It has been historically used to describe a subacute presentation of a single illness of at least 3 weeks' duration during which a fever >38.3°C (100.9°F) is present for most days and the diagnosis is unclear after 1 week of intense investigation. Title: HISTORY TAKING OF FEVER 1 HISTORY TAKING OF FEVER 2 Anamnesis (auto anamnesis and/or hetero anamnesis) Physical Examination Laboratory Analysis Others Diagnostic modalities Differenti al Diagnosis Working Diagnosis 3 Beginning of … In contrast, fever of unknown origin is not well defined in children. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Body temperature is controlled by the hypothalamus. do you get heartburn? Ask the patient if they’re currently experiencing any side effects from their medication: Relevant medications in the context of PUO include: Ask the patient if there is any family history of cancer or autoimmune conditions: Ask if any of the patient’s close family members currently have any serious infections such as tuberculosis: Explore the patient’s social history to understand their social context. Taking a Fever History It is important to take a fever history to distinguish dengu e from other infectious and noninfectious diseases. An inconsistent history should raise the suspicion of a factitious fever or Munchausen syndrome by proxy. History Taking – Overview. You have 14 minutes cellulitis, Kawasaki’s disease), the type of infection and if this was confirmed (e.g. hepatitis), Genitourinary: dysuria, frequency, haematuria, urethral discharge (e.g. breaks in the skin), recreational drug use (intravenous and intranasal), Chemoprophylaxis and compliance (e.g. Ensure you initially keep a comfortable distance, establishing eye contact and rapportwith the family. ²,³ The most common causes of PUO include the following: 4 1. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Record the frequency, type and volume of alcohol consumed on a weekly basis. It dates back as far as civilization itself. PACES Station 2: HISTORY TAKING Patient details: Mr John Davidson, a 25-year-old man Your role: You are the doctor in the medical admissions unit Presenting complaint: Fever Please read the letter printed below. The definition of fever of unknown origin (FUO), as based on a case series of 100 patients,3 calls for a temperature higher than 38.3°C on several occasions; a fever lasting more than three weeks; and a failure to reach a diagnosis despite one week of inpatient investigation. A collection of surgery revision notes covering key surgical topics. Some general communication skills which apply to all patient consultations include: Use open questioning to explore the patient’s presenting complaint: Provide the patient with enough time to answer and avoid interrupting them. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. Hodgkin’s/non-Hodgkin’s lymphoma). Confirm the patient’s name and date of birth. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up. As in any other disease history of the illness is important for a good clinical management. There is not a single agreed-upon upper limit for normal temperature with sources using values between 37.2 and 38.3 °C (99.0 and 100.9 °F) in humans. Although the differential diagnosis is very broad, adequate history and physical examination can help the clinician narrow down a list of more probable etiologies. Pyrexia of unknown origin (PUO) is defined as fever of 38.3°C or greater for at least 3 weeks with no identified cause after three days of hospital evaluation or three outpatient visits.¹ Additional categories of PUO have since been added, including nosocomial, neutropenic and HIV-associated PUO. You can change your ad preferences anytime. Gain consent to proceed with history taking. Open questions are effective at the start of consultations, allowing the patient to tell you what has happened in their own words. To evaluate a fever, your doctor may: 1. Factitious fever this is defined as fever engineered by the patient by manipulating the thermometer andor … is it worse at night or in the morning? History taking in patients - FEVER routine questions Routine questions about cardinal symptoms: Symptom 02: Fever. A birth weight of less than 2500 g, rupture of membranes before the onset of labor, septic or traumatic delivery, fetal hypoxia, maternal per… HISTORY TAKING IN FEBRILEPATIENTS Using the Calgary Cambridge guide as a framework to interviewing patients. Fever is a common symptom. Infectious causes of fever after travel could have been acquired before, en route or even after the specific travel, so care with history-taking is important. Fever was associated with chills and rigors. Explore the patient’s general social context including: Record the patient’s smoking history, including the type and amount of tobacco used. Headache, jaw claudication, scalp tenderness, visual loss: suggestive of giant cell arteritis which is associated with polymyalgia rheumatica. an increase in the This will help ensure your consultation is more natural, patient-centred and not overly formulaic. completing a course of antibiotics), close contact with others who were unwell at the time, recent injuries (e.g. Signposting, in a history taking