Written by Dr.Md.Redwanul Huq (Masum)

Sunday, 23 December 2012 01:33

Importance of name in Clinical History:

• Identification of the patient on religious, ethnic or geographic distribution
• Proper communication with the patient during history taking
• Patients usually like to be called by their names.

Importance of Age in Clinical History:

Many of the diseases have predilection towards the age of the patients. Here the diseases are listed on the basis of age predilection –

•  Diseases in newborn & Infant:

a) Birth defects-

1.Chromosomal defects – Achondroplasia, Down Syndrome, Klinefelter Syndrome, Fragile X Syndrome etc.

2. Cleft lip & cleft palate.

3.Congenital Heart Diseases

4.Spina Bifida

5.Urogenital defects- Undescended testicles, hypospadias , ambiguous genitalia,obstructive

defects of the renal pelvis (blocked ureters), absence of vas deferens & seminal vesicles

and renal agenesis (missing of one or both kidneys).

6.Marfan Syndrome.

b) Genetic & metabolic disorders-

1. Beta-Thalassemia

2. Hb S/ Hb C disease

3. Homocystinuria

4. Phenylketonuria

5. Sickle cell anemia

6. Cystic fibrosis

7. Classical galactosemia

8. Tyrosinemia type I

9. Congenital adrenal hyperplasia

10. Congenital hypothyroidism

11. Severe combined immunodeficiency

12. Carnitine uptake defect

13. Glutaric acidemia type I

14. Hearing loss

15. 3-Methylcrotonyl-CoA carboxylase deficiency

16. Hydroxymethylglutaric aciduria or HMG-CoA lyase deficiency

17. Isovaleric acidemia

18. Long-chain 3-OH acyl-CoA dehydrogenase deficiency

19. Maple syrup urine disease

20. Medium-chain acyl-CoA dehydrogenase deficiency

21. Methylmalonic acidemia due to

22. Multiple carboxylase deficiency

23. Argininosuccinic acidemia

24. Propionic acidemia

25. Very long-chain acyl-CoA dehydrogenase.

c) Infectious diseases-

Adenovirus Infections

Amebiasis

Appendicitis

Ascariasis

Bronchiolitis

Campylobacter infections

Cellulitis

Chickenpox

Chlamydia

Common cold

Conjunctivitis

Cytomegalovirus infections

Diaper Rash

Diarrhea

Diphtheria

E. Coli infections

Eczema

Encephalitis

Genital Herpes

Genital Warts

Giardiasis

Gonorrhea

HIV and AIDS

Head Lice

Helicobacter pylori infections

Hepatitis

Impetigo

Infant Botulism

Influenza

MRSA

Malaria

Measles

Meningitis

Middle Ear infections

Mononucleosis

Mumps

Neonatal Infections, e.g. Neonatal Sepsis, Neonatal Jaundice, Neonatal Asphyxia etc

Osteomyelitis

Pinkeye (i.e. Conjunctivitis)

Pinworm

Pneumocystis Pneumonia

Pneumonia

Polio

Rabies virus infections

Respiratory Syncytial Virus infections

Rotavirus infections

Rubella virus infections

Salmonella infections

Scabies

Shigella infections

Sinusitis

Staphylococcal Infections

Streptococcal Sore Throat

Syphilis

Tetanus

Tinea (Ringworm)

Tonsillitis

Toxic Shock Syndrome

Toxoplasmosis

Trichomoniasis

Tuberculosis

Urinary Tract Infections

Vaginal Yeast Infections

Warts

Whooping Cough (i.e. Pertussis)

Yersiniosis.

• Diseases in children:

Autism

Bronchial Asthma

Bronchiolitis

Candidiasis (Oral, Vaginal)

Chickenpox

Cystic Fibrosis

Diabetes(Type 1)

Diphtheria

Influenza

Iron deficiency anemia

Juvenile idiopathic arthritis

Leukemia

Measles

Meningitis

Mumps

Nephrotic syndrome

Pneumonia

Polio

Protein energy malnutrition

Rheumatic fever

Rickets

Tetanus

Thalassemia

Tuberculosis

Hepatitis A

Scarlet fever

Xerophthalmia.

Beyond the above list, there are many other diseases in children.

