OFFICIAL ANAMNESIS NAME GENDER AGE OCCUPATION KEM VI

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OFFICIAL CERTIFICATE OF COUNTY CANVASSING BOARD STATE
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OFFICIAL ANAMNESIS

NAME:

GENDER:

AGE:

OCCUPATION: KEM VI RABOTAETE?

VI NA PENSII? ( DLYA POJELIX)

U VAS EST GRUPPA INVALIDNOSTI? (DLYA INVALIDOV)

ADDRESS: GDYE VI JEVYOTE?/ KAKOY U VAS ADRES?

DATE OF ADMISSION: KOGDA VI SUDA POSTUPILI?

SOURCE OF REFERRAL: KTO VAS SUDA NAPRAVIL? (POLIKLINIKA/ SKORAYA POMOSH/ OBRATILSYA SAM)

INITIAL DIAGNOSIS: S KAKIM DIAGNOZOM VI POSTUPILI?

COMPLAINTS:

CHIEF COMPLAINT: SHTO VAS BESPOKOIT?

SYSTEMS REVIEW: A SHTO ESHO VAS BESPOKOIT?/ NA SHTO NIBUD ESHO JALUETES’?/ ESHO SHTO NIBUD’ BOLIT?

RESPIRATORY SYSTEM:

1.VOICE; NE BILO LI U VAS XRIPLOVA GOLASA?/ NE PROPADAL LI GOLAS?/ NE IZMINILSYA LI U VAS GOLAS V POSLEDNEE VREMYA?

HOARSE; XRIPLIY/ SIPLIY

SONOROUS; ZVUCHNIY/ GROMKIY/ YASNIY

WEAK; SLABIY

APHONIC; NE SLISHNIY/ NET GOLOSA

2.SORE THROAT; NET LI U VAS BOLEY ILI NEPRIYATNIX OSHUSHENIY V GORLE?/ NE BOLELO LI U VAS GORLA?

CONTINOUS; POSTAYANNIE

ON SWALLOWING; PRI GLOTANII

BURNING OR TICKLING; CHUSTVA JJENIYA ILI SHEKOTANIYA V GORLE

3.COLD IN THE HEAD; NE BESPOKOIT/ BESPOKOIL LI VAS NASMORK ILI ZALOJENNOST’ V NOSU?

CONTINOUS OR PERIODICAL; NASMORK U VAS POSTAYANNA ILI INOGDA PROXODIT?

4.CHARACTER OF BREATHING; THROUGH NOSE OR MOUTH

5.COUGH; KASHEL’ VAS BESPOKOIT?/ U VAS EST KASHEL’?

PRI KASHLE OTXODIT MOKROTA?/ KOGDA VI KASHLYAYTE, VIDELYAETSYA SHTO NIBUD’?

DRY OR PRODUCTIVE; SUXOY ILI S MOKROTOY?

TIME OF ATTACK; MORNING/ DAY/ EVENING; KOGDA KASHEL’ BOLSHE?

TIMBRE/ CHARACTER; BARKING/ HOARSE/ APHONIC; LAYUSHIY/ SIPLIY/ BEZZVUCHNIY; POKASHLIYTE PAJALSTA!!!

6.SPUTUM; SKOLKA MOKROTI U VAS OTXODIT ZA SUTKI?

SKOLKA EYO BUDET V STOLOVIX LOJKAX?

QUANTITY; IN TBS; KALECHESTVO ZA SUTKI V STOLOVIX LOJKAX

TIME OF COUGH WITH SPUTUM; MORNING/ DAY/ EVENING; V KAKOE VREMYA BOLSHE OTXODIT MOKROTA?

CHARACTER; KAKAYA MOKROTA NA VID?

MUCOUS/ PURULENT/ SEROUS; SLIZISTTAYA/ GNOYNAYA/ SEROZNAYA

COLOUR; KAKOY TSVET MOKROTI?

NE BILO LO RJAVOY MOKROTI ILI S KROVYU?

WHITE/ RUSTY/ YELLOW/ BROWN/ GREEN/ WITH BLOOD; BELAYA/BESSVETNAYA/ RJAVAYA/ JYOLTAYA/ ZELYONAYA/ KORICHNEVAYA/ S PRIMESYU KROVI

SMELL; A ZAPAX U MOKROTI KAKOY?

OBICHNIY?

NE BILO LI MOKROTI S PLOXIM ZAPAXOM

BAD/ ROTTEN/ USUAL/ WITHOUT SMELL; PLOXOY ILI GLINOSTNIY/ OBICHNIY ILI POCHTI BEZ ZAPAXA

BLOOD OR FOOD IN SPUTUM; NE BILO LI MOKROTI S PRIMESYU PISHI ILI KROVI?

POSTURE FOR BEST DISCHARGE OF SPUTUM; V KAKOM POLOJENII MOKROTA LUCHSHE OTXODIT?( SIDYA/ LYOJA/ NA LEVOM/ PRAVOM BOKU)

7.HEMOPTYSIS; KROVAXARKANIE

QUANTITY; MNOGA LI KRIVI V MOKROTE?/ TOLKA PROJILKI ILI CHISTAYA KROVI ILI TOLKA RAZOVATIY TSVET?

COLOUR; KAKOVA TSVETA PRIMES’ KROVI?

