NR I509 IMidterm IStudy IGuide IWeek I3
Ch. I1
● Basic Iand IAdvanced IInterviewing ITechniques
Basic Interviewing Techniques
I I
● Active Ilistening: IActive Ilistening Imeans Iclosely Iattending Ito Iwhat Ithe
Ipatient Iis Icommunicating, Iconnecting Ito Ithe Ipatient's Iemotional Istate, Iand
Iusing Iverbal Iand Inonverbal Iskills Ito Iencourage Ithe Ipatient Ito Iexpand Ion
Ihis Ior Iher Ifeelings Iand Iconcerns.
Empathic Iresponses: IEmpathy Ihas Ibeen Idescribed Ias Ithe Icapacity Ito
Iidentify Iwith Ithe Ipatient Iand Ifeel Ithe Ipatient's Ipain Ias Iyour Iown, Ithen
Irespond Iin Ia Isupportive Imanner.
Guided Iquestioning: IGuided Iquestions Ishow Iyour Isustained Iinterest Iin
Ithe Ipatient's Ifeelings Iand Ideepest Idisclosures Iand Iallows Ithe Iinterviewer
Ito Ifacilitate Ifull Icommunication, Iin Ithe Ipatient's Iown Iwords, Iwithout
Iinterruption.
Nonverbal Icommunication: INonverbal Icommunication Iincludes Ieye
Icontact, Ifacial Iexpression, Iposture, Ihead Iposition Iand Imovement Isuch Ias
Ishaking Ior Inodding, Iinterpersonal Idistance, Iand Iplacement Iof Ithe Iarms Ior
Ilegs—crossed, Ineutral, Ior Iopen.
Validation: IValidation Ihelps Ito Iaffirm Ithe Ilegitimacy Iof Ithe Ipatient'sIemotional
Iexperience.
Reassurance: IReassurance Iis Ian Iappropriate Iway Ito Ihelp Ithe Ipatient IfeelIthat
Iproblems Ihave Ibeen Ifully Iunderstood Iand Iare Ibeing Iaddressed.
Partnering: IWhen Ibuilding Irapport Iwith Ipatients, Iexpress IyourIcommitment
Ito Ian Iongoing Irelationship.
Summarization: IGiving Ia Icapsule Isummary Iof Ithe Ipatient's Istory Iduring
Ithe Icourse Iof Ithe Iinterview Ito Icommunicate Ithat Iyou Ihave Ibeen Ilistening
Icarefully.
Transitions: IInform Iyour Ipatient Iwhen Iyou Iare Ichanging Idirections IduringIthe
Iinterview.
Empowering Ithe Ipatient: IEmpower Ipatients Ito Iask Iquestions, Iexpress Itheir
Iconcerns, Iand Iprobe Iyour Irecommendations Iin Iorder Ito Iencourage Ithem
Ito Iadopt Iyour Iadvice, Imake Ilifestyle Ichanges, Ior Itake Imedications Ias
Iprescribed.
Advanced IInterview ITechniques
, 2
Determine Iscope Iof Iassessment: IFocused Ivs. IComprehensive:
Comprehensive: IUsed Ipatients Iyou Iare Iseeing Ifor Ithe Ifirst Itime Iin Ithe Ioffice Ior
I hospital. IIncludes Iall Ithe Ielements Iof Ithe Ihealth Ihistory Iand Icomplete Iphysical
Iexamination.
