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Systems by Mind Map: Systems

1. Gastrointestinal

1.1. Presenting symptoms

1.1.1. Weight loss or weight gain Weight loss + loss of appetite + increased appetite + early satiation

1.1.2. Dysphagia Is it true dysphagia, or just painful swallowing? Painful swallowing Dysphagia

1.1.3. Heartburn? Burning sensation? Aggravated by bending, stooping, or lying supine? Antacids relieve pain? Sour or bitter taste in mouth? Aggravated by alcohol, chocolate, caffeine, a fatty meal, theophylline, calcium channel blockers, anticholinergic drugs?

1.1.4. Nausea or vomiting Acute GIT infection? Small bowel obstruction? Chronic Pregnancy? Drugs? (digoxin, opiates, dopamine agonists, chemotherapy) Psychogenic, eating disorders (Rarely) increased intracranial pressure Peptic ulcer disease with gastric outlet obstruction Does the patient have diabetes? Gastroparesis? Has the patient had gastric surgery? Gastroparesis? Is the patient jaundiced? Acute hepatobiliary disease? Alcoholism?

1.1.5. Haematemesis

1.1.6. Abdominal pain "Is it acute or chronic?" "Where does it hurt?" Localised Epigastric Renal angle, possibly radiating to groin Periumbilical region Retrosternal, travelling upwards towards the throat "What is the nature of the pain?" Colicky Dull Burning "Does anything make it worse?" Eating Alcohol, chocolate, caffeine, fatty meals, theophylline, calclium channel blockers, anticholinergic drugs "Does anything make it better?" Rolling around Food / antacids Vomiting Defecation, Lying perfectly still Red flags Sudden onset Increasing severity Syncope/pre-syncope Vomiting (esp. protracted) Haematemesis Abdominal distension (esp. progressive) Pallor and sweating Tachycardia/atrial fibrillation Hypotension Fever Rebound tenderness, guarding, rigidity Decreased urine output

1.1.7. Jaundice "Is the urine dark?" Dark urine Not dark

1.1.8. Change in bowel motions Diarrhoea "How much has there been?" Constipation Chronic Mucus in bowel movements Rectal ulcer? Fistula? Villous adenoma? Irritable bowel syndrome? Blood in feces Malaena Small amounts of bright red blood Large amounts of blood

2. Respiratory

2.1. Cough

2.1.1. Moist or dry? Dry Viral infection? Asthma? Gastroesophageal reflux? Interstitial lung disease? ACE inhibitors? Moist Acute or chronic? What is the sputum like?

2.1.2. What time of day? Nocturnal cough Asthma? LVF? Post-nasal drip? Morning cough Smoking?

2.1.3. What's it sound like? Paroxysmal, w/ terminal whoop Whooping cough? Bovine Recurrent laryngeal nerve palsy? Harsh, seal-barking Croup?

2.2. Dyspnoea

2.2.1. "When does/did it occur?" On waking COPD? Nocturnal Asthma? LVF?

2.2.2. Sudden onset in young male Pneumothorax?

2.3. Stridor

2.3.1. Sudden onset Anaphylaxis? Inhaled foreign body? Epiglottitis? + look for classic forward-leaning posture Croup?

2.3.2. Gradual onset Malignancy?

2.4. Wheeze

2.4.1. Asthma?

2.4.2. Localised, not cleared with coughing Carcinoma?

3. Cardiovascular

3.1. Congenital heart diseases

3.1.1. L