SCARLET/ DARK RED/ CRIMSON/ ROSY; ALAYA/ TYOMNAYA/ MALINOVAYA/RAZOVATAYA

FOAMY SPUTUM; NE BILO LI PINISTOY MOKROTI?

FREQUENCY OF HEMOPTYSIS; SKOLKA RAZ BILA PRIMES’ KROVI V MOKROTE?/ CHASTO TAK BIVAET?

8.CHEST PAIN; NE BESPOKOIT LI VAS BOLI V GRUDI?

NE ZA GRUDINOY A V DRUGOM MESTE?

CHARACTER; A KAKIE ETO BOLI?, ONI KOLYUT, NOYUT, REJUT?

DULL/ ACUTE/ PIQUE; TUPAYA/ OSTRAYA/ KOLYUSHAYA

LOCALIZATION OF PAIN; GDYE?, V KAKOM MESTE BOLIT?, POKAJITE RUKOY PAJALSTA

RELATION OF PAIN TO BREATHING AND COUGHING; BOL V GRUDI SVYAZANA S DIXANIEM?, KOGDA VI KASLYAETE, BOL’USILIVAETSYA?

INTENSITY OF PAIN; BOL’ V GRUDI SILNAYA?/ BOL’KAKAYA?, SLABAYA, SREDNYAYA, SELNAYA?

FAINT/ MODERATE/ SEVERE;

IRRADIATION OF PAIN; BOL’ KUDA NIBUD OTDAYOT, ROSPRASTRANYAETSYA?, POKAJITE RUKOY PAJALSTA!!!

WHAT RELIEVES THE PAIN: SHTO OBLEGCHAET BOL’?/ SHTO VAM POMOGAET OT BOLI?/ SHTO VI DELAETE SHTOBI BOL’ UMENSHILAS’?;

MEDICINE/ THING/ ACTION

9.DYSPNEA; NE BESPOKOIT LI VAS ODISHKA?/ NE BILO LI U VAS ODISHKI ILI ZATRUDNENIYA DIXANIYA?

CHARACTER; SHTO TRUDNEE VAM, VDOXNUT ILI VIDOXNUT?, ILI TRUDNA SKAZAT?

INSPIRATION/ EXPIRATION/ BOTH

CONNECTION WITH MOTION; ODISHKA BESPOKOET PRI NAGRUZKE ILI V POKOE TOJE?

FREQUENCY; BIVAYUT LI U VAS PRISTUPI NEXVATKI VOZDUXA ILI KASHLYA?, KAK CHASTO?, SKOLKA RAZ V NEDELYU, MESYATS?

POSTURE; PRIXODITSYA LI PRI PRISTUPAX SADITSYA?/ VO VREMYA PRISTUPA V KAKOM POLOJENII LEGCHE DISHAT?

DURATION; TAKIE PRISTUPI BISTRO PROXODYAT?, SKOLAKA ONI DLITSYA?

BREATH WHEEZING; NE BIVAET LI SVISTOV, XRIPOV PRI DIXANII VO VREMYA PRISTUPOV?

RELIEVED BY; SHTO OBLEGCHAET PRISTUP UDUSHYA?/ SHTO VAM POMOGAET PRI PRISTUPE?/ SHTO VI DELAETE, SHTOBI ETO PROSHLO?

CARDIAC SYSTEM:

1.DYSPNEA

2.HEART TROUBLE; SERDTSE VAS BESPOKOIT?/ NE BIVAET LI U VAS BOLEY V OBLASTI SERDTSA?

DURATION; BOLI POSTAYANNIE ILI PERIODICHESKIE ILI V VIDE PRISTUPOV?

LOCATION; SUBSTERNAL/ LEFT OF STERNUM/ APEX AREA

CHARACTER; KAK VI MOJETE OPISAT BOLI?

HURTING/ COMPRESSING/ PRESSING/ STABBING; NAYUSHIE/ SJIMAYUSHIE/ DAVYASHIE/ KOLYUSHIE

INTENSITY; FAINT/ MODERATE/ SEVERE

IRRADIATION;

3.ADDITIONAL FEELINGS; SHTO VI CHUSTVUYTE PRI BOLI?

FEAR/ SPLEEN/ WEAKNESS/ COLD PERSPIRATION/ DIZZINESS; STRAX/ TOSKA/ SLABOST/ XOLODNIY POT/ GOLOVAKRUJENIE

DURATION OF ATTACKS; TAKIE PRISTUPI BISTRA PROXODYAT?, SKOLKA ONI DLITSYA?, CHAS, POLCHASA, ILI MENSHE?

FREQUENCY; CHASTO LI BIVAYUT TAKIE PRISTUPI?, SKOLKA RAZ V DEN’ NEDELYU, MESYATS?

REASON, RELATION WITH TIME, MOVEMENT,REST; OTCHEVO VOZNIKAYUT BOL’ V GRUDI?, OT NAGRUZKI, VOLNENIYA, KURENIYA, POSLE EDI?/ VOZNIKAYUT LI BOLI V POKOE ILI VO VREMYA SNA?

RELIEF; SHTO OBLEGCHAET BOL’?, POMOGAET LI NITROGLITSERIN, VALIDOL, KORVALOL?

CHEREZ KAKOE VREMYA POSLE PRINYATIYA NITROGLITSERINA BOL’ PROXODIT?/ SHTO VAM POMOGAET OT BOLI?/ SHTO VI DELAETE SHTOBI BOL’ UMENSHILAS’?