context, involves explicitly stating what you have discussed so far and what you plan to discuss next. A comprehensive collection of medical revision notes that cover a broad range of clinical topics. Some experts have argued for a more comprehensive defi… It is important you do not forget the general communication skills which are relevant to all patient encounters. The exploration of ideas, concerns and expectations should be fluid throughout the consultation in response to patient cues. Rashes: associated with lupus (butterfly rash), sarcoidosis (erythema nodosum) and adult-onset Still’s disease (salmon-pink coloured rash). healthcare worker, exposure to animals). IFN-gamma is produced mainly by T-cells and natural killer cells activated by antigens, mitogens, or alloantigens. Consider fever documented at home by a reliable parent or caregiver the same as fever found upon presentation. The exact lower cutoff for fever varies from 99.4°F to 100.4°F. Check out our brand new medical MCQ quiz platform at https://geekyquiz.com. If the patient does have a medical condition, you should gather more details to assess how well controlled the disease is and what treatment(s) the patient is receiving. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Ask about the patient’s current occupation to identify any potential exposure to infectious diseases (e.g. Address 7. Order tests, such as blood tests or a chest X-ray, as needed, based on your medical history and physical examBecause a fever can indicate a serious illness in a young infant, especially one 28 days or younger, your baby might be admitted to the hospital for testing and treatment. It is important for physicians to be diligent, as the differential diagnosis can include […] This is a very serious condition that can damage the liver and brain. Intravenous drug use is associated with an increased risk of developing blood-borne infections including HIV, hepatitis B/C and bacterial infections (e.g. Open, relaxed, yet professional body language (e.g. Demonstrating these skills will ensure your consultation remains patient-centred and not checklist-like (just because you’re running through a checklist in your head doesn’t mean this has to be obvious to the patient). abscesses, endocarditis, tuberculosis, osteomye… Introduction (WIIPP) Wash your hands; Introduce yourself: give your name and your job (e.g. Deciding on which symptoms to ask about depends on the presenting complaint and your level of experience. It is also important to ask about any complications associated with the condition including hospital admissions. However, checking fever patterns in febrile patients has been usually missed, and unnecessary tests have been performed. ²,³, The most common causes of PUO include the following: 4. Perform a physical exam 3. Religion 5. Summarise the key points back to the patient. Sex 4. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. Start typing to see results or hit ESC to close, DNACPR Discussion and Documentation – OSCE Guide, Cervical Spine X-ray Interpretation – OSCE Guide, Musculoskeletal (MSK) X-ray Interpretation – OSCE Guide, medical MCQ quiz platform at https://geekyquiz.com, Introduction to Trans – Definitions and FAQs, Dermatological History Taking – OSCE Guide, Bacterial infections (e.g. If you'd like to support us and get something great in return, check out our PDF OSCE Checklist Booklet containing over 100 OSCE checklists in PDF format. asking the patient how they are and offering them a seat). This guide provides a structured approach to taking a history from a patient with pyrexia of unknown origin (PUO) in an OSCE setting. Adults; Age Temperature What to do; 18 years and up: Up to 102 F (38.9 C) taken orally: Rest and drink plenty of fluids. abscesses, endocarditis, tuberculosis, osteomyelitis), Autoimmune conditions (e.g. It can be challenging to use the ICE structure in a way that sounds natural in your consultation, but we have provided several examples for each of the three areas below. D.O.A (Date Of Admission) 8. Smoking is a significant risk factor for malignancy and impairs immune function. rheumatoid arthritis, mixed connective tissue disease, polymyalgia rheumatica), Malignancy (e.g. General Presentation Children frequently present at the physician’s office or emergency room with a fever and rash. Some form of hpi is required for each level of care for every type of em encounter. corticosteroids, methotrexate, azathioprine, tacrolimus, biologics), the type of accommodation they currently reside in (e.g. Respiratory history ... do you suffer from or have a family history of asthma, eczema, hay fever or allergies? This strict definition prevents common and self-limiting medical conditions from being included as FUO. Ask if there are any triggers or exacerbating factors for the fever: Ask if anything seems to improve the fevers: Ask if there are other symptoms which are associated with the fever: Ask the patient if they have been recording their fevers and if so what those readings were: Explore the patient’s history for evidence of underlying infectious disease. contaminated water, animals). History of present illness sample fever. Name 2. Clipping is a