Diarrhea

HISTORY_LIST
number of stools 
   per hour
   per day
loose or watery stool
bloody stool
pus in stool
oily stool
foul smelling stool
fever
malaise
cramping
abdominal pain
tenesmus
nausea
vomiting
ability to keep food or liquids down
lightheadedness
myalgia
arthalgia
headache
upper respiratory infection
back pain
recent ingestion of 
     spoiled food
     raw foods
     undercooked poultry
     raw milk
     raw or uncercooked seafood
recent foreign travel
laxative abuse
long term antibiotic use
recent contact with other persons 
     with diarrhea
rectal urgency
stress related
AIDS risk factors
INFECTIOUS DISEASES
AIDS or HIV
CHRONIC DISEASE
SYSTEMIC DISORDERS
lactose intolerance
diabetes
inflammatory bowel dz.
hyperthyroidism
alcoholism
SURGERY
PREVIOUS HOSPITALIZATIONS
abdominal
intestinal
PREVIOUS TESTS
radiation
TRAUMA OR INJURIES
abdominal
head trauma
SOCIAL HISTORY
smoking
alcohol
caffeine
illicit drugs - cocaine
ALLERGY
medications
foods
seasonal
FAMILY HISTORY
coeliac dz.
colon cancer
diabetes
immunosuppression

MEDS_LAB_TESTS
**** MEDS
erythromycin
clindyamycin
magnesium containing antacids
cholinergic agents
quinidine
antihypertensives
colchicine association with 
    caffeine
    chocolate
    candy
    milk products
immunosuppression agents
**** LAB
Electrolytes
BUN
creatnine
CBC
calcium
albumen
Wright's stain
stool C&S
ova and parasites
Clostridium difficile and toxins
**** TESTS
abdominal X-ray
endoscopy
colonoscopy
abdominal CT or MRI


REVIEW_OF_SYSTEMS_1
GENERAL
weight changes
appetite changes
anorexia
difficulty sleeping
fever
chills
polyphagia
hypophagia
changes in thirst
sleeping habit change
bowel habit change
fatigue
hypertension
previous physical exams
SKIN
pigmentation changes
texture changes
lesions
eruptions
pruritis
easy bruising
easy bleeding
unusual hair loss
changes in hair distribution
skin masses
finger/toe nail change
rashes
hives
striae
skin atrophy
uremic frost
hirsutism
plethora
neurofibromatosis lesion
HEENT
head trauma
skull fractures
head masses
hearing loss
vertigo
chronic ear infection
ear discharge
ear pain
hearing aid use
loss of vision
recent change in vision
photophobia
diplopia (double vision)
glaucoma
exudates
dry eyes
eye pain
cataracts
eye surgery
itchy eyes
excessive tearing
corrective lenses
nose bleeds
chronic sinusitis
nasal fractures
nasal drainage
polyps
changes in sense of smell
edentulous (without teeth)
partial plate
full plate
recent dental work
oral lesions
tonsillitis
strep throat
tongue problems
voice changes
chronic hoarseness
chronic halitosis
NECK
neck masses
enlarged thyroid gland
brachial cleft cysts
neck injury

REVIEW_OF_SYSTEMS_2
CHEST
chronic coughing
sputum production
hemoptysis
wheezing
pneumonia
bronchitis
TB
TB exposure
SOB
SOB altered by position
edema
chest pains
pacemaker
HEART
MI
coronary artery disease
heart murmur
heart valve disease
left ventricular hypertrophy
mistral valve stenosis
pericarditis
palpitations
DOE
paroxysmal nocturnal dyspnea
orthopnea
edema
hypertension
rheumatic fever
cardiomyopathy
ectopic heart beats
arrhythmia
exercise intolerance
claudication
heart medications
ABDOMEN
abdominal pain
nausea
vomiting
diarrhea
constipation
hematochezia
hematemesis
hemorrhoids
GI x-rays
GI scopings
rectal bleeding
ulcers
bowel polyps
bowel incontinence
gall bladder disease
gall stones
hepatitis
cirrhosis
hepatomegaly
splenomegaly
GU
renal insufficiency
renal failure
dialysis
kidney stones
kidney disease
kidney cyst
flank pain
hematuria
pyuria
dysuria
chronic cystitis
nocturia
anuria
hesitancy
enuresis
change in urine color
prostatitis
epididymitis
scrotal problems
TURP
pain on intercourse
genital lesions
genital discharge

REVIEW_OF_SYSTEMS_3
OB/GYN
metorrhagia
menorrhagia
irregular menses
problems in pregnancy
use of contraception
breast masses
nipple discharge
breast skin changes
changes in axillary nodes
monthly breast exam
breast feeding children
EXTREMITIES
difficulty with gait
weakness
joint swelling
joint stiffness
muscle pain
muscle swelling
muscle injuries
sagittal plan scoliosis
coronal plane scoliosis
fractured bones
SLE
osteoarthritis
rheumatoid arthritis
fibromyalgia
NEURO
seizures
head injury
LOC
loss of coordination
difficulty in balance
sciatica
difficulty in fine motor skills
difficulty speaking
CVA (stroke)
weakness in arms
weakness in legs
tingling in legs and feet
tingling in arms
PSYCHIATRIC
depression
bipolar disorder
suicide attempts
psychiatric hospitalizations
personality disorders
ENDOCRINE
goiter
exophthalmos
dry skin
dry hair
intolerance to heat
intolerance to cold
changes in growth
sterility
impotence
decreased libido
LYMPHATIC AND HEMATOLOGICAL
lymphadenopathy
transfusion
anemia




PHYSICAL_EVAL_1
VITALS
BP
Pulse
Temp
Heart rate
GENERAL
lethargic
dehydrated
SKIN
skin turgor
capillary refill
jaundice
erythema nodsum 
pyoderma gangrenosum 
HEENT
oral ulcers (coeliac Dz. of IBD)
cracked lips (riboflavin deficiency)
dry mucus membranes
glossitis (B12, folate deficiency)

PHYSICAL_EVAL_2
ABDOMEN
bowel sounds
abdominal tenderness
abdominal rebound
hepatomegly
distention
pulsatile masses
GU
perianal ulcers
rectal ulcers
rectal tags
fissures
hemorrhoids
sphincter tone
rectal tenderness
rectal masses
blood on examining glove
occult blood positive
rectal pus
EXTREMITIES
back pain
arthritis
arthritis
joint swelling (Ulcerative colitis)
joint pain



DIFF_DIAGNOSIS
OSMOTIC DIARRHEA
laxatives
lactulose deficiency
lactase deficiency 
    (gastroenteritis or sprue)
other disaccharidase deficiencies
SECRETORY DIARRHEA
bacterial infection
AIDS associated disorders 
    (mycobacterial)
Zollinger-Ellison syndrome
vasoactive intestinal peptide tumor
carcinoid tumor
medullary thyroid carcinoma
colonic villus adenoma
EXUDATIVE DIARRHEA
bacterial infections
Clostridium difficile
viruses
parasites
Crohn's dz.
ulcerative colitis
diverticulitis
chemotherapy
intestinal ischemia
DIARRHEA 2nd TO CHANGE 
  IN INTESTINAL MOTILITY
diabetic gastroparesis
adrenal insufficiency
hypothyroidism
laxatives
antibiotics
cholinergics
irritable bowel syndrome
GI bleeding
DIARRHEA 2nd TO DEC. 
	SURFACE ABSORPTION
bowel resection
fistulas