4.ARRHYTHMIA; NE BILO LI U VAS CHUSTVA PEREBOEV V RABOTE SERDTSA, ZAMIRANIYA ILI VNEZAPNIX TOLCHKOV?

DURATION; VI POSTAYANNO CHUSTVUETE PEREBOI ILI INOGDA?

5.PALPITATION; U VAS BIVAET CHUSTVA SERDTSEBIENIYA?

DURATION; VI POSTAYANNA CHUSTVUETE SERDTSEBIENIE ILI INOGDA, PRISTUPAMI?

DURATION; KAK DOLGA, SKOLKA VREMINII DLITSYA PRISTUPI SERDTSEBIENIYA?

RELATION; PRI KAKIX USLOVIYAX VOZNIKAET SERDTSEBIENIE? PRI NAGRUZKE, V POKOE, PRI VOLNENII?

6.EDEMA; BIVAYUT LI U VAS OTYOKI?

LOCATION; NA KAKIX MESTAX BIVAYUT OTYOKI?, DOKUDA ONI DOXODYAT?

INTENSITY; BOLSHIE LI ONI BIVAYUT?

TIME OF ONSET; KOGDA ONI POYAVLYAYUTSYA?

DURATION; BISTRO LI ONI PROXODYAT?, SKOLKA VREMENI ONI DERJATSYA?

7.PERIPHERAL VESSEL SPASMS/ CRAMPS/ INTERMITTENT LAMENESS OR REYNAUD’S SIGN; NE BIVAET LI U VAS XROMOTI?, NE SINEYUT ILI BELEYUT LI PALTSI NA XOLODE?

GASTROINTESTINAL SYSTEM:

1.APPETITE AND WEIGHT CAHNGES; XOROSHIY LI U VAS APPETIT?/ KAK U VAS S APPETITOM?/ ZA POSLEDNEE VREMYA NE IZMINILSYA LI U VAS APPETIT?/NET LI U VAS OTBRASHENIYA K PISHE?/ ZA POSLEDNEE VREMYA NE POPRAVILIS’?,

NE POXUDELI?, NA SKOLKA KILOGRAMMOV I ZA KAKOE VREMYA?

GOOD/REDUCED/ LOSS/ INCREASED/ PERVERT/ AVERSION TO MEAL; XOROSHIY APPETIT/ SNIJENNIY/ NET APPETITA/ POVISHENNIY/ IZVRASHENNIY/ OTVRASHENIE K PISHE

2.SATISFACTION AFTER MEAL/ NASHSHAEMOST’; VI BISTRO NAEDAETES’?/ CHASTO LI VI ISPITIVAETE CHUSTVO GOLODA?

NORMAL/ QUICK/ CONSTANT HUNGER; NORMALNAYA/ BISTRAYA/ POSTAYANNOE CHUSTVO GOLODA

3.DRYNESS IN MOUTH; U VAS NE SOXNET VO RTU?

4.INCREASED SALIVATION; POVISHENNOE SLYUNOOTDELENIE; NE BIVAET LI U VAS POVISHENNOVA SLYUNOOTDELENIYA?/ NE BIVAET LI U VAS CHASTO MNOGA SLYUNI VO RTU?

5.THIRST; JAJDA; NE BIVAET LI U VAS CHUSTVA JAJDI?/ NE MUCHAET LI VAS JAJDA?, DAILY LIQUID INTAKE; SKOLKA JIDKOSTI VI VIPIVAETE ZA SUTKI?

6.TASTE IN THE MOUTH; VKUS VO RTU; NE ISPIVAETE LI VI KAKOVA LIBO POSTORONNEVA VKUSA VO RTU?

; ACID/ BITTER/ METALLIC; KISLIY/ GORKIY/ METALLICHESKIY

7.DYSPHAGIA; GLOTANIE I PROXOJDENIE PISHI; VI GLOTAETE SVABODNA?/ NE BIVAET LI U VAS ZATRUDNENIY PRI GLOTANII, OSOBENNA SUXOY PISHI?/ PISHA PROXODIT XOROSHO?

; FREELY/ WITH TENDERNESS/ WITH DIFFICULTY; SVABODNA/ S BOLYU/ TRUDNA

; KAKAYA PISHA XUJE PROXODIT, TVYORDAYA ILI JIDKAYA?

DRY/ WET

STOMACH:

1.PAIN IN EPIGASTRIUM; U VAS BIVAYUT BOLI V VERXNEY CHASTI JIVOTA?; POD LOJEZHKOY, V EPIGASTRII

CHARACTER; KAKOVA XARAKTERA ETI BOLI?, OSTRIE, TUPIE, NOYUSHIE ILI KAKIE LIBO DRUGIE?

ACUTE/ DULL; OSTRIE/ TUPIE

LOCALIZATION; GDYE VI IX CHUSTVUYTE?

IRRADIATION; BOLI KUDA NIBUD OTDAYUT?

RELATION; BOLI SVYAZANI S PRIEMOM PISHI?, KOGDA ONI VOZNIKAYUT, DO EDI, POSLE EDI, NA GOLODNIY JELUDOK, NOCHYU?,

CHEREZ KAKOE VREMYA POSLE EDI POYAVLYAYUTSYA BOLI?

DURATION; CONSTANT/ PERIODICAL/ EPISODE LIKE

RELIEF; OT CHEVO BOLI UMENSHAYUTSYA ILI PROXODYAT?/ SHTO VI DELAETE SHTOBI UMENSHIT’ILI SNYAT BOL’?

