List of suggested questions in the medical history to identify non-cardiac conditions in a periodic health evaluation
| Suggested question/s in the medical history* | |
| Pulmonary system | Do you have a past history or currently suffer from any symptoms of respiratory (lung) disease including asthma, wheezing, cough, postnasal drip, hay fever or repeated flu-like illness? |
| Haematological system | Do you have a past history or currently suffer from any symptoms of disease of the blood system including low iron stores, anaemia (in particular iron-deficiency anaemia)? |
| Allergies | Do you have a past history or currently suffer from any symptoms of allergies including allergies to pollen, foods, medication, any plant material or any animal material? |
| Infection/immunological | Do you have a past history or currently suffer from any symptoms of disease of the immune system including current infections, recurrent infections, HIV/AIDS or leukaemia, or are you using any immunosuppressive medication? |
| Ear, nose, throat (ENT) | Do you have a past history or currently suffer from any symptoms of disease of the ears (infections, hearing loss, pain), nose (sneezing, itchy nose, sinusitis, blocked nose) or throat (sore throat, hoarse voice, swollen glands in the neck)? |
| Dermatological | Do you have a past history or currently suffer from any symptoms of skin disease including skin rashes, skin infections, itchy skin, allergies or skin cancer? |
| Urological | Do you have a past history or currently suffer from any symptoms of disease of the kidney or bladder including past history of kidney or bladder disease, blood in the urine, loin pain, kidney stones, frequent urination or burning during urination? |
| Gastrointestinal | Do you have a past history or currently suffer from any symptoms of gastrointestinal disease including heartburn, nausea, vomiting, abdominal pain, weight loss or gain (>5 kg), a change in bowel habits, chronic diarrhoea, blood in the stools or past history of liver, pancreatic or gall-bladder disease? |
| Neurological | Do you have a past history or currently suffer from any symptoms of diseases of the nervous system including past history of stroke or transient ischaemic attack, frequent headaches, dizziness, blackouts, epilepsy, depression, anxiety attacks, muscle weakness, nerve tingling, loss of sensation, muscle cramps or chronic fatigue? |
| Endocrine/metabolic | Do you have a past history or currently suffer from any symptoms of metabolic or hormonal disease including diabetes mellitus, thyroid gland disorders, hypoglycemia (low blood sugar) or heat intolerance? |
| Opthalmological | Do you have a past history or currently suffer from any symptoms of eye disease or injury including decreased vision, pain in the eyes, itchy eyes, increased or decreased tear production, discharge from the eye or red eyes? |
*If the answer to any of these questions is “yes,” further details and directed in-depth assessment are required.