handy way to collect important slides you want to go back to later. Fever of short duration [ I would like to define it as less than 2 weeks] is perhaps the most challenging problem in clinical practice. No public clipboards found for this slide, Approach to history taking in a patient with fever. Viral fever symptoms include a high temperature, coughing, nausea, and a runny nose. Learning in 10 3,980 views. Specific causes of fever vary depending on the patient's destination. Fever: A rise in body temperature in response to endogenous cytokines. Ask questions about your symptoms and medical history 2. uncrossed legs and arms, leaning slightly forward in the chair). culture or PCR), the symptoms the patient experienced and if these have fully resolved, the treatments the patient received and if these were taken as prescribed (e.g. Wash your hands and don PPE if appropriate. #x203A; Fever is perhaps the most ancient hallmark of disease. Febrile Phase • Does the patient still … Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. self-hygiene, housework, food shopping), if they have any carer input (e.g. Characteristic fever patterns of malarial infection are clues for diagnosis. Closed questions can also be used to identify relevant risk factors and narrow the differential diagnosis. A powerpoint presentation on Approach to history taking in a patient with a fever.. Looks like you’ve clipped this slide to already. Alcohol is a significant risk factor for malignancy and impairs immune function. Respiratory: cough, dyspnoea, haemoptysis (e.g. Ask the patient if they use recreational drugs and if so determine the type of drugs used and their frequency of use. Ask if the patient has previously undergone any surgery or procedures (e.g. Morning joint stiffness and swelling: associated with rheumatoid arthritis and psoriatic arthritis. HPC- history of presenting complaintPMH- Past medical history, URTI- Upper resp tract infectionLRTI- Lower resp tract infection, Macule – A macule is a change in surface color, without elevation or depression and, therefore, nonpalpable, well or ill-defined,[28] variously sized, but generally considered less than either 5[28] or 10 mm in diameter at the widest point.Vesicle – A vesicle is a circumscribed, fluid-containing, epidermal elevation generally considered less than either 5[28] or 10 mm in diameter at the widest pointNodule – A nodule is morphologically similar to a papule, but is greater than either 5[26] or 10 mm in both width and depth, and most frequently centered in the dermis or subcutaneous fat. Vasculitis (plural: vasculitides) refers to a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels. Introduce yourself to the patient including your name and role. Call the doctor if the fever is accompanied by a severe headache, stiff neck, shortness of breath, or other unusual signs or symptoms. Explain that you’d like to take a history from the patient. The patient condition was relieved when he takes paracetamol. These two types of signals are integrated by the thermoregulatory center of the hypothalamus to maintain normal temperature. Treatment typically involves resting and drinking fluids. 1. Dispose of PPE appropriately and wash your hands. Occupation 6. mild rash vs anaphylaxis). A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. An appropriate level of eye contact throughout the consultation. The most important step is taking a meticulous detailed history to explore the patients problems from three perspectives. pericarditis), Gastrointestinal: abdominal pain, diarrhoea (e.g. house, bungalow) and if there are any adaptations to assist them (e.g. systemic lupus erythematosus, sarcoidosis, rheumatoid arthritis), Immunosuppressants (e.g. Ask about the patient’s current hobbies to identify potential exposure to infectious diseases (e.g. Cardiovascular history ..... 61. Important associated symptoms that suggest serious illness include poor appetite, irritability, lethargy, and change in crying (eg, duration, character). After taking the history, it's useful to give the patient a run-down of what they've told you as you understand it. Following are general particulars you need to note in Clinical history taking format: 1. Age 3. Case presentation of fever • The story started as high grade intermittent fever that started abruptly on the several few days. It means rise in body temperature above normal. D.O.E (Date Of Examination) septic arthritis), Dermatological: rash, erythema, skin breaks (e.g. malarone for malaria), Activities (e.g. twice daily carer visits). This allows you to check your understanding of the patient’s history and provides an opportunity for the patient to correct any inaccurate information. Contact your health care provider if your child: Has a fever and is less than 6 months old. See our User Agreement and Privacy Policy. General history taking ..... 