Throat History
As with all specialities a concise yet thorough history is paramount to ensure no important information is missed. The format you have learned from day one enables this, however, taking a focused speciality history requires specific, closed questions.
There are five main symptoms to consider when taking a history from a patient with a throat problem:
1. Dysphagia (difficulty with swallowing)
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Solids / liquids or complete (both)
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Regurgitation and its timing
2. Odynophagia (pain on swallowing)
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Laterality. (Get the patient to point with single finger to the site)
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Use the full SOCRATES memory aid for the pain
3. Dysphonia (hoarseness)
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Duration
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Onset
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Fatiguability (does it get worse throughout the day?)
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Occupation (singer's nodules)
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Smoker (Reinke's oedema)
4. Stridor
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Inspiratory / expiratory / biphasic
For more information see our tutorial on stridor
5. Haemoptysis (coughing up blood)
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Frequency
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Presence of clots
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Associated shortness of breath
6. We also consider the following symptoms depending on the site of the patient's problems:
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Pain
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Symptoms of acid reflux disease
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Presence of a neck lump and its characteristics
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Smoking history and alcohol consumption
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Other risk factors e.g. radiotherapy of thyroid disease, frequency of chest infection, weight loss
Please also visit our ENT red flag symptoms page.