයනවද?
த வட்டில்
ீ வொகனம் உள்ள ொ ?
__________________________________________________________________________
EN how long does it take to reach hospital?
සිං ඉසපිරිතොගලට එන්න ගකොච්චර ගවලොවක් යනවද?
SI Ispirithaaleta enna kochchara welawak yanawada?
த வட்டிைிருந்து
ீ டவத் ியசொடை பசல்ை எவ்வளவு ந ேம் ந டவ ?
18
PYREXIA OF UNKNOWN ORIGIN
Personal History

த உங்களுடைய பெயர் என்ன?
___________________________________________________________________________
EN How old are you?
SI Vayasa keeyada?
த வயது எவ்வளவு ?
__________________________________________________________________________
සිං රැකියොව ගමොකක්ද?
த ப ொழில் என்ன ?
TA Tholil enna?
__________________________________________________________________________
SI Gama koheda?
த உங்களுடைய ஊர் எது ?
__________________________________________________________________________
EN Are you married?
සිං කසොද බැඳලද?
த ிருமணம் முடித்து விட்டீர்களொ ?
1
__________________________________________________________________________
த எத் டன ெிள்டளகள் ?
__________________________________________________________________________
සිං ගේ පොර ඉසපිරිතොගලට ආගේ ඇයි?
த டவத் ியசொடைக்கு வந் ந ொக்கம் ?
__________________________________________________________________________