57. Dr. Louise Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and date of birth) What was the day and time of the first fever? Continue to periodically summarise as you move through the rest of the history. joint replacement): Take an immunisation history to ensure the patient has received all of the relevant vaccinations: Ask if the patient has any allergies and if so, clarify what kind of reaction they had to the substance (e.g. Fever (History Taking) - Omar AlRahbeeni ... History Taking In Stroke And Transient Ischemic Attack Excluding Stroke Mimics - Duration: 11:16. Explore the patient’s ideas about the current issue: Explore the patient’s current concerns: Ask what the patient hopes to gain from the consultation: Summarise what the patient has told you about their presenting complaint. There are many causes. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. PUO is defined as fever of 38.3°C or greater for at least 3 weeks with no identified cause after three days of hospital evaluation or three outpatient visits.¹Additional categories of PUO have since been added, including nosocomial, neutropenic and HIV-associated PUO. Making sure not to interrupt the patient throughout the consultation. Discoloured fingers and toes: may be caused by Raynaud’s phenomenon which is associated with connective tissue diseases such as rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis. endocarditis). Normal body temperature is 37 C or 98.6 F. variation of 1 degree F between morning and evening temperature is normal. We reviewed electrical medical record to check whether history-taking included questions on fever pattern in febrile patients. 2012School of Clinical Medicine Clinical Skills NRMSM UKZN Dr RM Abraham. 11:16. A collection of anatomy notes covering the key anatomy concepts that medical students need to learn. Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. A review of the prenatal history, including maternal history of sexually transmitted infections (human immunodeficiency virus [HIV], hepatitis B and hepatitis C, syphilis, gonorrhea, chlamydia, herpes simplex), maternal group B Streptococcus(GBS) status and prophylaxis, mode of delivery, prolonged rupture of membranes, and history of maternal fever should be noted. Has a fever … A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Accept parental reports of maximum temperature. Medication isn't needed. History taking should always have an objective which … What was the day and time of the last fever? Demonstrating empathy in response to patient cues: both verbal and non-verbal. At this point it is a good idea to find out if the patient has any allergies. Both arteries and veins are affected. Medical history relevant to PUO includes: Surgical history relevant to PUO includes: Ask if the patient is currently taking any prescribed medications or over-the-counter remedies: If the patient is taking prescribed or over the counter medications, document the medication name, dose, frequency, form and route. When the bell sounds, enter the room. tuberculosis), Cardiovascular: chest pain (e.g. If the fever is due to chickenpox, influenza or certain other viral infections, taking aspirin can increase the risk of Reye’s syndrome. Dry eyes and/or mouth: associated with Sjogren’s syndrome. Step 05 - Drug History (DH) Find out what medications the patient is taking, including dosage and how often they are taking them, for example: once-a-day, twice-a-day, etc. Change in bowel habit (including blood in stool), Previous and current infections (e.g. A systemic enquiry may also identify symptoms that the patient has forgotten to mention in the presenting complaint. does exercise, cold air or pollen make it worse? It is produced by lymphocytes expressing the surface antigens CD4 and CD8. Neurons in both the preoptic anterior hypothalamus and the posterior hypothalamus receive two kinds of signals: one from peripheral nerves that reflect warmth/cold receptors and the other from the temperature of the blood bathing the region. cerebral abscess, encephalitis), Musculoskeletal: joint pain and swelling (e.g. Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES. Dry cough: associated with several connective tissue diseases including sarcoidosis. Screen for current symptoms suggestive of underlying infection including: Ask the patient if they have had any recent infections and if so gather more details including: Ask the patient if they have potentially been exposed to sources of infection locally including: Take a thorough travel history to identify areas in which the patient may have been infected: Screen for clinical features of autoimmune disease including: Screen for clinical features of malignancy including: A key component of history taking involves exploring a patient’s ideas, concerns and expectations (often referred to as ICE) to gain insight into how a patient currently perceives their situation, what they are worried about and what they expect from the consultation. A recent study suggests that with modern thermometers, an early morning temperature of greater than 99.0°F or an evening temperature of 100.0°F should be considered abnormal. diabetes, myeloma, transplant recipient), Autoimmune disease (e.g. Signposting: this involves explaining to the patient what you have discussed so far and what you plan to discuss next. Explain what you have covered so far: “Ok, so we’ve talked about your symptoms, your concerns and what you’re hoping we achieve today.”, What you plan to cover next: “Next I’d like to discuss your past medical history and then explore what medications you currently take.”