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Red Flags by System

When you are taking a history based around a presenting complaint, it is very useful to eliminate ‘red flags’ that might indicate serious underlying pathology. 

Here are some red flags for a variety of systems:

Cardiovascular

Pain, Palpitations, SOB (on exertion, at rest, orthopnoea, PND) Ankle Swelling, Dizziness, Smoking, Exercise, Diet

Respiratory

Wheeze, SOB, cough, sputum, haemoptysis, chest pain, calf pain/swelling, Smoking

GI

Loss of appetite, Weight loss, nausea/vomit, dysphagia, reflux, pain, change in bowel habit, blood/mucus PR, blood in stool/vomit, jaundice, itching, darkened urine, pale stool

Urogenital

Frequency, Urgency, Pain/tingling, Haematuria, lower back pain, Discharge, Menstrual problems, last Sexual Health check 

Neurological

Collateral hx of GCS/Cognitive change, Visual Disturbance, Hearing Loss,  Speech/Swallowing probs, Headache, Neck/Back Pain, Weakness, Parasthesia, Balance/Coordination, Bowel/Bladder Control

Rheumatological

Morning stiffness, joint pain/swelling/stiffness, deformity, malaise/fatigue, weight loss, arthralgia, myalgia, rash, raynauds, hair loss, red/sore/dry eyes, dry mouth, Oral/Genital Ulcers

Diabetic/Endocrine

Polyuria, polydipsia, fatigue, weight loss, neck swelling/tenderness, tremor, heat/cold intolerance, sweating, changes in appearance – hair, skin, voice, hands, feet, pigmentation.

ENT

Ear Pain/Discharge, Nasal Discharge/Crusting, Sore Throat

General

Fever, sweats, fatigue/malaise, loss of appetite, weight loss, lumps