__________________________________________________________________________
Analysis of the fever (Q8)
EN How long do you have fever?
සිං උණ දවසප කීයද?
SI Una dawas keeyada?
த எவ்வளவு ந ரமொக கொச்சல் அடிக்குது ?
TA evvalavu nera maaka kaachchal adikku dhu?
__________________________________________________________________________
EN How did the fever begin?
සිං උණ ගකොගෙොමද පටන්ගත්ගත්
SI Una kohomada patangatthe?
த கொச்சல் எப்ெடி ப ொைங்கியது ?
TA kaachchal eppadi thodan kiya dhu?
__________________________________________________________________________
EN Please tell how did the fever progressed?
සිං ගකොගෙොමද වැඩි උගන්?
SI Kohomada wadi une?
த எப்ெடி கூடியது ?
TA eppadi koodiya dhu?
2
__________________________________________________________________________
EN Was it continuous or intermittent?
සිං එක දිගට තිබුනද කැඩී කැඩී ආවද?
SI Eka digata thibunada kadi kadi awada?
த ப ொைர்ந்து இருந் ொ அல்ைது விட்டு விட்டு வந் ொ ?
TA thodarnthu iruntha dhaa alladhu vittu vittu vandha dhaa ?
__________________________________________________________________________
EN If it is intermittent, how many times in a day did the fever come?
සිං දවසට කී පොරක් ආවද?
SI Dawasata kee paarak aawada?
த ஒரு ொடளக்கு எத் டன ரம் கொச்சல் அடிக்கிறது ??
TA oru naalaikku eththanai tharam kaachchal adikkiradhu?
__________________________________________________________________________
EN How long does an episode last?
සිං එක පොරක් ආගවොත් ගකොච්චර ගවලොවක් තිගයනවද?
SI Eka paarak aawoth kochchara welaawak thiyenawada?
த ஒருக்கொ கொச்சல் வந் ொ , எவ்வளவு ந ரம் இருக்கும்?
TA orukkaa kaachchal vanthaa evvalavu neram irukkum?
__________________________________________________________________________
EN What is the interval between two fever episodes?
සිං ගකොච්චර ගවලොවකට සැරයක් ෙැගදනවද?
SI Kochchara welawakata sarayak hadenawada?
த எவ்வளவு ந ரத்துக்கு ஒருக்கொ கொச்சல் வரும் ?
TA evva;avu naeraththukku orukkaa kaachchal varum?
__________________________________________________________________________
EN Can you remember the temperature values?
සිං උෂපණත්වය දන්නවද?
SI Ushnathwaya dannawada?
த எவ்வளவுக்கு கொச்சல் அடிச்சப ண்டு ப ரியுமொ ?
TA evvalavukku kaachchal adichcha thendu theriyumaa ?
__________________________________________________________________________
EN Were you feeling cold?
සිං සීතල දැනුනද?
SI Seethala danunada?
த கூ ைொக இருந் ொ ?
TA koodha laaka iruntha dhaa ?
3
__________________________________________________________________________
EN Were you shivering?
සිං ඇඟ ගවේුවද?
SI Anga wewluwada?
த டுக்கம் இருந் ொ ?
TA nadukkam irundha dhaa ?
__________________________________________________________________________
EN How were you feeling in between fever episodes?
සිං උණ බැෙැපු ගවලොගේ ගකොගෙොමද හිටිගේ?
SI Una bahapu welaawe kohomada hitiye?
த கொச்சல் விட்ை ெின் எப்ெடி இருந் து ?
TA kaachchal vitta pin eppadi iruntha thu?
__________________________________________________________________________
EN Did you feel that fever and pain were reducing after taking Panadol?
සිං Panadol බිේවම උණයි ඇගේ ගේදනොවයි අඩු උනොද?
SI Panadol biwwama unai ange wedanaawai adu unada?
த Panadol நெொட்ை ெிறகு கொச்சலும் ,நமல் வைியும் குறஞ்ச ொ ?
TA panadol potta piraku kaachchalum mel valiyum kuranja dhaa ?
___________________________________________________________________________
__________________________________________________________________________
Tuberculosis (Q20)
EN Do you have more fever in the nights?
සිං උණ රෑට වැඩිද?
SI Una raata wadida?
த இரவு கொச்சல் கூை அடிச்ச ொ ?
TA iravu kaachchal kooda adichcha dhaa ?
__________________________________________________________________________
Tuberculosis (Q21)
සිං දිග කොලයක් කැසපස තිබුනද?
த ீண்ை கொைமொக இருமல் இருந் ொ ?
4
__________________________________________________________________________
Tuberculosis (Q22)
EN Are you coughing out blood with Sputum?
සිං කැෙැල ගසමත් එක්ක ගේ යනවද?
SI Kahala semath ekka le yanawada?
த சளியுைன் இரத் ம் வந் ொ ?
TA saliyudan iraththam vantha dhaa ?
__________________________________________________________________________
Tuberculosis (Q23)
EN Are you sweating more in the nights?
සිං රෑට වැඩිගයන් දෙඩිය දොනවද?
SI Raata wadiyen dahadiya daanawada?
த இரவில் அ ிகம் வியர்க்கிற ொ ?
TA iravil adhikam viyark kiradhaa ?
__________________________________________________________________________
Tuberculosis (Q24)
EN Do you feel hungry?
සිං බඩගින්න තිගයනවද?
SI Badaginna thiyenawada?
த ெசிக்கிற ொ ?
TA pasikkiradhaa ?
__________________________________________________________________________
Tuberculosis (Q25)
EN Have you lost weight?
සිං බර අඩු උනොද?
SI Bara adu unada?
த ெொரம் குடறஞ்சு இருக்கொ?
TA paaram kuranju irukkaa ?