Is Iappropriate Ifor Inew Ipatients Iin Ithe Ioffice Ior Ihospital
Provides Ifundamental Iand Ipersonalized Iknowledge Iabout Ithe Ipatient
IStrengthens Ithe Iclinician–patient Irelationship
IIHelps Iidentify Ior Irule Iout Iphysical Icauses Irelated Ito Ipatient IconcernsIProvides
Ia Ibaseline Ifor Ifuture Iassessments
Creates Ia Iplatform Ifor Ihealth Ipromotion Ithrough Ieducation Iand Icounseling
IDevelops Iproficiency Iin Ithe Iessential Iskills Iof Iphysical Iexamination
Focused: IFor Ipatients Iyou Iknow Iwell Ireturning Ifor Iroutine Icare, Ior Ithose Iwith
Ispecific I“urgent Icare” Iconcerns Ilike Isore Ithroat Ior Iknee Ipain. IYou Iwill Iadjust
Ithe Iscope Iof Iyour Ihistory Iand Iphysical Iexamination Ito Ithe Isituation Iat Ihand,
Ikeeping Iseveral Ifactors Iin Imind: Ithe Imagnitude Iand Iseverity Iof Ithe Ipatient’s
Iprob- Ilems; Ithe Ineed Ifor Ithoroughness; Ithe Iclinical Isetting—inpatient Ior
Ioutpatient, Iprimary Ior Isubspecialty Icare; Iand Ithe Itime Iavailable.
Is Iappropriate Ifor Iestablished Ipatients, Iespecially Iduring Iroutine Ior Iurgent
Icare Ivisits
Addresses Ifocused Iconcerns Ior Isymptoms
Assesses I symptoms I restricted I to I a I specific I body I system
Applies Iexamination Imethods Irelevant Ito Iassessing Ithe Iconcern Ior Iproblem Ias
Ithoroughly Iand Icarefully Ias Ipossible
Being Iaware Iof Iyour Ireactions Ihelps Idevelop Iyour Iclinical Iskills.
Your Isuccess Iin Ieliciting Ithe Ihistory Ifrom Idifferent Itypes Iof Ipatients Igrows Iwith
Iexperience, Ibut Itake Iinto Iaccount Iyour Iown Istressors, Isuch Ias Ifatigue, Imood, Iand
Ioverwork.
Self-care Iis Ialso Iimportant Iin Icaring Ifor Iothers. IEven Iif Ia Ipatient Iis Ichallenging,
Ialways Iremember Ithe Iimportance Iof Ilistening Ito Ithe Ipatient Iand Iclarifying Ihis Ior
Iher Iconcerns.
Components Iof Ithe IHealth IHistory
IInitial Iinformation
Date Iand Itime Iof Ihistory-time Iis Iespecially Iimportant Iin Iemergent Isituations
Identifying Idata-age, Igender, Imarital Istatus, Ioccupation-identify Isource Iof Ihistory Iie: Ifamily
Imember, Ifriend Ietc.
Reliability-usually Idocumented Iat Iend Iof Iinterview Iie: I“patient Iis Ivague Iwhen Idescribing
Isymptoms”.
Chief IComplaint(s)
Try Ito Iquote Ithe Ipatients Iwords
IPresent IIllness
Complete, Iclear Iand Ichronological Idescription Iof Ithe Iproblem Iprompting Ithe Ipatient Ivisit
IOnset, Isetting Iin Iwhich Iit Ioccurred, Imanifestations Iand Iany Itreatments
, 3
Should Iinclude I7 Iattributes Iof Ia Isymptom:
Location
IQuality
Quantity Ior Iseverity
Timing, Ionset, Iduration, Ifrequency
ISetting Iin Iwhich Iit Ioccurs
IAggravating Ior Irelieving Ifactors
IAssociated Imanifestations
Differential Idiagnosis Iis Iderived Ifrom Ithe I“pertinent Ipositives” Iand I“pertinent Inegatives”
Iwhen Idoing IReview Iof ISystems Ithat Iare Irelevant Ito Ithe Ichief Icomplaint.
Present Iillness Ishould Ireveal Ipatient’s Iresponses Ito Ihis Ior Iher Isymptoms Iand Iwhat Ieffect Ithis
Ihas Ion Itheir Ilife.
Each Isymptom Ineeds Iits Iown Iparagraph Iand Ia Ifull Idescription.
