How to take history of nose(nasal obstruction)ENT Clinical Methods Series for medical students. скачать в хорошем качестве

How to take history of nose(nasal obstruction)ENT Clinical Methods Series for medical students.

This vides is showing a good way to present your history.This video may be helpful for improving communication skills of undergraduate and post graduate students who are preparing for their exams Following are the steps of nasal history taking BIO DATA Presenting Complaints and their duration in chronological order. 1. Nasal Obstruction2.nasal discharge3.Nasal bleeding 4. Posterior nasal discharge6.Sneezing 7.Headache & facial pain7. Foul smell from nose/breath 8. Smell related problems 9. Eye/vision problems 10. External nasal deformity 11. Facial asymmetry 12. Snoring/sleep related problems History of present illness: 1. Nasal Obstruction a. Duration i. Since childhood ii. Following nasal trauma b. Mode of onset.Gradual ii. Sudden (following trauma?) c. Character i. Persistent Age and Gender ii. Progressive/ same as at onset iii. Off and on iv. Partial or complete d. Laterality i. Both sided (Is there any dominant side?) ii. Right/Left sided iii. Switches sides iv. Began on one side then progressed to the other. e. Any relationship with local/per-oral/ systemic use of drugs f. Any other relationship 2. Anterior nasal discharge: a. Duration b. Mode of onset c. Amount d. Consistency i. Watery ii. Mucoid iii. Admixed with blood iv. Fresh bleed e. Color If any? f. Any relationship with seasonal variation g. Is exposure to any substance, smell the cause? i. If yes name the agent h. Is there any history of irritation of nose? 3. Nose bleed: a. Duration b. Mode of onset c. Frequency d. Fresh blood or admixed with nasal discharge e. Amount (streaks/drops/profuse/massive) f. Does the patient have the habit of nose picking? g. Is the patient on anticoagulants? h. Is the patient on radio/chemotherapy? i. Is the patient hypertensive or on antihypertensive drugs? j. Any history of nasal trauma, surgical or otherwise. 4. Post nasal drip a. Duration b. Mode of onset c. Amount d. Frequency (How many times in a day) e. Consistency f. Color g. Admixed with blood or whitish granules h. Does it smell bad? 5. Headache/facial pain a. Duration b. Mode c. Site of i. ii. iii. iv. v. vi. of onset pain Forehead Over the cheeks/teeth In between nose and eye Top of the head In and/or around the eye Over the temple d. Character i. Dull/sharp/throbbing/pulsatile ii. Persistent or varies (any diurnal variation such as more in the morning) e. Intensity i. Grade of pain on VAS ii. Constant or varies 6. Sneezing: a. Duration b. Mode of onset c. Seasonal/perineal d. How many episodes in a day? e. How many sneezes in an episode? f. What are the provoking factors? g. Any other accompanying symptom. 7. Bad smell from nose/breath a. Is the patient himself aware of bad smell emanating from his nose or his relatives have told him? b. Has the patient undergone any nasal surgery/radio or chemotherapy? c. Is the patient currently undergoing radio or chemotherapy? d. Is the patient on any long-term treatment? e. Does it interfere with his social or personal life? f. Is there any complaint of excessive nasal crustation? g. Does the removal of these crusts result in nose bleed? 8. Olfaction related symptoms: a. Duration b. Mode of onset (Sudden or Gradual) c. Grade (Total or Partial) d. Progression (same as at time of onset or there is a change in grade) 9. Eye/Vision related problems a. Duration b. Mode of onset c. Are the symptoms one-sided or involve both eyes? d. Is there loss of vision (Partial or total)? e. Does the patient have double vision? f. Does the patient complain of bulging or sunken eye ball? g. Are movements of the eye ball absent or restricted? h. Any complaint of pain in/around/behind the eye ball 10. External nasal deformity: a. Duration b. Mode of onset (Trauma/iatrogenic) c. Involves bony or cartilaginous nasal bridge? 11. Facial Asymmetry: a. Duration b. Mode of onset i. Any history of facial trauma or surgery ii. Sudden or in c. Progression Sudden or gradual 12. Snoring / Sleep related problems a. What is patient’s Epworth Sleepiness Score? Personal history: A. Use of smoke or non-smoke tobacco a. If yes details in terms of duration, number of cigarettes or pan,gutka consumed in a day. B. Use of alcohol or any other addiction a. If yes then details C. details of the profession a. Works in leather industry b. Works in wood industry c. Works in chemicals industry d. Other profession_____________________________ D. Family History______________________________________ E.previous treatment history: a. Previous surgery b. history of radiation c. Drug History i. Anti-allergic medicines ii.steroids iii. Chemotherapy iv. Antibiotics/antifungal medicines