2.FEELING OF OVERFEEDING AND HEAVINESS IN EPIGASTRIA; CHUSTVA RASPIRANIYA/ TYAJEST POD LOJEZHKOY; NE BIVAET LI U VAS TYAJESTI, RASPIRANIYA V JIVOTE/ POD LOJEZHKOY?

3.DYSPEPSIA; DISPEPTICHESKIE RASTROYSTVA

4.ERUCTATION;NE BESPOKOIT LI VAS OTRIJKA?, A KAKAYA ONA?, S KAKIM ZAPAXOM?;

WITH AIR/ FOOD/ ACID/ BITTER/ THE SMELL OF ROTTEN EGGS; VOZDUXOM/ PISHEY/KISLIM/ GORKIM/ TUXLIMI YAYTSAMI

5.HEARTBURN AND ACID REGURGITATION; IZJOGA VAS NE BESPOKOIT?

RELATION; IZJOGA SVYAZANA S PRIYOMOM PISHI?, IZJOGA BIVAET DO ILI POSLE PRIYOMA PISHI ILI NA GOLODNIY JELUDOK?

RELIEF; OT CHEVO ONA PROXODIT ILI UMENSHAETSYA?/ ESLI VI POKUSHAETE ILI PRIMITE KAKIE NIBUD LEKARSTVA IZJOGA UMENSHAETSYA?, KAKIE LEKARSTVA?

6.NAUSEA; TOSHNOTA VAS NE BESPOKOIT?

RELATION; TOSHNOTA SVYAZANA S PRIOMOM PISHI?, TOSHNOTA BIVAET DO ILI POSLE PRIOMA PISHI ILI NA GOLODNIY JELUDOK?

7.VOMITTING; RVOTI U VAS NE BIVAET?

RELATION; RVOTA SVYAZANA S PRIOMOM PISHI?, RVOTA BIVAET DO ILI POSLE PRIOMA PISHI ILI NA GOLODNIY JELUDOK?, RVOTA BIVAET SRAZU POSLE EDI ILI NEMNOGA POGODYA?, NE BIVAET TAK SHTO VI SAMI VIZIVAETE RVOTU, PACHEMU ESLI BIVAET?

CHARACTER OF VOMITTING MASS; KAKOY XARAKTER RVOTNIX MASS?/ CHEM RVYOT?/ ETA PISHA JELCH, JIDKAYA, JIDKOST’?

FOOD/ ACID LIQUOR/ ADMIXTURE OF BILE OR BLOOD/

HAEMATEMESIS; PISHA/ KISLAYA JIDKOST’/ PIMES’JELCHI ILI KROVI/ RVOTA S KROVYU.

BLOOD COLOUR; NE BIVAET LI PRIMESI KROVI V RVOTNIX MASSAX?, KAK ONA VIGLIDIT?;

CRIMSON/ DARK RED/ COFFEE GROUND; LAYA KROV’/ TYOMNAYA/ TSVETA KOFEYNOY GUSHI

SMELL; KAKOY ZAPAX RVOTNIX MASS?;

NEPRIYATNIY/ GNILOY/ KISLIY/ NET NEKAKOVA ZAPAXA

BOWELS:

1.PAIN; BOLI V JIVOTE VAS NE BESPOKOYAT?/ U VAS NE BIVAET BOLEY PO XODU KISHESHNIKA?

LOCATION;

CHARACTER; BOLI KAKIE?; OSTRIE/ TUPIE/ SILNIE ILI NE OCHEN’?

DURATION; POSTAYANNIE/ PERIODICHESKIE/ PRISTUPAMI

2.EXCESSIVE BELCHING OR PASSING OF GAS; VZDUSHIE JIVOTA , GAZI VAS NE BESPOKOYAT?

3.DAEFECATION OR STOOL; KAK U VAS SO STULOM?, STUL U VAS REGULYARNIY? KAJDIY DEN’? CHEREZ SKOLKA DNEY?, NE PIXODITSYA LI VAM PRIMINYAT KLIZMU, SLABITELNOE?, KAK CHASTO?

4.CONSTIPATION; BIVAYUT LI U VAS ZAPORI?

CHARACTER; KAK VIGLIDIT STUL?, KAK OREXI ILI V VIDE KOLBASI?

DURATION;DOLGA LI DLITSYA U VAS ZAPORI/ ZADERJKA STULA?

5.DIARRHEA; BIVAYUT LI U VAS PONOS?

CAUSE; A S CHEM ONI, PO VASHEMU MNENIYU, SVYAZANI?, POSLE CHEVO ONI BIVAYUT?

FREQUENCY; SKOLKA RAZ V SUTKI BIVAET STUL PRI PONOSE

TENESMA; BIVAYUT LI SILNIE POZIVI/ POTUGI S BOLYU?

CHARACTER; PRI PONOSE STUL KAKOY?

WATERY/ LIQUID/ PORRIDGE LIKE/ LIKE RICE DECOCTION; PODYANISTIY/ JIDKIY/ KASHITSEOBRAZNIY/ KAK RISOVIY OTVAR

COLOR/ SMELL/ SIZE; KAL KAKOVA TSVETA?, NE BILO LI CHORNAVA KAK BEGOT STULA?, U NEVO KAKOY ZAPAX?, KAKAYA FORMA KALA?, BIVAET LI UZKAYA?