Medication Ishould Ibe Idocumented, Iname, Idose, Iroute, Iand Ifrequency. IHome Iremedies, Inon-
Iprescriptions Idrugs, Ivitamins, Imineral Ior Iherbal Isupplements, Ioral Icontraceptives, Ior
Iborrowed Imedications.
Allergies-foods, Iinsects, Ior Ienvironmental, Iincluding Ispecific Ireaction
Tobacco Iuse, Iincluding Ithe Itype. IIf Isomeone Ihas Iquit, Inote Ifor Ihow
I
long
I
Alcohol Iand Idrug Iuse Ishould Ialways Ibe Iinvestigated Iand Iis Ioften Ipertinent Ito Ithe IPresenting
IIllness.
Past Ihistory
Childhood IIllness: Imeasles, Irubella, Imumps, Iwhooping Icough, Ichickenpox, Irheumatic Ifever,
Iscarlet Ifever, Iand Ipolio. IAlso Iinclude Iany Ichronic Ichildhood Iillness
Adult Iillnesses: IProvide Iinformation Iin Ieach Iof Ithe I4 Iareas:
Medical: Idiabetes, Ihypertension, Ihepatitis, Iasthma Iand IHIV; Ihospitaliations; Inumber Iand
Igender Iof Isexual Ipartners; Iand Irisk Itaking Isexual Ipractices.
Surgical: Idates, Iindications, Iand Itypes Iof Ioperations
Obstetric/gynecologic: IObstetric Ihistory, Imenstrual Ihistory, Imethods Iof Icontraception, Iand
Isexual Ifunction.
Psychiatric: IIllness Iand Itime Iframe, Idiagnoses, Ihospitalizations, Iand Itreatments.
Health IMaintenance: IFind Iout Iif Ithey Iare Iup Ito Idate Ion
IimmunizationsIand Iscreening Itests.
, 4
Family Ihistory
Outlines Ior Idiagrams Iage Iand Ihealth, Ior Iage Iand Icause Iof Ideath, Iof Isiblings,
Iparents, Iand Igrandparents
Documents Ipresence Ior Iabsence Iof Ispecific Iillnesses Iin Ifamily, Isuch Ias
Ihypertension, Icoronary Iartery Idisease, Ielevated Icholesterol Ilevels, Istroke,
Idiabetes, Ithyroid Ior Irenal Idisease, Iarthritis, Ituberculosis, Iasthma Ior Ilung
Idisease, Iheadache, Iseizure Idisorder, Imental Iillness, Isuicide, Isubstance Iabuse,
Iand Iallergies, Iand Isymtoms Ireported Iby Ipatient.
Ask Iabout Ihistory Iof Ibreast, Iovarian, Icolon, Ior Iprostate IcancerIAsk
Iabout IGenetically Itransmitted Idiseases
Personal Ior Isocial Ihistory
Describes Ieducational Ilevel, Ioccupation, Ifamily Iof Iorigin, Icurrent Ihousehold,
Ipersonal Iinterests, I and Ilifestyle
Capture Ithe Ipatients Ipersonality Iand Iinterests, Isources Iof Isupport, Icoping
Istyle, Istrengths, Iand Iconcerns
Includes Ilifestyle Ihabits Ithat Ipromote Ihealth Ior Icreate Irisk, Isuch Ias IexerciseIand
Idiet, Isafety Imeasures, Isexual Ipractices, Iand Iuse Iof Ialcohol, Idrugs, Iand
Itobacco
Expanded Ipersonal Iand Isocial Ihistory Ipersonalizes Iyour Irelationship Iwith Ithe
Ipatient I and Ibuilds Ia Irapport
Review Iof Isystems
Documents Ipresence Ior Iabsence Iof Icommon Isymptoms Irelated Ito Ieach Iof Ithe
Imajor Ibody I systems
Understanding Iand Iusing IReview Iof ISystems Iquestions Imay Iseem Ichalleng-
Iing Iat Ifirst. IThese I“yes-no” Iquestions Ishould Icome Iat Ithe Iend Iof Ithe Iinter-
Iview. IThink Iabout Iasking Ia Iseries Iof Iquestions Igoing Ifrom I“head Ito Itoe.” IIt Iis
Ihelpful Ito I prepare I the Ipatient I by I saying, I “The Inext I part I of Ithe I history I may
Ifeel Ilike Ia Ihundred Iquestions, Ibut Iit Iis Iimportant Ito Imake Isure Iwe Ihave Inot
Imissed Ianything.”