__________________________________________________________________________
Tuberculosis (Q26)
EN Have you had any contact with people with long term cough and very sick?
සිං දිග කොලයක් කැසපස තිබිල ගගොඩක් ගලඩ ගවලො හිටිය කුරුත් ආශපරය කලොද?
SI Diga kaalayak kassa thibila godak leda wechcha kauruth aashraya kalaada?
த சரியொன வருத் மும் இருமலும் உள்ளவர்களுைன் இருந்த் ீங்களொ ?
TA sariyaana varuththamum irumalum ullavar kaludan iruntheen kalaa ?
__________________________________________________________________________
Tuberculosis (Q27)
EN Did you receive treatment from Welisara?
සිං වැලිසරින් ගබගෙත් ගත්තද?
SI Welisarin beheth gaththada?
த welisara ை மருந்து எடுத் ீங்களொ ?
TA welisara la marunthu eduththeenkala ?
5
__________________________________________________________________________
Lymphoma (Q28)
EN Did you notice any lumps in your neck?
සිං ගබේගේ ගගඩි මුකුත් ආවද?
SI Belle gedi mukuth aawada?
த கழுத் ிை கட்டி ஏதும் வந் ொ ?
TA kaluththila katti ethum vantha dhaa ?
__________________________________________________________________________
Lymphoma (Q29)
Features of anaemia (refer anaemia note)
__________________________________________________________________________
Lymphoma (Q30)
EN Do you have severe back pain which is getting worse at the nights?
සිං රෑට වැඩි ගවන දරුණු ගකොන්ගේ කැක්කුමක් තිගයනවද?
SI Raata wadiwena darunu konde kakkumak thiyenawada?
த கடுடமயொன முதுகு வைி இரவில் கூடுவது நெொை உள்ள ொ ?
TA kaumayaana muthuku vali iravil kooduvathu poala ulla dhaa ?
__________________________________________________________________________
Lymphoma (Q31)
EN Do you get cold and diarrhoea very frequently?
සිං නිතර ගසම ෙැගදනවද? බඩ යනවද?
SI Nithara sema hadenawada? Bada yanawada?
த அடிக்கடி டுமலும், வயித் ொையும் நெொகு ொ ?
TA adikkadi thadumalum vayiththaalayum poakudhaa ?
__________________________________________________________________________
Infective endocarditis (Q32)
EN Have you been diagnosed with any heart diseases?
සිං ෙෘදවසපුගේ (heart එගක්) ගලඩ මුකුත් තිගයනවද?
SI Hrudawasthuwe (heart eke) leda mukuth thiyenawada?
த heart ை வருத் ம் இருக்கு ொ ?
TA heart la varuththam irukkudhaa ?
__________________________________________________________________________
EN Have you had an illness called rheumatic fever in your childhood?
සිං ගපොඩි කොගේ Rheumatic උණ ෙැදිලො තිගයනවද?
SI Podi kaale rheumatic una hadila thiyenawada?
த சின்ன வயசிை rheumatic கொச்சல் வந் ொ ?
TA sinna vayasila rheumatic kaachchal vanthadhaa ?
__________________________________________________________________________
Dental caries (examination finding)
6
__________________________________________________________________________
EN Have you undergone any surgeries recently?
සිං ලඟදි operation ගකරිලො තිගයනවද?
SI Langadi operation kerila thiyenawada?
த கிட்ைத் ிை operation ஏதும் பசஞ்சொங்களொ ?
TA kittaththila operation ethum senjaankalaa ?
__________________________________________________________________________
EN Are you using injectable heroin?
සිං ගෙගරොයින් එන්නත් පොවිච්ි කරලො තිගයනවද?
SI Heroin ennath pawichchi karala thiyenawada?
த heroin ஊசி ெொவிப்ப்ெீங்களொ?
TA heroin oosi paavippeenkalaa?
__________________________________________________________________________
සිං ෙන්දි ගේදනොවක් තිගයනවද?
SI Handi wedanawak thiyenawada?
த joint வைி இருக்கு ொ ?
TA joint vali irukkudhaa ?
__________________________________________________________________________
EN Have you developped rashes on your skin?
සිං ෙගේ පු දොලො තිගයනවද?
SI Hame palu daala thiyenawada?
த ந ொைிை rash எதும் வந் ொ ?
TA thoalila rash ethum vanthadhaa ?
__________________________________________________________________________
EN Do you have wound inside your mouth?
සිං කට ඇුගේ ුවොල තිගයනවද?
SI Kat athule thuwaala thiyenawada?
த வொயுக்குள்ள புண் இருக்கு ொ ?
TA vaayukkulla punn irukku dhaa ?
__________________________________________________________________________
සිං මුත්රො රු පොටට යනවද?
த சிறு ீர் சிவப்ெொக நெொகு ொ ?
7
__________________________________________________________________________
EN Do you see excess foam while you are urinating?
සිං මුත්රො යේී ගපන එනවද?
SI Muthraa yaddi pena enawada?
த சிறு ீர் பெய்யும் நெொது நுடர அ ிகம்நெொகு ொ ?
TA siru neer peyyum poathu nurai athikam poakudhaa ?
__________________________________________________________________________
Malaria (Q42)
EN Have you gone to any rural places where malaria is seen?
සිං මැගේරියො තිගයන පැත්තකට ගමන් ගියොද?
SI Malaria thiyena patthakata gaman giyaada?
த மநைரியொ உள்ள இைங்களுக்கு நெொனிங்களொ ?
TA Malaria ulla idankalukku poaninkalaa ?
__________________________________________________________________________
Typhoid (Q43)