• Disease in adult:

Allergy

Alzheimer’s Disease

Anemia

Anxiety Disorders

Benign Prostatic Hyperplasia (In case of male)

Bladder Problems

Breast Cancer

Bronchial Asthma

Bursitis

COPD

Cataracts

Chronic Kidney Disease

Colon Cancer

Common colds

Depression

Diabetes Insipidus

Diabetes Mellitus

Fatigability

Glaucoma

Headache

Hearing Loss

Hypercholesterolemia

Hypertension

Indigestion

Low Back Pain

Macular degeneration

Memory Loss

Menopause (In case of female)

Osteoarthritis

Osteoporosis

Parkinson’s Disease

Prostate Cancer (In case of male)

Rheumatoid Arthritis

Sleep Disorders

Stress

Stroke

Tendonitis

Thyroid Disorders

Urinary Problems.

• Diseases in old age:

Following are the diseases in old age–

Alzheimer’s Disease

Anemia

Anxiety Disorders

Balance Disorders

Bell’s Palsy

Benign Prostatic Hyperplasia (In case of male)

Bladder Problems

Blepharitis

Breast Cancer

Bursitis

COPD

Cancer

Cataracts

Chalazion

Chronic Kidney Disease

Colon Cancer

Congestive Heart Failure

Corneal Abrasion

Coronary Artery Disease

Dehydration

Dementia

Depression

Diabetes Insipidus

Diabetes Mellitus

Failure to Thrive

Fatigability

Glaucoma

Headache

Hearing Loss

Heart Attack

Heart Disease

Heart Failure

Hip Dislocation

Hip Fracture

Hypercholesterolemia

Hypertension

Indigestion

Macular degeneration

Memory Loss

Mobility Disorders

Neck Fracture

Osteoarthritis

Osteoporosis

Parkinson’s Disease

Prostate Cancer (In case of male)

Rheumatoid Arthritis

Sleep Disorders

Spinal Stenosis

Stress

Stroke

Urinary Problems(e.g. Dysuria, Incontinence)

Vertebral Fracture.

Importance of Sex in Clinical History:

Sex of the patient is important for following reasons-

• Males require high dosage of drugs than the females as their body weight is more in comparison to the females.
• Prolonged use of anti hypertensive drugs may produce impotency in males.
• Male may have gynecomastia due to some medications like spironolactone, digitalis, ketoconazole, chlorpromazine etc.
• Care should be taken while prescribing medicines to patients who are in Pregnancy or Lactation.
• Diseases also have predilection towards the sex of the patients. Here the diseases are listed on the basis of sex predilection-

Disease more in male:

Athlete’s Foot

Bladder Problems

Bladder Tumors

COPD

Chondrosarcoma

Cirrhosis of the Liver

Color Blindness

Duchenne Muscular Dystrophy

Epilepsy

Ewings Sarcoma

Gout

Hemophilia

Herpes Simplex

Hodgkins Disease

Hypertension

Inguinal Hernia

Ischemic Heart Diseases

Kaposi’s Sarcoma

Kleinfelter’s Syndrome

Liposarcoma

Mouth Ulcers

Multiple Myeloma

Nasal Bleeding

Osteoarthritis

Pancreatitis

Rectal Abscess

Rectal Prolapse

Traumatic Brain Injury

Tuberculosis

Urinary Problems

Varicocele.

Disease more in female:

Autoimmune Diseases, e.g.

Antiphospholipid syndrome- primary & secondary

Autoimmune hepatitis

Autoimmune thrombocytopenic purpura (ITP)

Graves’ disease

Hashimoto’s thyroiditis

Multiple sclerosis

Myasthenia gravis

Primary biliary cirrhosis

Rheumatoid arthritis

Scleroderma

Sjogren’s syndrome

Systemic lupus erythematosus

Carcinoma Pancreas

Colorectal cancer

Gallstones

Hypertension

Iron Deficiency Anemia

Migraine

Osteoporosis

STD, e.g.

Chancroid

Dyspareunia

Genital warts

Gonorrhea

Trichomoniasis

Sickle Cell Anemia

Urinary tract infections, e.g.

Cystitis

Pyelonephritis

Vertebral Fracture.

