review of system - drpeace2014

[ArchivalUser]

do we have to review all systems in all cases or pertaning to complains?

[ArchivalUser]

Yes,but you can make it short.
There are multiple mnemonics for ROS,pick the one that is suitable for You.
Always try to review systems in the order - head to toe.
I like the one from Laura from Youtube
The first letter helps to remember the key word,go from there and ask additional questions for that specific organ-system if needed:

THEN FR CS ; PABSAWED

T-Traumas?Travel History?Temperature?
H-Headache?
E-Edema?Enlarged Lymph nodes (on neck etc)?
N-Nausea?(Vomitting?)

F-Fever/Chills?
R-Racing Heart?(Palpitations?)

C-Chest Pain?Cough?
S-Shortness of Breath?

PuBSAWED (I think of it as if it is a funny name)

P-Pain in joints
U-Urinary (Frequency?Burning?Foul smell)
B-Bowel (diarrhea,constipation,blood in stool etc)
S-Sleeping problems?(do u sleep well?)
A-Appetite?
W-Weight?(have you noticed unusual weight gain/loss)
E-Exercise (u need to ask for counseling,if the answer is NO)
D-Drugs ( illicit )



Just remember to start from HEAD and move Down

[ArchivalUser]

But if yoou have a good memory,just try to memorize this:

ROS:

fevers, chills, night sweats, appetite change, weight change, fatigue, depression,
headache, visual changes, seizures, pain or difficulty swallowing, thyroid problems,
shortness of breath, chest pain, heart racing (palpitations), cough, wheeze, abdominal
pain, nausea, vomiting, diarrhea, blood in your urine or stool, moving your bowels okay,
painful urination, increased frequency of urination, kidney stone, pain in your joints,
numbness, weakness, tingling, rash.

[ArchivalUser]

Dochtorc thanks. I like the Laura version I think it's quick and easy to remember . I also want to know for PE do we need to mention everything in detail like inspection... Palpation.. Percussion ... Auscultation or just mention what is present and significant and omit the normal stuff ?

[ArchivalUser]

Trust your judgement.I am not sure myself yet and I hate to give misleading information on PE,because if I am wrong it might hurt you.
But,You can always do a quick general exam in each case- palpate lymph nodes and check LE for edema,skin-color,elasticity and then quick auscultation-lungs and heart and after that examine the affected organ/system (for example: abdomen for append. or neuro exam for dizziness)

[ArchivalUser]

Thanks dochtorc. I appreciate your advice .