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) 

• Solids / liquids or complete (both)

• Regurgitation and its timing

2. Odynophagia (pain on swallowing)

• Laterality. (Get the patient to point with single finger to the site)

• Use the full SOCRATES memory aid for the pain

3. Dysphonia (hoarseness)

• Duration

• Onset 

• Fatiguability (does it get worse throughout the day?)

• Occupation (singer's nodules)

• Smoker (Reinke's oedema)

4. Stridor 

• Inspiratory / expiratory / biphasic 

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For more information see our tutorial on stridor

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5. Haemoptysis (coughing up blood)

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• Frequency 

• Presence of clots

• Associated shortness of breath

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6. We also consider the following symptoms depending on the site of the patient's problems:

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• Pain

• Symptoms of acid reflux disease

• Presence of a neck lump and its characteristics

• Smoking history and alcohol consumption

• Other risk factors e.g. radiotherapy of thyroid disease, frequency of chest infection, weight loss

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Please also visit our ENT red flag symptoms page. 

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