ADMIXTURE; NE ZAMECHALI KAKIX LIBO PRIMECEY V KALE?

BLOOD/ SLIME/ PUS/ HELMINTHES; KROV’/SLIZ’/ GNOY/ GLISTI

BLOOD DISCHARGE; BIVAET U VAS TAK SHTO SO STULOM VIDELYAETSYA KROV’?

PERIOD OF BLOOD DISCHARGE; A KOGDA VIDELYAETSYA KROV, PIRIOD, VO VREMYA ILI POSLE OTXOJDENIYA STULA; BEFORE/ DURING/ AFTER DAEFECATION

PAIN; NE BIVAET LI U VAS BOLI VO VREMYA STULA?

CHARACTER; KAKAYA ETA BOL’?; OSTRAYA/ TUPAYA/ NOYUSHAYA

HAEMORRHOID; U VAS NE OBNARUJIVALI GEMORROY?

LIVER AND BILIARY TRACT:

1.PAIN IN RIGHT HYPOCHONDRIA; U VAS BIVAYUT BOLI V PRAVOM PODREBER’E?

CHARACTER; KAKOY XARAXTER ETIX BOLEY?, CHUSTVA TYAJESTI/ NOYUSHIE/ TUPIE/ OSTRIE?

IRRADIATION;

DURATION; CONSTANT/ PERIODICAL/ LIKE ATTACKS

RELATION; BOLI SVYAZANI S PRIOMOM PISHI?, ONI VOZNIKAYUT DO ILI POSLE PRIOMA PISHI?, CHEREZ KAKOE VREMYA POSLE PRIOMA PISHI ONI VOZNIKAYUT?

2.JAUNDICE; U VAS NE BILO JELTUXI?, NE BILO TAKOVA SHTO POSLE PRISTUPA KOJA JOLTILA?

3.DARK URINE; NE BILO LI U VAS TIMNOY MOCHI ILI MOCHI TSVETA PIVA?

4.PALE STOOL; NE BILO LI U VAS SVETLAVA/ BELAVA/ OBESSVECHENNAVA STULA?

5.PRURITUS; NE CHESALAS’ LI U VAS KOJA?, V KAKOM MESTE?

6.ERUCTATION;NE BESPOKOIT LI VAS OTRIJKA?, A KAKAYA ONA?, S KAKIM ZAPAXOM?;

WITH AIR/ FOOD/ ACID/ BITTER/ THE SMELL OF ROTTEN EGGS; VOZDUXOM/ PISHEY/KISLIM/ GORKIM/ TUXLIMI YAYTSAMI

7.HEARTBURN AND ACID REGURGITATION; IZJOGA VAS NE BESPOKOIT?

RELATION; IZJOGA SVYAZANA S PRIYOMOM PISHI?, IZJOGA BIVAET DO ILI POSLE PRIYOMA PISHI ILI NA GOLODNIY JELUDOK?

RELIEF; OT CHEVO ONA PROXODIT ILI UMENSHAETSYA?/ ESLI VI POKUSHAETE ILI PRIMITE KAKIE NIBUD LEKARSTVA IZJOGA UMENSHAETSYA?, KAKIE LEKARSTVA?

8.NAUSEA; TOSHNOTA VAS NE BESPOKOIT?

RELATION; TOSHNOTA SVYAZANA S PRIOMOM PISHI?, TOSHNOTA BIVAET DO ILI POSLE PRIOMA PISHI ILI NA GOLODNIY JELUDOK?

9.VOMITTING; RVOTI U VAS NE BIVAET?

CHARACTER OF VOMITTING MASS; KAKOY XARAKTER RVOTNIX MASS?/ CHEM RVYOT?/ ETA PISHA JELCH, JIDKAYA, JIDKOST’?

FOOD/ ACID LIQUOR/ ADMIXTURE OF BILE OR BLOOD/ HAEMATEMESIS; PISHA/ KISLAYA JIDKOST’/ PIMES’JELCHI ILI KROVI/ RVOTA S KROVYU.

BLOOD COLOUR; NE BIVAET LI PRIMESI KROVI V RVOTNIX MASSAX?, KAK ONA VIGLIDIT?;

CRIMSON/ DARK RED/ COFFEE GROUND; LAYA KROV’/ TYOMNAYA/ TSVETA KOFEYNOY GUSHI

SMELL; KAKOY ZAPAX RVOTNIX MASS?;

NEPRIYATNIY/ GNILOY/ KISLIY/ NET NEKAKOVA ZAPAXA

PANCREAS;

1.PAIN N THE LEFT HYPOCHONDRIA, EPIGASTRIUM OR IN THE UPPER HALF OF THE ABDOMEN; U VAS BIVAYUT BOLI V LEVOM PODREBER’E, V EPIGASTRII, V VERXNEY POLOVINE JIVOTA?

CHARACTER; KAKIOY XARAKTER ETIX BOLEY?, CHUSTVA TIJASTI, NOYUSHIE, TUPIE, OSTRIE BOLI?

DULL/ ACUTE/ SENSATION OF OVERFILLING

IRRADIATION;

DURATION;

RELATION WITH MEALS;

RELATION WITH ALCOHOL CONSUMPTION; BIVAET TAK, SHTO BOLI POYAVLYAYUTSYA ILI USILIVAYUTSYA POSLE PRIOMA ALKOGOLYA?