Most IReview Iof ISystems Iquestions Ipertain Ito Isymptoms, Ibut Ion Ioccasion,Isome
Iclinicians Iinclude Idiseases Ilike Ipneumonia Ior Ituberculosis.
Note Ithat Ias Iyou Ielicit Ithe IPresent IIllness, Iyou Imay Ialso Idraw Ion IReview Iof
ISystems Iquestions Irelated Ito Isystem(s) Irelevant Ito Ithe IChief IComplaint Ito
Iestablish I“pertinent Ipositives Iand Inegatives” Ithat Ihelp Iclarify Ithe Idiagnosis.
IFor Iexample, Iafter Ia Ifull Idescription Iof Ichest Ipain, Iyou Imay Iask, I“Do Iyou Ihave
Iany Ihistory Iof Ihigh Iblood Ipressure I. I. I. Ipalpitations I. I. I. Ishortness Iof
breath I. I. I. Iswelling Iin Iyour Iankles Ior Ifeet?” Ior Ieven Imove Ito Iquestions Ifrom
Ithe IRespiratory Ior IGastrointestinal IReview Iof ISystems
The IReview Iof ISystems Iquestions Imay Iuncover Iproblems Ithat Ithe Ipatient Ihas
Ioverlooked, Iparticularly Iin Iareas Iunrelated Ito Ithe IPresent IIllness. ISignificant
Ch. I1
● Basic Iand IAdvanced IInterviewing ITechniques
Basic Interviewing Techniques
I I
● Active Ilistening: IActive Ilistening Imeans Iclosely Iattending Ito Iwhat Ithe
Ipatient Iis Icommunicating, Iconnecting Ito Ithe Ipatient's Iemotional Istate, Iand
Iusing Iverbal Iand Inonverbal Iskills Ito Iencourage Ithe Ipatient Ito Iexpand Ion
Ihis Ior Iher Ifeelings Iand Iconcerns.
Empathic Iresponses: IEmpathy Ihas Ibeen Idescribed Ias Ithe Icapacity Ito
Iidentify Iwith Ithe Ipatient Iand Ifeel Ithe Ipatient's Ipain Ias Iyour Iown, Ithen
Irespond Iin Ia Isupportive Imanner.
Guided Iquestioning: IGuided Iquestions Ishow Iyour Isustained Iinterest Iin
Ithe Ipatient's Ifeelings Iand Ideepest Idisclosures Iand Iallows Ithe Iinterviewer
Ito Ifacilitate Ifull Icommunication, Iin Ithe Ipatient's Iown Iwords, Iwithout
Iinterruption.
Nonverbal Icommunication: INonverbal Icommunication Iincludes Ieye
Icontact, Ifacial Iexpression, Iposture, Ihead Iposition Iand Imovement Isuch Ias
Ishaking Ior Inodding, Iinterpersonal Idistance, Iand Iplacement Iof Ithe Iarms Ior
Ilegs—crossed, Ineutral, Ior Iopen.
Validation: IValidation Ihelps Ito Iaffirm Ithe Ilegitimacy Iof Ithe Ipatient'sIemotional
Iexperience.
Reassurance: IReassurance Iis Ian Iappropriate Iway Ito Ihelp Ithe Ipatient IfeelIthat
Iproblems Ihave Ibeen Ifully Iunderstood Iand Iare Ibeing Iaddressed.