. 1: Hyperthermia Facilitate the patient to expand on their presenting complaint if required: History taking typically involves a combination of open and closed questions. HIV, tuberculosis, endocarditis, abscesses, osteomyelitis), Conditions associated with reduced immunity (e.g. ), shivering (to raise temperature by muscle activity) and vasoregulation (constriction and dilatation). The central thermostat is situated in the hypothalamus. Heat and cold sensitive neurons are located in the anterior hypothalamus and pre-optic areas. Temperature information from peripheral receptors is integrated in the hypothalamus , allowing modulation of the body’s heat production, conservation and loss. This is controlled by neuronal mechanisms involving the limbic system, lower brain stem, spinal cord and autonomic nerves. Temperature in healthy adults is tightly controlled at a mean of 36.8C; there is however a physiological diurnal variation of approx 0.5C, with the maximum occurring btw 4 and 8pm and the minimum btw 2 and 6am. See our Privacy Policy and User Agreement for details. A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. Bacterial infections (e.g. Biomedical perspective- to understand the chronology of symptoms, analyse each symptom and review each system to localize the source of the … stairlift), who else the patient lives with and their personal support network, what tasks they are able to carry out independently and what they require assistance with (e.g. When taking a history from a patient with PUO you need to ask a broad range of questions to help narrow the differential diagnosis. Campylobacter jejuni), Hepatic: jaundice, nausea, right upper quadrant tenderness (e.g. Closed questions can allow you to explore the symptoms mentioned by the patient in more detail to gain a better understanding of their presentation. [27] The depth of involvement is what differentiates a nodule from a papulePapule-A papule is a circumscribed, solid elevation of skin with no visible fluid, varying in size from a pinhead to less than either 5[28] or 10 mm in diameter at the widest point, Living conditionsIf in squatter’s area-reflect on the lifestyle of Pt, easy transmissibility of other infections due overpopulation within the area, hygiene and cleanlinessIf living near a body of water-especially stagnant water, may bring about the possibility of contracting the disease from vectors for example: mosquitoes (Dengue) Source of water-may indicate if water-borne pathogens have a role in the disease (Typhoid, Cholera)Geographic area of living-Malaria-Saudi (malaria area)/Africa/IndiaBrucella-Saudi/Gulf AreaTyphoid-India/Pakistan/Egypt/IndonesiaHistoplasmosis-USA (West Coast)Tuberculosis, Liver Abscess, AIDS- All over the world, Which countries and regions were visited, arrival and departure datesDetails of living hx including living and sleeping conditions, whether bed nets were used, what type of food and water was consumed and whether there was any contact with animals, hospitals or fresh water.Sexual hx-Unprotected sexual intercourse with a commercial sex worker, 1. Once you have summarised, ask the patient if there’s anything else that you’ve overlooked. Now customize the name of a clipboard to store your clips. If you continue browsing the site, you agree to the use of cookies on this website. We’ve broken down the history of presenting complaint into several areas of focus including: Take a comprehensive history of the patient’s fever. For example: 'So, Michael, from what I understand you've been losing weight, feeling sick, had trouble swallowing - particularly meat - and the whole thing's been getting you down. Establishing rapport (e.g. Some examples of symptoms you could screen for in each system include: Ask if the patient has any medical conditions:Â. 2. Signposting can be a useful tool when transitioning between different parts of the patient’s history and it provides the patient with time to prepare for what is coming next. › The oldest civilizations (Egyptian, Mesopotamian, Chinese, Indian, and Greek) demonstrated extensive knowledge of anatomy and physiology, but they tended to view fever as being induced by evil spirits. urinary tract infection, sexually transmitted infection), Central nervous system: headache, photophobia, seizures, confusion (e.g. Ask the patient if they have any questions or concerns that have not been addressed. If you continue browsing the site, you agree to the use of cookies on this website. INTRODUCTION • FEVER(Pyrexia) Is an elevation of body temperature above the normal circadian range (daily variation) as a result of a change in the thermoregulatory center located in the anterior hypothalamus and pre-optic area (i.e. water-based activity, animal contact). History of present illness should note degree and duration of fever, method of measurement, and the dose and frequency of antipyretics (if any). A systemic enquiry involves performing a brief screen for symptoms in other body systems which may or may not be relevant to the primary presenting complaint. History of present illness.  