OTHER REASON; OT CHEVO ESHO MOGUT VOZNIKAT’ BOLI?

RELIEF; OT CHEVO BOLI PROXODYAT?, SHTO VI DELAETE, SHTOBI UMENSHIT BOLI?

2.METEORISM; U VAS BIVAET VZDUTIE JIVOTA?, VAS NE BESPOKOYAT GAZI V JIVOTE?

3.DIARRHEA/ CONSTIPATION; PONOSOV ILI ZAPOROV U VAS NE BIVAET?

SPLEEN:

1.SENSATION OF OVERFILLING OR PAIN IN THE LEFT HYPOCHONDRIUM; U VAS BIVAET CHUSTVA TIJESTI ILI BOL’ V LEVOM PODREBER’E?

CHARACTER/ TIME; OPISHITE PAJALSTA SHTO CHUSTVA?, VI VSYO VREMYA CHUSTVUYTE TIJEST V LEVOM BOKU ILI INOGDA?, KOGDA ETO U VAS POYAVILOS’?

GENITOURINARY SYSTEM:

1.BACK PAIN; U VAS BIVAYUT BOLI V POYASNITSE?

CHARACTER; ACUTE/ DULL

DURATION; PODOLGU PRODALJAYUTSYA ETI BOLI?;CONTINOUS/ PERIODICAL/ ATTACK/ EPISODE LIKE

IRRADIATION

CAUSE AND INTENSITY; KAK VI DUMAETE, OT CHEVO POYAVLYAYUTSYA ILI USILIVAYUTSYA BOLI?; SHTO SPOSOBSTVUET POYAVLENIYU ILI USILENIYU BOLEY?

RELIEF; SHTO VI DELAETE SHTOBI BOLI PROSHLI ILI UMENSHILIS’?

2.FREQUENCY OF MICTURITION; SKOLKA RAZ V SUTKI V MOCHITES’?

3.NOCTURIA;VAM PRIXODITSYA VSTAVAT NOCHYU, SHTOBI POMOCHITSYA?, SKOLKA RAZ?, KOGDA BOLSHE BIVAET MOCHI?, DNYOM ILI NOCHYU?

4,FREQUENT AND URGENT MICTURITION; U VAS BIVAYUT CHASTIE POZIVI NA MOCHEISPUSKANIE( KOGDA MALA MOCHI NO XOCHETSYA POMOCHITSYA)

5.DAILY URINE VOLUME/ DIURESIS; SKOLKA MOCHI ZA SUTKI U VAS VIDELYAETSYA?, SKOLKA MOCHI U VAS VIDELILOS’ ZA VCHERASHNIY DEN’?, NOCH?

6.DYSURIA (PAINFUL MICTURITION OR STRANGURY); BOLI VO VREMYA MOCHEISPUSKANIYA VAS NE BESPOKOYAT?, U VAS NE BIVAET BOLEY, JJENIYA, REZI, KOGDA VI MOCHITES?

7.URETHRAL DISCHARGE; VAS NE BESPOKOYAT VIDELENIYA IZ MOCHEISPUSKATELNAVA KANALA?

8.URINARY OBSTRUCTION; U VAS MOCHA VIXODIT SVABODNA?, U VAS NE BIVAET TAKOVA SHTO MOCHA VIXODIT TONKOY STRUYKOY, S TRUDOM, S PERIRIVAMI?

9.DIFFICULTY IN STARTING MICTURITION; NE BIVAET LI VAM TRUDNA NACHINAT MOCHITSYA

8.DRIBBLING; BIVAET U VAS TAK, SHTO MOCHA VIXODIT PO KAPLYAM?

9.URINE COLOUR; U VAS NE BIVAET MOCHI NEOBICHNAVA TSVETA?, KAKOVA TSVETA U VAS MOCHA?

10.URINE TRANSPARENCY; MOCHA U VAS PROZRACHNAYA ILI MUTNAVATAYA?; TRANSPARENT/ CLOUDY

11.BLOOD IN URINE; KRASNOVA TSVETA MOCHI NE ZAMECHALI?/ NE BILO LI PRIMESI KROVI V MOCHE?

TIME; KOGDA POYAVLYAETSYA KROV V MOCHE?, V NACHALE, V KONTSE, VO VSEX PORTSIYAX?

12.INVOLUNTARY URINATION/INCONTINENCE/ ENURESIS; NE BIVAET LI TAK SHTO MOCHA SAMA VIXODIT, NEMNOGA ILI VSYA?/ NE BILO LI KOGDA NIBUD TAKOVA SHTO VI OBSIKALIS’?, PRI KAKIX USLOVIYAX?, MOJET BIT’ PRI SMEXE, KASHLE?

13.MENSTRUATION; U VAS EST MESYACHNIE MENSTRUATSII?;

SINCE; S KAKOVA VOZRASTA ONI NACHALIS?

REGULARITY; ONI REGULYARNIE?

DURATION; SKOLKA DNEY ONI PRODALJAYUTSYA?

ABUNDANCE;

PAINFUL SENSATION IN SUPRPUBIC AREA, IN THE BACK; MENSTRUATSII BOLEZNENNIE?, GDYE BOLIT?

IF IT STOPPED;

SINCE; KOGDA U VAS PRIKRATILIS MENSTRUATSII?

INCREASED EXCITABILITY; KAK VI PERENESLI KLIMAKS?