Partnering: IWhen Ibuilding Irapport Iwith Ipatients, Iexpress IyourIcommitment
Ito Ian Iongoing Irelationship.
Summarization: IGiving Ia Icapsule Isummary Iof Ithe Ipatient's Istory Iduring
Ithe Icourse Iof Ithe Iinterview Ito Icommunicate Ithat Iyou Ihave Ibeen Ilistening
Icarefully.
Transitions: IInform Iyour Ipatient Iwhen Iyou Iare Ichanging Idirections IduringIthe
Iinterview.
Empowering Ithe Ipatient: IEmpower Ipatients Ito Iask Iquestions, Iexpress Itheir
Iconcerns, Iand Iprobe Iyour Irecommendations Iin Iorder Ito Iencourage Ithem
Ito Iadopt Iyour Iadvice, Imake Ilifestyle Ichanges, Ior Itake Imedications Ias
Iprescribed.
Advanced IInterview ITechniques
, 2
Determine Iscope Iof Iassessment: IFocused Ivs. IComprehensive:
Comprehensive: IUsed Ipatients Iyou Iare Iseeing Ifor Ithe Ifirst Itime Iin Ithe Ioffice Ior
I hospital. IIncludes Iall Ithe Ielements Iof Ithe Ihealth Ihistory Iand Icomplete Iphysical
Iexamination.
Is Iappropriate Ifor Inew Ipatients Iin Ithe Ioffice Ior Ihospital
Provides Ifundamental Iand Ipersonalized Iknowledge Iabout Ithe Ipatient
IStrengthens Ithe Iclinician–patient Irelationship
IIHelps Iidentify Ior Irule Iout Iphysical Icauses Irelated Ito Ipatient IconcernsIProvides
Ia Ibaseline Ifor Ifuture Iassessments
Creates Ia Iplatform Ifor Ihealth Ipromotion Ithrough Ieducation Iand Icounseling
IDevelops Iproficiency Iin Ithe Iessential Iskills Iof Iphysical Iexamination
Focused: IFor Ipatients Iyou Iknow Iwell Ireturning Ifor Iroutine Icare, Ior Ithose Iwith
Ispecific I“urgent Icare” Iconcerns Ilike Isore Ithroat Ior Iknee Ipain. IYou Iwill Iadjust
Ithe Iscope Iof Iyour Ihistory Iand Iphysical Iexamination Ito Ithe Isituation Iat Ihand,
Ikeeping Iseveral Ifactors Iin Imind: Ithe Imagnitude Iand Iseverity Iof Ithe Ipatient’s
Iprob- Ilems; Ithe Ineed Ifor Ithoroughness; Ithe Iclinical Isetting—inpatient Ior
Ioutpatient, Iprimary Ior Isubspecialty Icare; Iand Ithe Itime Iavailable.
Is Iappropriate Ifor Iestablished Ipatients, Iespecially Iduring Iroutine Ior Iurgent
Icare Ivisits
Addresses Ifocused Iconcerns Ior Isymptoms
Assesses I symptoms I restricted I to I a I specific I body I system
Applies Iexamination Imethods Irelevant Ito Iassessing Ithe Iconcern Ior Iproblem Ias
Ithoroughly Iand Icarefully Ias Ipossible
Being Iaware Iof Iyour Ireactions Ihelps Idevelop Iyour Iclinical Iskills.
Your Isuccess Iin Ieliciting Ithe Ihistory Ifrom Idifferent Itypes Iof Ipatients Igrows Iwith
Iexperience, Ibut Itake Iinto Iaccount Iyour Iown Istressors, Isuch Ias Ifatigue, Imood, Iand
Ioverwork.
Self-care Iis Ialso Iimportant Iin Icaring Ifor Iothers. IEven Iif Ia Ipatient Iis Ichallenging,
Ialways Iremember Ithe Iimportance Iof Ilistening Ito Ithe Ipatient Iand Iclarifying Ihis Ior
Iher Iconcerns.
