The Long Case

The History (Hx)

• Name,
• Age,
• (Occupation),
• (Ethnicity),
• Sex,
• Presenting complaint.

• HPC - include history of the whole relevant system, including risk factors.
  Symptoms = PQRST EAR:
    Position
    Quality
    Radiation
    Severity
    Timing (Onset, Duration, Does it come and go?)
    Exacerbating factors
    Alleviating factors
    Related Symptoms

• PMHx

• DHx - *ALLERGIES*
• SHx = SWARM (Smoking+Alcohol, Work, Accomodation, Relatives, Money)

• FHx
• ROS - Other systems

The Examination (Ex)

1. General appearance - including oxygen mask, nebs, etc.
2. BP, Pulse, Temp, RR.
3. JACCOL (Jaundice, Anaemia, Cyanosis, Clubbing, Oedema, Lympadenopathy).
4. The relevant system(s) - positives AND negatives.
5. The other systems - positive findings ONLY.

Summary

Investigation (Ix)

• Bedside (dipstick urine; peak air flow meter)
• Bleed - Haem, Biochem, Special
• Imagery (eg. ECG, CXR, AXR)
• Invasive

Management (Dependent on Hx)

• Diagnosis = Hx + Ex + Ix
• Management = Diagnosis + Rx

Treatment (Rx):

1. Conservitive
2. Medical
3. Surgery