ED3: History of Present Illness

What 8 elements are mean to be on a HPI?

1. Onset

2. Timing

3. Location

4. Quality

5. Severity

6. Modifying Factors

7. Associated Sx

8. Context

What order should you structure a HPI in?

1. age and sex

2. complaint and onset

3. quality, severity, timing, location

4. modifying factors

5. positive associated sx

6. pertinent negative sx

7. other important context

If patient says... it started on Monday

symptoms began ___ days ago

If patient says... it got better

symptoms improved

If patient says... I took tums and it didn't help

the symptoms unchanged by tums

it hurts when I touch it

pain is worsened by palpation of the area

If patient says... I throw up when I eat or drink anything

the vomiting is exacerbated by PO intake

If patient says... I have low back pain, but I always have that

patient has chronic lower back pain, unchanged from baseline

If patient says... my sister has the same cold

positive sick contact with a sister who has similar sx

If patient says... it feels like a fizzing soda in my chest

chest pain is described as a "fizzing soda" sensation

If patient says... I have the flu

pt has runny nose and cough