Components Iof Ithe IHealth IHistory
IInitial Iinformation
Date Iand Itime Iof Ihistory-time Iis Iespecially Iimportant Iin Iemergent Isituations
Identifying Idata-age, Igender, Imarital Istatus, Ioccupation-identify Isource Iof Ihistory Iie: Ifamily
Imember, Ifriend Ietc.
Reliability-usually Idocumented Iat Iend Iof Iinterview Iie: I“patient Iis Ivague Iwhen Idescribing
Isymptoms”.
Chief IComplaint(s)
Try Ito Iquote Ithe Ipatients Iwords
IPresent IIllness
Complete, Iclear Iand Ichronological Idescription Iof Ithe Iproblem Iprompting Ithe Ipatient Ivisit
IOnset, Isetting Iin Iwhich Iit Ioccurred, Imanifestations Iand Iany Itreatments
, 3
Should Iinclude I7 Iattributes Iof Ia Isymptom:
Location
IQuality
Quantity Ior Iseverity
Timing, Ionset, Iduration, Ifrequency
ISetting Iin Iwhich Iit Ioccurs
IAggravating Ior Irelieving Ifactors
IAssociated Imanifestations
Differential Idiagnosis Iis Iderived Ifrom Ithe I“pertinent Ipositives” Iand I“pertinent Inegatives”
Iwhen Idoing IReview Iof ISystems Ithat Iare Irelevant Ito Ithe Ichief Icomplaint.
Present Iillness Ishould Ireveal Ipatient’s Iresponses Ito Ihis Ior Iher Isymptoms Iand Iwhat Ieffect Ithis
Ihas Ion Itheir Ilife.
Each Isymptom Ineeds Iits Iown Iparagraph Iand Ia Ifull Idescription.
Medication Ishould Ibe Idocumented, Iname, Idose, Iroute, Iand Ifrequency. IHome Iremedies, Inon-
Iprescriptions Idrugs, Ivitamins, Imineral Ior Iherbal Isupplements, Ioral Icontraceptives, Ior
Iborrowed Imedications.
Allergies-foods, Iinsects, Ior Ienvironmental, Iincluding Ispecific Ireaction
Tobacco Iuse, Iincluding Ithe Itype. IIf Isomeone Ihas Iquit, Inote Ifor Ihow
I
long
I
Alcohol Iand Idrug Iuse Ishould Ialways Ibe Iinvestigated Iand Iis Ioften Ipertinent Ito Ithe IPresenting
IIllness.
Past Ihistory
Childhood IIllness: Imeasles, Irubella, Imumps, Iwhooping Icough, Ichickenpox, Irheumatic Ifever,
Iscarlet Ifever, Iand Ipolio. IAlso Iinclude Iany Ichronic Ichildhood Iillness
Adult Iillnesses: IProvide Iinformation Iin Ieach Iof Ithe I4 Iareas:
Medical: Idiabetes, Ihypertension, Ihepatitis, Iasthma Iand IHIV; Ihospitaliations; Inumber Iand
Igender Iof Isexual Ipartners; Iand Irisk Itaking Isexual Ipractices.
Surgical: Idates, Iindications, Iand Itypes Iof Ioperations
Obstetric/gynecologic: IObstetric Ihistory, Imenstrual Ihistory, Imethods Iof Icontraception, Iand
Isexual Ifunction.
Psychiatric: IIllness Iand Itime Iframe, Idiagnoses, Ihospitalizations, Iand Itreatments.
Health IMaintenance: IFind Iout Iif Ithey Iare Iup Ito Idate Ion
IimmunizationsIand Iscreening Itests.
