USMLE Step2 CS：臓器症候別の暗記すべき質問集〜その②

• Do you feel sad?
• Tell me about your sleep schedule. Do you wake up early in the morning (early-morning awakening)?
• How is your level of interest (Loss of Interest/anhedonia)?
• Do you feel guilty about your symptoms?
• Do you feel tired easily (Loss of Energy/fatigue)? During what time of the day do you feel tired?
• How is your concentration (Concentration loss/impaired concentration)? How is your performance on your job?
• How is your appetite (anorexia)?
• Have you thought about hurting yourself (Suicide ideation/commit suicide)?
• When was the last baby?

• Are you worrying or more nervous than usual?
• What are you worrying about (ex. humiliation, public speaking, social situation)?
• Do you have any symptom (ex. shortness of breath, hyperventilation, palpitations, tremors, sweating, psychological irritability)?

• Do you feel tired (Fatigue)?
• Do you have palpitations/dizziness/shortness of breath?
• Are your periods heavy/light/medium?(heavy menstrual flow)
• Do you have constipation/cold intolerance/leg cramps??

• Do you still have period?
• When was your last menstrual period?
• Do you have any hot flashes/mood swings(emotional liability)?
• Do you have palpitations/dizziness/shortness of breath/night sweats?
• Do you have any sleep problems?
• When did your mother begin menopause?
• Did you notice any vaginal dryness (dyspareunia)?
• Do you have any pain during sexual intercourse?

• Do you feel tired (fatigue)?
• Do you have fever/chills/night sweats/rash?
• Do you have lumps/swollen gland? Where in your body (lymphadenopathy)?
• Did you lose your weight (weight loss)?
• How is your appetite?
• Were you in contact with a sick person?
• Have you traveled outside the country?
• When is the last time you had PPD test (TB test)? Have you ever had PPD test?

• Do you have fever/hair loss (alopecia)/oral or genital ulcer?
• Do you have rash? Is that worse with sunlight (photosensitivity)?
• Do you have any joint problem? Is there any redness/swelling/warmth/pain(arthralgia)/stiffness?
• Does cold temperature cause any problems with your fingers (Raynaud)?

• Is there any redness/swelling/warmth/pain (arthralgia)/stiffness in your joint?
• During what time of the day do you have the stiffness? How long does it last?
• Do you have any pain in other joints / anywhere else in your body?

• Do you feel safe at home?
• Do you feel safe in your relationship
• Are there any conflicts with your partner?
• Is there anyone treating you bad?
• Do you think you are (physically or emotionally hurt or) abused by anybody?
• Do you have any children?
• Does your husband abuse your children?
• Do you feel afraid in this relationship?
• Are your friends and family aware? Would they support you?
• Do you have a safe place to go in an emergency?

Event (general):

• Please tell me what happened? How can you describe the event?
• When did that happen?
• Where did that happen?
• Do you know the people?
• Did you report it to the police?

Event (sexual):

• Was there sexualintercourse/assault?
• What type of sexual intercourse was it (oral, vaginal, anal)?
• Did the ejaculation happen? Did they use condom?
• Do you have stomachache/nausea/vomiting [for pregnancy]?

Patient: 

• Do you use any contraception?
• When was the last menstrual period?
• Did you drink at the time?
• Were you under the influence of any substances at that time?

Other assault: 

• Were you beaten on anywhere else in your body?
• Do you have any other pain?
• Do you have bruise or bleeding?

Onset:

• When were you diagnosed with XX?
• What symptoms did you have at the time of diagnosis?

Treatment:

• What treatment do you receive?
• Are you compliant with your medication?
• Are you having any side effect of your medication?

Monitor:

• Do you monitor your (blood sugar) regularly (at home)?
• What’s the highest/lowest reading?
• When was the last time you check your BP/HbA1c?
• What was the number?

• Retinopathy: Do you see eye doctor? When was the last eye checkup? Was it normal? Do you have any change in your vision?
• Neuropathy: Do you have numbness/tingling/foot ulcer? Do you see foot doctor?
• Hypoglycemia: Did you have dizziness/sweating/palpitation? Have you fainted?
• Gastroparalysis: Do you have digestive symptoms? Do you have nausea/vomit/change in bowel habit/change in appetite?
• ED: Do you have any concern about sexual function (trouble in achieving an erection)?

• Stroke
• Eye: Do you have blurred vision?
• Orthostatic hypotension: Do you have dizziness when you stand up?
• IHD
• Kidney: Tell me about your urine habit.
• Intestine (bowel movement),
• ED (erectile dysfunction),
• Vascular: Do you have any leg or buttock pain while walking (obstruction of arteries/leg claudication)?

Dietary:

• What are you feeding him?
• Breast milk or formula?(Breast-feed vs. bottle-feed) What formula do you use?
• When did he start eating solid food?
• How many times do you feed him per day?
• Is he sucking well?

Birth history:

• Tell me about his/her birth history?
• How long was your pregnancy?
• Was the baby full-term?
• Vaginal delivery or caesarean section?
• Did you have any complications during your delivery or after delivery?
• Did your child have any medical problems after birth?)

Last checkup (Development):

• When was your child’s last physical check-up [about weight, height, and language development]? Was it normal?
• Is your child gaining weight at a good rate?
• Has there been any sudden gain or loss of physical growth [for DM]?

Vaccinations:

• Are your child’s vaccinations up to date?

• Is there any problem about your hair (hair loss, hirsutism)?
• Is it (non-)itchy/(non-)painful?
• Do you have facial acne?

• Have you felt a need to Cut down on drinking?
• Have you felt Annoyed by criticism of your drinking?
• Have you felt Guilty about drinking?
• Have you had a drink (an Eye opener) in the morning to steady your nerves?

Location:

• Can you tell me where the location is?
• Can you point out with one finger?

Movement:

• Does it move anywhere?

Severity:

• On a scale from 0 to 10, with 10 being the worst XX you’ve ever had, what’s the severity (when you are in pain)?
• Is it the worst headache of your life?

Quality:

• What’s the quality of this pain?
• How can you describe (dull vs.stabbing/sharp, squeezing, throbbing/pulsating)?

Onset:

• When did its chest pain start?

Precipitating factor:

• What do you think causes this?

Constant:

• Is it constant?
• Does it come and go? How often does it occur? How long does it last? During what time of the daydoes your pain occur?

Progression:

• Since that time until now, is it getting better or worse?
• How has it progressed?
• What makes it worse/better? Does it change with exercise/rest/position/food/breathing?
• Is the belly pain related to food? When do you get the pain, before food or after food? How long does it take after eating to get the pain?