Systemic Review: (ROS) Cardiovascular:

*cardiac: Chest pain. Dyspnea/orthopnea/paroxysmal nocturnal dyspnea(PND), Claudication, L.L edema, Palpitation, Cyanosis (central/peripheral). *vascular: Peripheral coldness/hotness, Leg cramps/claudication, Abnormal color, varicosity, ulcers.

(5th ): (7th ): (8th ): Deafness, dizziness (lightheadedness), vertigo, tinitis. (9th &10th ): swallowing defect+ dysphnoia, loss of taste from posterior third of tongue. (11th ): Dropping of the shoulders, difficult in turning the neck, (12th ): dysphasia, dysarthria or dysphonia. Motor system: -Destructive lesion: weakness or paralysis (specify: starting episode, tone & wasting, proximal/distal, upper or lower limb, affection of daily life). -Irritative lesion: syncope(faint) or seizure(fits=convulsion), Tremor, Involuntary movement. Sensory system: -Destructive lesion: Hyposthesia (decrease sensation), anaesthesia (no sensation). - Irritative lesion: Pain, hyperesthesia and/or paresthesia (numbness). Autonomic (Sphincteric) Disturbances: control of micturation or defecation. impotence. Others: Back pain. Gait abnormality. face symmetry, eyelid dropping(or loss of blink ), food accumulation behind cheek, loss of taste from the anterior two-thirds of the tongue. sensory: face sensation, Motor: deviation of the jaw(difficult in mastication).

Musculoskeletal: Athralgia, myalgias, Stiffness, redness, swelling, Arthritis,

Respiratory: Cough, sputum (color+amount), hemoptysis, wheezing, sneezing, Snoring, hoarseness, Fever, night sweat. Gastrointestinal: Oral ulcers, nausea/vomiting, hematemesis/blenching, dysphagia/odynophagia, heartburn/regurgitation, abdominal pain/distension, diarrhea/constipation, bleeding per rectum(color+amount)/incotinence, melena/hematochezia.

Genitourinary: -Urinary: Dysuria, hematuria, nocturia, frequency, agency, hesitancy, pain (e,g: loin,suprepubicetc), discharge, fever. -Genital: pain/itching (penis, testes, vulva,), discharge (color+amount+timing), masses ( e.g. hernia, testicular mass,).

Neurological: General: headache, sleep disturbances( e.g. insomnia). Higher mental function: conscious level, memory disturbances, speech abnormalities (dysphasia- dysarthriadusphonia) depression C.Ns: (1st ): smell abnormality: Anosmia Parosmia (perception of nonexistent odors) (2nd ,3rd ,4th &6th ): Decrease visual acuity, diplopia (double vision), amblyopia (blurred vision), photophobia, visual loss.

Gynecological &O.B: -Gynecological: menarche age: menstrual bleeding duration & amount: length of the cycle: presence of pain &its relation to bleeding:... the first day of last menstrual bleeding:. contraception: dysmenorrhea, dyspareunia, instrumental bleeding, menopausal age: postmenopausal bleeding duration & amount: -Obstetrics: A) In each delivery ask: duration of pregnancy (preterm, fullterm, postterm) mode of delivery (spontaneous vaginal, by forceps,) the newborn (male or female, alive or dead): complication (fetal or maternal) in the puerperium B) In each abortion: duration of pregnancy (weeks): mode of termination (spontaneous or induced) complication in the post abortive period:
*sexual history: in some cases as: infertility, STDs, any G.U discharge *breast: pain, lump, discoloration, bleeding/discharge.

Endocrine: Polyuria/polydipsia, Aphagia (loss of appetite)/hyperphagia, Amenorrhea/galctorrhea, Heat/cold intolerance, Gain/loss of weight, Skin /hair changes, Sweating/dryness.

Hematological: easy fatigability, easy bleeding, bruising, yellow skin, lymphadenopathy. Dermatolgical : Rashes, skin discolorations, nail changes.

Done by: Dr.Khalid Alorabi Dr.alorabi@hotmail.com