, 4
Family Ihistory
Outlines Ior Idiagrams Iage Iand Ihealth, Ior Iage Iand Icause Iof Ideath, Iof Isiblings,
Iparents, Iand Igrandparents
Documents Ipresence Ior Iabsence Iof Ispecific Iillnesses Iin Ifamily, Isuch Ias
Ihypertension, Icoronary Iartery Idisease, Ielevated Icholesterol Ilevels, Istroke,
Idiabetes, Ithyroid Ior Irenal Idisease, Iarthritis, Ituberculosis, Iasthma Ior Ilung
Idisease, Iheadache, Iseizure Idisorder, Imental Iillness, Isuicide, Isubstance Iabuse,
Iand Iallergies, Iand Isymtoms Ireported Iby Ipatient.
Ask Iabout Ihistory Iof Ibreast, Iovarian, Icolon, Ior Iprostate IcancerIAsk
Iabout IGenetically Itransmitted Idiseases
Personal Ior Isocial Ihistory
Describes Ieducational Ilevel, Ioccupation, Ifamily Iof Iorigin, Icurrent Ihousehold,
Ipersonal Iinterests, I and Ilifestyle
Capture Ithe Ipatients Ipersonality Iand Iinterests, Isources Iof Isupport, Icoping
Istyle, Istrengths, Iand Iconcerns
Includes Ilifestyle Ihabits Ithat Ipromote Ihealth Ior Icreate Irisk, Isuch Ias IexerciseIand
Idiet, Isafety Imeasures, Isexual Ipractices, Iand Iuse Iof Ialcohol, Idrugs, Iand
Itobacco
Expanded Ipersonal Iand Isocial Ihistory Ipersonalizes Iyour Irelationship Iwith Ithe
Ipatient I and Ibuilds Ia Irapport
Review Iof Isystems
Documents Ipresence Ior Iabsence Iof Icommon Isymptoms Irelated Ito Ieach Iof Ithe
Imajor Ibody I systems
Understanding Iand Iusing IReview Iof ISystems Iquestions Imay Iseem Ichalleng-
Iing Iat Ifirst. IThese I“yes-no” Iquestions Ishould Icome Iat Ithe Iend Iof Ithe Iinter-
Iview. IThink Iabout Iasking Ia Iseries Iof Iquestions Igoing Ifrom I“head Ito Itoe.” IIt Iis
Ihelpful Ito I prepare I the Ipatient I by I saying, I “The Inext I part I of Ithe I history I may
Ifeel Ilike Ia Ihundred Iquestions, Ibut Iit Iis Iimportant Ito Imake Isure Iwe Ihave Inot
Imissed Ianything.”
Most IReview Iof ISystems Iquestions Ipertain Ito Isymptoms, Ibut Ion Ioccasion,Isome
Iclinicians Iinclude Idiseases Ilike Ipneumonia Ior Ituberculosis.
Note Ithat Ias Iyou Ielicit Ithe IPresent IIllness, Iyou Imay Ialso Idraw Ion IReview Iof
ISystems Iquestions Irelated Ito Isystem(s) Irelevant Ito Ithe IChief IComplaint Ito
Iestablish I“pertinent Ipositives Iand Inegatives” Ithat Ihelp Iclarify Ithe Idiagnosis.
IFor Iexample, Iafter Ia Ifull Idescription Iof Ichest Ipain, Iyou Imay Iask, I“Do Iyou Ihave
Iany Ihistory Iof Ihigh Iblood Ipressure I. I. I. Ipalpitations I. I. I. Ishortness Iof
breath I. I. I. Iswelling Iin Iyour Iankles Ior Ifeet?” Ior Ieven Imove Ito Iquestions Ifrom
Ithe IRespiratory Ior IGastrointestinal IReview Iof ISystems
The IReview Iof ISystems Iquestions Imay Iuncover Iproblems Ithat Ithe Ipatient Ihas
Ioverlooked, Iparticularly Iin Iareas Iunrelated Ito Ithe IPresent IIllness. ISignificant