Importance of Religion in History:

Some diseases have predilection to the religion of the patients,like-

• Carcinoma of penis, Phimosis *less in Muslims,
• Taeniasis ( Tapeworm infection) by Taenia solium usually does not occur in Muslims,
• Taeniasis ( Tapeworm infection) by Taenia saginata less in Hindus.

Importance of Occupation in Clinical History:

Some diseases are associated with the occupation, for example-

DISEASE	ASSOCIATED OCCUPATION
Asbestosis	Asbestos miners
Bronchial asthma	Workers in jute mills
Byssinosis industry	Workers in cotton textile
COPD	Welding workers
Carpal tunnel syndrome	Workers in poultry industries, Workers in information technologies
Carcinoma of Urinary Bladder	Workers in dying industry / rubber industry
Coalworker’s pneumoconiosis	Coal miners
Contact Dermatitis	Workers in chemical industries
Eczema	Workers in chemical industries
Hand Arm Vibration Syndrome	Operating drills in mining or construction or using tools such as chainsaws
Lead poisoning	Workers in lead industries
Lung cancer	Uranium or gold miners
Nail Bed infection	Radiographers, Dark room assistants
Pulmonary diseases	Workers in acetic acid plants
Radiation sickness	Workers in nuclear industries
Skin cancer	Workers in chemical industries
Squamous cell carcinoma of the skin of the scrotum	Chimney sweeps
Tuberculosis	Tobacco factory workers
Varicose vein	Long standing workers (e.g. Surgeon,Traffic police etc.)

Importance of Marital Status in Clinical History:

•  Married people are less prone to Sexually transmitted Diseases (STDs) :

Bacterial Vaginosis

Calymmatobacterium granulomatis

Cervical cancer

Chancroid

Chlamydia

Genital Herpes

Genital warts

Gonorrhea

Granuloma inguinale

HIV/AIDS

Hepatitis B

Hepatitis C

Human Papillomavirus infections

Kaposi’s sarcoma

Lymphogranuloma Venereum

Molluscum contagiosum

Mononucleosis

Non-gonococcal urethritis

Pelvic Inflammatory Disease

Staphylococcal infection

Syphilis

Tinea cruris

Trichomoniasis

Yeast Infection.

Importance of Address in Clinical History:

Address of the patient is important for following reasons-

•  It is important for communication with the and follow up of the patient.

•  Some diseases have predilection to the geographic distribution of the patients, some examples are given below-

For Bangladesh-

Goitre ,filariasis – North Bengal

Kala azar – Jamalpur ,Mymensing ,Tangail

Leprosy -West Bengal

Malaria – Chittagong , Sylhet, Other Hill tracts.

For other areas-

Anemia and Malnutrition severe in Rural Areas

Buccal Carcinoma – Tamilnadu

Carcinoma of the Palate – Srikakulam A.P

Filariasis – Orissa

Kangri Cancer – Kashmiris

Sleeping Sickness – South Africans.

Importance of date of admission & date of examination in Clinical History:

To monitor the progress/deterioration of the patient.

Importance of family history in Clinical History:

•  Infectious disease of a patient may spread to others living with him/her.

•  Many diseases run in the family (which are called Hereditary diseases) like-

1.Autosomal Dominant Diseases-

Achondroplasia

Hereditary Hemochromatosis

Down Syndrome

Hereditary Spherocytosis.

2.Autosomal Recessive Diseases-

Albinism

Cystic fibrosis

Hereditary Fructose Intolerance

Phenylketonuria

Polycystic Kidney Disease

Sickle cell anemia

Tay-Sachs Disease

Usher Syndrome.

3.Gender Linked Diseases-

Color Blindness

Hemophilia

Muscular Dystrophy.

4.Polygenic Disorders-

Allergy

Alzheimer’s diseases

Autoimmune diseases-

Antiphospholipid syndrome- primary & secondary

Autoimmune hepatitis

Autoimmune thrombocytopenic purpura (ITP)

Graves’ disease

Hashimoto’s thyroiditis

Multiple sclerosis

Myasthenia gravis

Primary biliary cirrhosis

Rheumatoid arthritis

Scleroderma

Sjogren’s syndrome

Systemic lupus erythematosus

Breast cancer

Bronchial Asthma

Coronary heart diseases

Depression

Diabetes

Glaucoma

Hypertension

Malignant Melanoma

Obesity

Ovarian cancer

Hypercholesterolemia.