WHINING CONDITION;

FACE CONGESTION;

EXCESSIVE SWEATING AND PALPITATION;

PAIN IN THE HEART;

NE BILO LI PRILIVOV, SLEZ, POTLIVOSTI, SERDTSEBIENIY, BELEY V SERDTSE?

MUSCOSKELETAL SYSTEM

1.PAIN IN THE BONES, MUSCLES, JOINTS;

CHARACTER ; CONSTANT/ EPISODE LIKE

CAUSES; KAK VI DUMAETE?, OT CHEVO POYAVLYAYUTSYA ILI USILIVAYUTSYA BOLI?

INTENSITY

TIME; KOGDA BOLI XUJE?, UTROM, DNYOM, VECHEROM, NOCHYU?, BOLI BISTRO PROXODYAT?

RELATION OF RELIEF; U VAS EST BOLI PRI DVIJENIYAX?, VI GIMNASTIKOY MOJETE ZANIMATSYA?

RELIEF; SHTO VAM POMOGAET OT BOLEY?

2.MORNING STIFFNESS; U VAS BIVAET UTRENYAYA SKOVANNOST’?, ONA DOLGA DLITSYA?, SKOLKA VAM NADA VREMENII UTROM, SHTOBI RAZOYTIS’?/

KOGDA VI PROSIPAETES’UTROM NO ESHO NE VSTALI, KAKOE U VAS OSHUSHENIE V SUSTAVAX?

3.SOFT TISSUE SWELLING AND JOINT SWELLING (DEFIGURATION); U VAS NE BIVAET PRIPUXLOSTI V SUSTAVAX?, V KAKIX, POKAJITE PAJALSTA!!!

4.JOINT MOBILITY;

XOROSHO LI DVIGAYUTSYA SUSTAVI?

PODNIMITE RUKI VVERX CHEREZ STORONI, OPUSTITE

SOGNITE RUKI V LOKTYAX, PAZOGNITE

SOJMITE RUKI V KULAK, PAZOJMITE

SOGNITE RUKI V LUCHEZAPYASNIX SUSTAVAX, RAZOGNITE

PRISYADTE NA KARTOCHKI PAJALSTA ESLI SMOJETE

VSTANTE

DOSTANTE RUKAMI DO POLA

VSTANTE NA NOSOHKI/ NA TSIPOCHKI, OPUSTITES

SDELAYTE PAJALSTA KAK YA

GOLAVU NAKLONITE NAZAD, VPERIOD

UXOM NAKLONITES’ K PLICHU, K DRUGOMU

POVERNITE GOLAVU VPRAVA, VLYEVA

5.PAIN IN THE VERTEBRAL COLUMN AND MOVEMENT DIFFICULTY, IN WHAT PARTS;

NE BESPOKOYAT LI VAS BOLI V OZVANOCHNIKE?, V KAKOM MESTE?, ETA MESHAET DVIGATSYA?

NERVOUS SYSTEM AND SENSE ORGANS

1.MOOD; INCREASED IRRATIBILITY/ APATHY/ BEHAVIOUR;

KAK U VAS OBICNO NASTROENIE?; XOROSHEE, PLOXOE, SREDNEE

NE BIVAET LI RAZDRAJITELNOSTI, PLAKSIVOSTI, APATII?

VI CHASTO PLACHETE, SERDITES’?

2.MEMORY/ ATTENTION;

NA SVOYU PAMYAT VI NE JALUETES’?

SHTO LUCHSHE POMNITE, SHTO BILO NEDAVNO ILI DAVNO?

VNIMATELNI LI VI?

3.SLEEP AND DREAM; DEPTH/ DURATION/ INSOMNIA/ MEDICATION

SON U VAS XOROSHIY?

NE BIVAET LI BESSONNITSI?

KAK DOLGA VI SPITE NOCHYU?, SKOLKA CHASOV?, S PIRIRIVAMI ILI NET?

OT BESSONNITSI VI SHTO NIBUD PRINIMAETE?, ETO POMOGAET?

4.HEADACHE; U VAS BIVAYUT GOLOVNIE BOLI?

INTENSITY; KAKIE; SILNIE/ SREDNIE/ SLABIE

LOCATION; V KAKOM MESTE GOLOVI?

PERIODICITY; DOLGA LI ONI PRODALJAYUTSYA?

BP; KAKOE PRI ETOM DAVLENIE?

HEADACHE DURATION

DURATION OF ACCOMPANYING SYMPTOMS; GOLOVA PRI ETOM NE KRUJITSYA?

NE BIVAET LI PRI ETOM TOSHNOTI, RVOTI?

CAUSE; VI CHUSTVUYTE, SHTO U VAS SKORA MOJET’ZABOLET’GOLOVA?, KAK VI ETO CHUSTVUYTE?/ SHTO U VAS MOJET VIZVAT’GOLOVNUYU BOL’?, CHEM ONI SOPRAVAJDAYUTSYA?

5.NOISE IN THE HEAD OR BUZZINGIN THE EARS; SHUM V GOLOVE VAS NE BESPOKOIT?, SHUM V USHAX VAS NE BESPOKOIT?

6.FAINTS (SYNCOPE); NE BIVAET LI U VAS OBMOROKOV?, KAK CHASTO?

FREQUENCY;

ONSET CONDITIONS; PRI KAKIX USLOVIYAX ONI VOZNIKAYUT?

