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

5. Haemoptysis (coughing up blood)

  • Frequency 

  • Presence of clots

  • Associated shortness of breath

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

  • 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.