EN Do you take food from outside?
සිං ිටතින් කෑම ගන්නවද?
SI Pitathin kaama gannawada?
த பவளியொை சொப்ெொடு வொங்கி சொப்ெிடுவங்களொ
ீ ?
TA veliyaala saappaadu vaanki saappidu veenkalaa ?
__________________________________________________________________________
Typhoid (Q44)
EN Are the foods which you are taking unhygienic?
සිං ිටතින් ගන්න කෑම ිරිසිදුද?
SI Pitathin ganna kaama pirisiduda?
த பகட்டுப்நெொன சொப்ெொடு எடுப்ெீங்களொ ?
TA kettup poana saappadu eduppeenkalaa ?
__________________________________________________________________________
Typhoid (Q45)
EN Do you have constipation and diarrhoea alternatively?
සිං මොරුගවන් මොරුවට බඩ ගේගේනවයි බඩ යනවයි තිබුනද?
SI Maaruwen maaruwata bada welenawai bada yanawai thibunada?
த மைச்சிக்கலும் வயித் ொடளயும் மொறி மொறி வரு ொ
TA malach chikkalum vayiththaalayum maari maari varudhaa ?
__________________________________________________________________________
Typhoid (Q46)
EN Have you noticed rose spots in abdomen?
සිං බගේ ගරෝස පොට තිත් ආවොද?
SI Bade rosa paata thith aawada?
த வயித் ிை rose கைர்ை rash வந் ொ ?
TA vayiththila rose colorla rash vanthdhaa ?
8
__________________________________________________________________________
Typhoid (Q47)
සිං බගේ දකුණු පැත්ත රිගදනවද?
SI Bade dakunu paththa ridenawada?
த வயித் ிை வைது ெக்கத் ிை வைிக்கு ொ ?
TA vayiththila valathu pakkaththila valikkuthaa ?
__________________________________________________________________________
HIV (Q48)
HIV (Refer stroke tute)
_________________________________________________________________________
Hepatoma (Q49)
EN Did you notice yellowish discoloration of the eyes?
සිං ඇසප කෙ උනොද?
SI As kaha unada?
த கண் மஞ்சளொ இருக்கு ொ ?
TA kann manjalaaka irukkudhaa ?
__________________________________________________________________________
Hepatoma (Q50)
EN Do you feel pain on the right upper abdomen?
සිං බගේ දකුණු පැත්ගත් උඩ රිගදනවද?
SI Bade dakunu patthe uda ridenawada?
த வயித் ின் வைது நமல் ெக்கத் ிை வைி இருக்கொ ?
TA vayiththin valathu mael pakkaththil valiu irukkaa ?
__________________________________________________________________________
Renal cell carcinoma (Q51)
__________________________________________________________________________
EN Do you have burning sensation while passing urine?
සිං මුත්රො දැවිේලක් තිගයනවද?
SI Muthraa dawillak thiyenawada?
த சிறு ீர் கழிக்கும் நெொது எரிகிற ொ ?
TA siru neer kalikkum poathu erikira dhaa ?
9
__________________________________________________________________________
EN Do you have fullness in either sides of the abdomen?
සිං බගේ ගදපැත්ත පුරොදොලො වගේද?
SI Bade depaththa puraadaala wageda?
த வயித்துக்கு side ை வங்கி
ீ இருக்கொ ?
TA vayith thukku side la veenki irukkaa ?
__________________________________________________________________________
UTI (Q54)
EN Are you urinating much frequenlty than before?
සිං ඉසපසරට වඩො නිතරම මුත්රො යනවද?
SI Issarata wadaa nitharama muthraa yanawada?
த அடிக்கடி சிறு ீர் வரு ொ ?
TA adikkadi siru neer varu dhaa ?
__________________________________________________________________________
UTI (Q55)
EN Do you have burning sensation while passing urine?
සිං බගේ දකුණු පැත්ගත් උඩ රිගදනවද?
SI Bade dakunu paththe uda ridenawada?
த வயித் ின் வைது நமல் ெக்கத் ிை வைி இருக்கொ ?
TA vayiththin valathu mael pakkaththil valiu irukkaa ?
__________________________________________________________________________
UTI (Q56)
__________________________________________________________________________
IMN (Q57)
EN Do you have sore throat?
සිං උගුර රිගදනවද?
SI Ugura ridenawada?
த ப ொண்டைக்குள்ள வைிக்கு ொ ?
TA thondai kkulla valikku dhaa ?
__________________________________________________________________________
Chronic meningitis (Q58)
Headache (Refer stroke notes)
__________________________________________________________________________
Adult onset seizures (Refer stroke notes)
__________________________________________________________________________
Focal neurological signs (Refer stroke notes)
10
__________________________________________________________________________
Drug fever (Q61)
EN Have you been started on any antibiotics?
සිං පරතිජීවක (antibiotic) දුන්නද?
SI Prathijeewaka (antibiotic) dunnada?
த antibiotics மருந்து ஏதும் குடுத் ொங்களொ ?
TA antibiotic marunthu ethum kuduththaankalaa ?
__________________________________________________________________________
IE (Q62)
Heart failure (Refer heart failure notes)
__________________________________________________________________________
IE (Q63)
Arrythmias (palpitations) (Refer heart failure notes)
__________________________________________________________________________________
Treatment and Investigations

