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Systems by Mind Map: Systems

1. Gastrointestinal

1.1. Presenting symptoms

1.1.1. Weight loss or weight gain

1.1.1.1. Weight loss

1.1.1.1.1. + loss of appetite

1.1.1.1.2. + increased appetite

1.1.1.1.3. + early satiation

1.1.2. Dysphagia

1.1.2.1. Is it true dysphagia, or just painful swallowing?

1.1.2.1.1. Painful swallowing

1.1.2.1.2. Dysphagia

1.1.3. Heartburn?

1.1.3.1. Burning sensation?

1.1.3.2. Aggravated by bending, stooping, or lying supine?

1.1.3.3. Antacids relieve pain?

1.1.3.4. Sour or bitter taste in mouth?

1.1.3.5. Aggravated by alcohol, chocolate, caffeine, a fatty meal, theophylline, calcium channel blockers, anticholinergic drugs?

1.1.4. Nausea or vomiting

1.1.4.1. Acute

1.1.4.1.1. GIT infection?

1.1.4.1.2. Small bowel obstruction?

1.1.4.2. Chronic

1.1.4.2.1. Pregnancy?

1.1.4.2.2. Drugs? (digoxin, opiates, dopamine agonists, chemotherapy)

1.1.4.2.3. Psychogenic, eating disorders

1.1.4.2.4. (Rarely) increased intracranial pressure

1.1.4.3. Peptic ulcer disease with gastric outlet obstruction

1.1.4.4. Does the patient have diabetes?

1.1.4.4.1. Gastroparesis?

1.1.4.5. Has the patient had gastric surgery?

1.1.4.5.1. Gastroparesis?

1.1.4.6. Is the patient jaundiced?

1.1.4.6.1. Acute hepatobiliary disease?

1.1.4.7. Alcoholism?

1.1.5. Haematemesis

1.1.6. Abdominal pain

1.1.6.1. "Is it acute or chronic?"

1.1.6.2. "Where does it hurt?"

1.1.6.2.1. Localised

1.1.6.2.2. Epigastric

1.1.6.2.3. Renal angle, possibly radiating to groin

1.1.6.2.4. Periumbilical region

1.1.6.2.5. Retrosternal, travelling upwards towards the throat

1.1.6.3. "What is the nature of the pain?"

1.1.6.3.1. Colicky

1.1.6.3.2. Dull

1.1.6.3.3. Burning

1.1.6.4. "Does anything make it worse?"

1.1.6.4.1. Eating

1.1.6.4.2. Alcohol, chocolate, caffeine, fatty meals, theophylline, calclium channel blockers, anticholinergic drugs

1.1.6.5. "Does anything make it better?"

1.1.6.5.1. Rolling around

1.1.6.5.2. Food / antacids

1.1.6.5.3. Vomiting

1.1.6.5.4. Defecation,

1.1.6.5.5. Lying perfectly still

1.1.6.6. Red flags

1.1.6.6.1. Sudden onset

1.1.6.6.2. Increasing severity

1.1.6.6.3. Syncope/pre-syncope

1.1.6.6.4. Vomiting (esp. protracted)

1.1.6.6.5. Haematemesis

1.1.6.6.6. Abdominal distension (esp. progressive)

1.1.6.6.7. Pallor and sweating

1.1.6.6.8. Tachycardia/atrial fibrillation

1.1.6.6.9. Hypotension

1.1.6.6.10. Fever

1.1.6.6.11. Rebound tenderness, guarding, rigidity

1.1.6.6.12. Decreased urine output

1.1.7. Jaundice

1.1.7.1. "Is the urine dark?"

1.1.7.1.1. Dark urine

1.1.7.1.2. Not dark

1.1.8. Change in bowel motions

1.1.8.1. Diarrhoea

1.1.8.1.1. "How much has there been?"

1.1.8.2. Constipation

1.1.8.2.1. Chronic

1.1.8.3. Mucus in bowel movements

1.1.8.3.1. Rectal ulcer?

1.1.8.3.2. Fistula?

1.1.8.3.3. Villous adenoma?

1.1.8.3.4. Irritable bowel syndrome?

1.1.8.4. Blood in feces

1.1.8.4.1. Malaena

1.1.8.4.2. Small amounts of bright red blood

1.1.8.4.3. Large amounts of blood

2. Respiratory

2.1. Cough

2.1.1. Moist or dry?

2.1.1.1. Dry

2.1.1.1.1. Viral infection?

2.1.1.1.2. Asthma?

2.1.1.1.3. Gastroesophageal reflux?

2.1.1.1.4. Interstitial lung disease?

2.1.1.1.5. ACE inhibitors?

2.1.1.2. Moist

2.1.1.2.1. Acute or chronic?

2.1.1.2.2. What is the sputum like?

2.1.2. What time of day?

2.1.2.1. Nocturnal cough

2.1.2.1.1. Asthma?

2.1.2.1.2. LVF?

2.1.2.1.3. Post-nasal drip?

2.1.2.2. Morning cough

2.1.2.2.1. Smoking?

2.1.3. What's it sound like?

2.1.3.1. Paroxysmal, w/ terminal whoop

2.1.3.1.1. Whooping cough?

2.1.3.2. Bovine

2.1.3.2.1. Recurrent laryngeal nerve palsy?

2.1.3.3. Harsh, seal-barking

2.1.3.3.1. Croup?

2.2. Dyspnoea

2.2.1. "When does/did it occur?"

2.2.1.1. On waking

2.2.1.1.1. COPD?

2.2.1.2. Nocturnal

2.2.1.2.1. Asthma?

2.2.1.2.2. LVF?

2.2.2. Sudden onset in young male

2.2.2.1. Pneumothorax?

2.3. Stridor

2.3.1. Sudden onset

2.3.1.1. Anaphylaxis?

2.3.1.2. Inhaled foreign body?

2.3.1.3. Epiglottitis?

2.3.1.3.1. + look for classic forward-leaning posture

2.3.1.4. Croup?

2.3.2. Gradual onset

2.3.2.1. Malignancy?

2.4. Wheeze

2.4.1. Asthma?

2.4.2. Localised, not cleared with coughing

2.4.2.1. Carcinoma?

3. Cardiovascular

3.1. Congenital heart diseases

3.1.1. L