Human metabolic processes are temperature dependent, and an individual’s body temperature rarely varies by more than 1C from baseline. The peripheral effector mechanisms are sweating (to reduce temp. Learn more about viral fever … Active listening: through body language and your verbal responses to what the patient has said. Customize the name of a clipboard to store your clips salmon-pink coloured rash ) surgery notes... Febrile Phase • Does the patient has previously undergone any surgery or procedures ( e.g also! Cookies to improve functionality and performance, and unnecessary tests have been performed hpi is required for each level eye..., urethral discharge ( e.g are the basis for a focused clue-directed of... Autoimmune disease ( e.g to check your understanding of the first fever type and volume of consumed!, nausea, and unnecessary tests have been performed, your doctor may: 1 important step taking! Andâ what you have 14 minutes history of asthma, eczema, hay fever or allergies symptoms you could forÂ! Sjogren ’ s fever history taking and Date of birth ensure your consultation is more natural patient-centred! Surgery or procedures ( e.g from other infectious and noninfectious diseases to show more... A comprehensive collection of OSCE guides that include step-by-step images of key,. At this point it is also important to ask a broad range of clinical examination OSCE guides to common procedures. Use is associated with an increased risk of Reye’s syndrome, Central nervous system headache... Skills which are relevant to all patient encounters that you’ve overlooked to maintain normal temperature,:. S current hobbies to identify any potential exposure to infectious diseases (.! Surface antigens CD4 and CD8 WIIPP ) Wash your hands ; Introduce yourself to the patient to correct any information. Close contact with others who were unwell at the time, recent injuries ( e.g occupation to identify any exposure! Exploration of ideas, concerns and expectations should be fluid throughout the consultation, involves explicitly stating what you to... Due to chickenpox, influenza or certain other viral infections, taking aspirin can increase risk! Cover a broad range of questions to help you learn how to interpret laboratory! With others who were unwell at the start of consultations, allowing the patient has previously undergone any or. Recent injuries ( e.g and brain headache, jaw claudication, scalp tenderness, visual loss: suggestive giant... Close contact with others who were unwell at the start of consultations allowing! Hepatitis B/C and bacterial infections ( e.g killer cells activated by antigens, mitogens, or alloantigens has forgotten mention... Recent injuries ( e.g OSCE guides to common clinical procedures, including history taking and information.. Will help ensure your consultation is more natural, patient-centred and not overly formulaic • Does the patient how are. And to provide you with relevant advertising and if so determine the type of em encounter, (. Has a fever and is less than 6 months old this point it is also important to take a history! You could screen for in each system include: ask if the fever is due to,... Cookies on this website your name and role months old including history,. Intermittent fever that started abruptly on the presenting complaint and your level of experience allowing the patient has any conditions... Lupus erythematosus, sarcoidosis ( erythema nodosum ) and adult-onset Still’s disease salmon-pink. Infection, sexually transmitted infection ), Genitourinary: dysuria, frequency, haematuria, discharge! History... do you suffer from or have a family history of patient’s.: headache, photophobia, seizures fever history taking confusion ( e.g each system include: if! Endocarditis, tuberculosis, endocarditis, abscesses, osteomyelitis ), close contact others. Malarial infection are clues for diagnosis slides you want to go back to later their... Enquiry may also identify symptoms that the patient to expand on their presenting complaint if required: history taking for. And role Policy and fever history taking Agreement for details a clipboard to store your clips symptoms. Less than 6 months old the name of a clipboard to store your clips an risk. Occupationâ to identify any potential exposure to infectious diseases ( e.g high grade intermittent fever that started abruptly on patient! To interpret various laboratory and radiology investigations antibiotics ), the most important is. Food shopping ), the most important step is taking a fever history is... Of PUO include the following:  collection of clinical topics of a clipboard store! The start of consultations, allowing the patient including your name and role with! Calgary Cambridge guide as a framework to interviewing patients, myeloma, transplant recipient ), Central system! Upper quadrant tenderness ( e.g listening: through body language ( e.g history do... So far and what you have 14 minutes history of asthma, eczema, hay fever or allergies the... Professional body language ( e.g unlike most other fever-of-unknown-origin reviews, this article presents a clinical.. Symptomsâ you could screen for in each system include: ask if the throughout... Guides to common clinical procedures, including history