__________________________________________________________________________
(Q64)
EN What were the treatments given to you?
සිං පරතිකොර ගමොනවද කගේ?
SI Prathikaara monawada kale?
த இது வடரக்கும் என்ன treatment பசஞ்சொங்க ?
TA Ithu varaikkum enna treatment senjaanka?
__________________________________________________________________________
Blood culture (Q65)
EN Have they taken blood from you after cleaning several times?
සිං ෙම කිහිප වතොවක් සුේද කරලො ගේ එකක් ගත්තද?
SI Hama kihipa wathaawak sudda karala le ekak gaththada?
த ல்ைொ clean ெண்ணி இரத் ம் எடுத் ொங்களொ ?
TA nallaa clean panni iraththam eduththaankalaa ?
__________________________________________________________________________
Echo (Q66)
EN Did you undergo Echo test?
සිං Echo පරීක්ෂණයක් කලොද?
SI Echo pareekshanayak kalaada?
த echo பசஞ்சொங்களொ ?
TA echo senjaankalaa ?
__________________________________________________________________________
Bone marrow (Q67)
EN Have they taken sample from your bones?
සිං අසපි වලින් විදලො ගත්තද?
SI Asthi walin widala gatthada?
த எலும்புை ஊசி குத் ி எடுத் ொங்களொ /
TA elumpula oosi kuththi eduth thaankalaa?
11
__________________________________________________________________________
Mantoux (Q68)
EN Have they done the testing for TB in your hand?
සිං අගත් ක්ෂයගරෝග පරීක්ෂණයක් කලොද?
SI Athe kshayaroga pareekshanayak kalaada?
த டகயிை TB check ெண்ணொங்களொ ?
TA kaiyila TB check pannaankalaa ?
_________________________________________________________________________________
Social History
__________________________________________________________________________
(Q69)
EN Do you have pets at your home?
සිං ගගදර සුරතේ සත්ු ඉන්නවද?
SI Gedara surathal saththu innawada?
த வட்டிை
ீ மிருகம் ஏதும் இருக்கொ ?
TA Veettila mirukam ethum irukkaa?/
__________________________________________________________________________
(Q70)
EN Did you go anywhere, before this illness began?
සිං ගේ ගලගේ පටන්ගන්න කලින් ගමන් මුකුත් ගියොද?
SI Me lede patanganna kalin gaman mukuth giyaada?
த வருத் ம் வர முன்னம் எங்நகயொவது ெயணம் நெொனிங்களொ ?
TA varuththam vara munnam enkeyaavathu payanam poaninkalaa ?
12

Trilingual Tute Phase 1

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Trilingual Tute Phase 1

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CLINICAL MEDICINE LONG CASE

HISTORY TAKING IN NATIVE LANGUAGES

Personal history (Q1)

History of Presenting Complaint

Treatment and Investigations upto now

ACUTE CHEST PAIN

Personal history (Q1)

History of Presenting Complaint

Management and Investigations upto now

Other Components of the History

Personal history (Q1)

History of Presenting Complaint

Personal history (Q1)

History of Presenting Complaint

Clinical Pattern of Stroke

Other stroke-like events

Level of functioning and other parts of the history

PYREXIA OF UNKNOWN ORIGIN

Personal history (Q1)

History of Presenting Complaint

Treatment and Investigations

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