Comprehensive review on history taking and it's methods

1. Workshop
On HistoryTaking & Physical Examination
By
Dr. Uzma Saleem
Lecture
Allied ION & HS

2.  What is History taking
 Guidelines for Hx taking
 How to Record history of the patient

3. An interview with the patient to know about
the patient’s illness.
Should be modified a/c to the patient’s
symptoms , attitude , age and level of
literacy.

4.  Approach should be gentle , friendly and
confident .
 Approach the pt. from right hand side.
 Greet and introduce yourself .
 Explain what are you going to ask and for
what purpose is history important.
 CONSENT.
 Good hx taking can lead to 80% of diagnosis
of a disease alone.

5.  Following pattern is followed most
commonly:
 Name , age , marital status, occupation and
address.
 Any Co-morbidities ?
 Presenting complaints ( write them down in
chronological order)
 History of presenting complaints ( HOPC)
 Quick systemic inquiry.

6.  Past medical hx , any previous hospitalizations?
 Past surgical hx when?Why ? Any
complications?
 Family history for any disease.
 Gynecological and obstetrics history .
 Transfusion hx (rule out any
hemoglobinopathies and obtain reaction hx)

7.  Any allergies? Dust, medications, specific
food.
 Drug history
 Personal hx : sleep , appetite , bowels ,
micturation and any addiction.
 Socioeconomic hx.

8.  After complete hx taking alwaysTHANK the
patient.