taking, investigations, diagnosis management! Of surgery revision notes that cover a broad range of clinical Medicine clinical skills NRMSM UKZN Dr Abraham. Natural, patient-centred and not overly formulaic fever patterns of malarial infection are clues for.. A history taking and information giving your job ( e.g fever.. Looks like you’ve this. E from other infectious and noninfectious diseases: 11:16 so far and what plan! Clinical management fever symptoms include a high temperature, coughing, nausea, and a nose!, Previous and current infections ( e.g any questions or concerns that have been. Medical revision on history taking in FEBRILEPATIENTS Using the Calgary Cambridge guide as a framework to interviewing patients and the! Introduction ( WIIPP ) Wash your hands ; Introduce yourself to the test it... Work through history taking and information giving natural killer cells activated by antigens, mitogens or! Of clinical examination OSCE guides that include step-by-step images of key steps, video and! Symptomsâ you could screen for in each system include: ask if the is! Identify relevant risk factors and narrow the differential diagnosis confirm the patient throughout the consultation and noninfectious diseases surgical to... House, bungalow ) and adult-onset Still’s disease ( e.g yet professional body language and your verbal to... So determine the type of accommodation they currently reside in ( e.g of alcohol consumed on a weekly.! 'S useful to give the patient to expand on their presenting complaint if required: history taking and giving... Has been usually missed, and to provide you with fever history taking advertising infection, sexually transmitted )! Most important step is taking a history taking, investigations, diagnosis and management to. And User Agreement for details integrated by the thermoregulatory center of the last fever to interviewing.!, hay fever or allergies abnormalities are the basis for a good idea to find out if patient. May: 1 have a family history of the first fever told you as move! Diagnosis and management concerns that have not been addressed more detail to gain a better understanding of presentation! If there are any adaptations to assist them ( e.g ask the patient including your name and role to! They have any questions or concerns that have not been addressed fever-of-unknown-origin reviews, this presents! Both verbal and non-verbal provide you with relevant advertising, encephalitis ), Autoimmune conditions ( e.g broad of. Guides, for common OSCE scenarios, including history taking in FEBRILEPATIENTS Using the Calgary Cambridge guide as a to... Weekly basis the consultation and non-verbal a comprehensive collection of OSCE guides that include step-by-step images of steps... A framework to interviewing patients febrile patients or allergies mitogens, or alloantigens couldÂ. Cover a broad range of clinical examination OSCE guides that include step-by-step images of key steps, demonstrations. Pain ( e.g Sjogren ’ s name and Date of birth group disorders... To identify relevant risk factors and narrow the differential diagnosis your doctor may: 1 basis for a good to... Of asthma, eczema, hay fever or allergies, seizures, confusion ( e.g diagnosticÂ. Eye contact throughout the consultation ) refers to a heterogeneous group of disorders that are by... Occupationâ to identify relevant risk factors and narrow the differential diagnosis point is! Coloured rash ), coughing, nausea, right upper quadrant tenderness ( e.g taking for. Patient with PUO you need to ask a broad range of questions to help you how. Undergone any surgery or procedures ( e.g common causes of fever vary depending on the several few.! To put your medical and surgical knowledge to the use of cookies on this website forgotten! To a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels presenting complaint if:... Concepts that medical students need to ask a broad range of questions to help narrow the differential diagnosis to about! Taking aspirin can increase the risk of Reye’s syndrome depends on the presenting complaint any carer input e.g! Examples of symptoms you could screen for in each system include: ask if the is. With an increased risk of developing blood-borne infections including HIV, tuberculosis, osteomyelitis ) sarcoidosis! To identify potential exposure to infectious diseases ( e.g to evaluate a fever history it also! Still … history taking in a patient with fever by lymphocytes expressing surface. You plan to discuss next infectious and noninfectious diseases your level of care for every type accommodation... Patient if there’s anything else that you’ve overlooked, patient-centred and not overly formulaic surgical. Radiology investigations infection are clues for diagnosis presentation children frequently present at the time, recent injuries e.g!, Previous and current infections ( e.g of clinical Medicine clinical skills NRMSM UKZN Dr RM Abraham their presenting if... ’ d like to take a history from the patient ’ s current hobbies to identify relevant factors... To interpret various laboratory and radiology investigations pain, diarrhoea ( e.g pollen make it worse,...

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