فحص جهازي

جزء من عملية استجواب المريض يركز على الأعراض الإيجابية في كل جهاز.

استعراض الأجهزة (بالإنجليزية: ROS)، هو أسلوب يستخدم من قبل الممارس الصحي من أجل الحصول على التاريخ الطبي للمريض. غالبا ما يكون منظم كعنصر من عناصر استمارة القبول لتغطي أجهزة الجسم، مع التركيز على الأعراض الخاصة بكل جهاز. [1]

أمثلة عدل

أياَ كانت الحالة المرضية تبدو خاصة بجاهز معين من الجسم يجب مراجعة باقي الأجهزة أثناء أخذ التاريخ الطبي للمريض.

هناك 14 جهاز معترف به من قبل مراكز الرعاية الطبية والخدمات الطبية:[2]

الجهاز أمثلة
عَرَض بنيوي نقص الوزن غير المفسّر

التعرق الليلي
الإعياء/التوعك/الخمول
الشهية
الحمى
الحكة
الطفح

العين تغيّر في الرؤية

صداع
ألم العين
ازدواج الرؤية عتمة
بقعة عمياء
نزيف شبكية العين 

الأذن، الأنف، الفم، الحنجرة
سيلان الأنف

نزيف الأنف
التهاب الجيوب
ألم الأذن
طنين
ألم الأسنان
التهاب الحلق
ألم عند الأكل

الجهاز الدوري ألم صدر 

ضيق التنفس
صعوبة التمارين
استسقاء
خفقان
إغماء
فقدان الوعي

Respiratory cough, sputum, wheeze, haemoptysis, shortness of breath, exercise intolerance
Gastrointestinal abdominal pain, unintentional weight loss, difficulty swallowing (solids vs liquids), indigestion, bloating, cramping, anorexia, food avoidance, nausea/vomiting, diarrhea/constipation, inability to pass gas (obstipation), vomiting blood (haematemesis), bright red blood per rectum (BRBPR, hematochezia), foul smelling dark black tarry stools (melaena), dry heaves of the bowels (tenesmus)
Genitourinary Urinary: Irritative vs Obstructive symptoms: Micturition – incontinence, dysuria, haematuria, nocturia, polyuria, hesitancy, terminal dribbling, decreased force of stream

Genital: Vaginal – discharge, pain, Menses – frequency, regularity, heavy or light (ask about excessive use of pads/tampons, staining of clothes, clots always indicate heavy bleeding), duration, pain, first day of last menstrual period (LMP), gravida/para/abortus, menarche, menopause, contraception (if relevant), date of last smear test and result

Musculoskeletal pain, misalignment, stiffness (morning vs day long; improves/worsens with activity), joint swelling, decreased range of motion, crepitus, functional deficit, arthritis
Integumentary/Breast pruritus, rashes, stria, lesions, wounds, incisions, acanthosis nigricans, nodules, tumors, eczema, excessive dryness and/or discoloration. Breast pain, soreness, lumps, or discharge.
Neurological Special senses – any changes in sight, smell, hearing and taste, seizures, faints, fits, funny turns, headache, pins and needles (paraesthesiae) or numbness, limb weakness, poor balance, speech problems, sphincter disturbance, higher mental function and psychiatric symptoms
Psychiatric depression, sleep patterns, anxiety, difficulty concentrating, body image, work and school performance, paranoia, anhedonia, lack of energy, episodes of mania, episodic change in personality, expansive personality, sexual or financial binges
Endocrine Hyperthyroid: prefer cold weather, mood swings, sweaty, diarrhoea, oligomenorrhoea, weight loss despite increased appetite, tremor, palpitations, visual disturbances;

Hypothyroid – prefer hot weather, slow, tired, depressed, thin hair, croaky voice, heavy periods, constipation, dry skin
Diabetes: polydipsia, polyuria, polyphagia (constant hunger without weight gain is more typical for a type I diabetic than type II), symptoms of hypoglycemia such as dizziness, sweating, headache,hunger, tongue dysarticulation
Adrenal: difficult to treat hypertension, chronic low blood pressure, orthostatic symptoms, darkening of skin in non-sun exposed places
Reproductive (female): menarche, cycle duration and frequency, vaginal bleeding irregularities, use of birth control pills, changes in sexual arousal or libido
Reproductive (male): difficulty with erection or sexual arousal, depression, lack of stamina/energy

Hematologic/lymphatic anemia, purpura, petechia, results from routine hemolytic diseases screening, prolonged or excessive bleeding after dental extraction / injury, use of anticoagulant and antiplatelet drugs (including aspirin), family history of hemophilia, history of a blood transfusion, refused for blood donation
Allergic/immunologic "Difficulty breathing" or "choking" (anaphylaxis) as a result of exposure to anything (and state what; e.g. "bee sting"). Swelling or pain at groin(s), axilla(e) or neck (swollen lymph nodes/glands), allergic response (rash/itch) to materials, foods, animals (e.g. cats); reaction to bee sting, unusual sneezing (in response to what), runny nose or itchy/teary eyes; food, medication or environmental allergy test(s) results.

مراجع عدل

  1. ^ "Parkinsonism: a review-of-systems approach to diagnosis". Semin Neurol. ج. 27 ع. 2: 113–22. أبريل 2007. DOI:10.1055/s-2007-971174. PMID:17390256. مؤرشف من الأصل في 2019-12-10.
  2. ^ "www.cms.gov" (PDF). مؤرشف من الأصل (PDF) في 2012-03-24. اطلع عليه بتاريخ 2011-02-27.