RELATIONS; NE BIVAET LI PRI ETOM POVISHENNAVA DAVLENIYA ILI REDKAVA PULSA, SERDTSEBIENIYA?

7.OTHERS; SHTO NIBUD ESHO VAS BESPOKOIT?/ NET LI SLABOSTI V RUKAX, NOGAX?/ NE BIVAET LI CHUSTVA DROJI V TELE, SUDOROG?/ POTLIVOST’VAS NE BESPOKOIT?/ NET LI U VAS NARUSHENIY KOJNOY CHUVSTVITELNOSTI?, CHUSTVA POLZANIYA MURASHEK?

WEAKNESS IN EXTREMITIES/ SHIVERING/ CONVULSIONS/ EXCESSIVE SWEATING(HYPERHYDROSIS)/ DISORDERS OF SKIN SENSITIVITY( HYPERESTHESIA OR HYPOESTHESIA)

8.HEARING IMPAIRMENT, VISION IMPAIRMENT, OLFACTION ABNORMALITIES; U VAS EST JALOBI NA SLUX, ZRENIE, OBAYANIE?/ KAK U VAS SO SLUXOM, ZRENIEM, OBONYANIEM?

FEVER;

NE POVISHALAS’ LI U VAS TEMPERATURA?

INCREASE, UPPER AND LOWER LIMIT IN A DAY; KAKAYA U VAS BILA TEMPERATURA, UTROM, VECHEROM?, SAMAYA VISOKAYA, SAMAYA NIZKAYA TEMPERATURA?

DURATION; DOLGA LI TEMPERATURA DERJALAS’?

RELIEF; SHTO VI PRINIMALI OT TEMPERATURI?, ETO POMAGALO?

SHIVERING AND SWEATING; OZNOBI, POTI BEZPOKOILI?

PRESENT ILLNESS/ ANAMNESIS MORBI

1.FIRST SYMPTOMS OF DISEASE, DEVELOPMENT AND CLINICAL CAUSE

ONSET OF DISEASE; KOGDA NACHALOS’ ETO ZABOLIVANIE, GDYE?

WHEN;

WHERE;

CIRCUMSTANCE;PRI KAKIX OBSTATELSTVAX?

DURATION;

2.CAUSE; IZ ZA CHEVO PO VASHEMU, NACHALOS’ ZABOLIVANIE?

RELATION; S CHEM ETO BILO SVYAZANO, KAK VI SHITAETE?

3.MENTAL TRAUMAS/ PHYSICAL OR MENTAL OVERWORK/ LACK OF SLEEP/ INTOXICATION/ SUPERCOOLING

NE BILO LI PSIXICHESKOY TRAVMI( PEREJIVANIY), FIZICHESKAVA ILI UMSTVENNAVA PEREUTOMLENIYA, NEDOSIPANIYA, OTRAVLENIYA, PEREOXLAJDENIYA

4.ONSET; KAK NACHALOS’ ZABOLIVANIE?, VNEZAPNO ILI POSTEPENNO?, KAK ONA PRODALJALOS’?, BILI LI SVETLIE PROMEJUTKI, KOGDA NECHIVO NE BESPOKOILA?

ACUTE/ GRADUAL/ INSTANT; CONTINOUS/ INTERMITTENT

FIRST SYMPTOMS; S CHEVO VSE NACHALOS’?, SHTO NACHALA BESPOKOIT’?

LOCATION; V KAKOM MESTE STALO BOLET ILI BESPOKOIT?

RADIATION; KUDA NIBUD OTDAVALA?

CHARACTER; ONA BILA OSTROY, TUPOY, PRONZAYUSHEY,TYANUSHEY, JGUCHEY ILI SXVATKAOBRAZNOY?

SEVERITY; ETA MESHALA VAM RABOTAT, VIPOLNYAT DOMASHNIE DELA, OTDIXAT, SPAT?

RELIEF; SHTO UXUDSHAET VASHE SOSTAYANIE?

DYNAMIC CHANGES; OPISHITE PAJALSTA, PODROBNA, VASHE ZABOLIVANIE S SAMOVA NACHAL DO SIVODNISHNAVA VREMENI?

FREQUENCY OF ACUTE EPISODES/ CAUSES OF EXACERBATION/ RELATION TO SEASON/ PROGRESSION;

CHASTO LI BIVAYUT OBOSTRENIE?/SVYAZANI LI OBOSTRENIYA SO VREMENIM GODA?, A S CHEM ESHO SVYAZANI OBOSTRENIYA?, KAK VASHE SOSTAYANIE IZMENYAETSYA S GODAMI?

5.VISIT TO DOCTOR;VI OBRASHALIS K VRACHU?

DOCTOR’S PERSCRIPTION; SHTO ON VAM NAZNACHIL?

PREVIOUS DIAGNOSTICS AND MEDICAL MEASURES; KAKOY VAM RANSHE STAVILI DIAGNOZ

DIAGNOSIS;

DURATION AND EFFICACY OF PREVIOUS TREATMENT; CHEM I KAK DOLGA VI LICHILIS?

MEDICATION; KAKIE LEKARSTVA VI PRINIMALI?, VITAMINI, PISHEVIE DOBAVKI, NARODNIE SREDSTVA, CHUJIE LEKARSTVA?

RELIEF; SHTO IZ LEKARSTVA VAM LUCHSHE POMOGALA?

6.FOLLOW UP; STOYALI LI VI NA DIPENSERNOM UCHOTE?

DIAGNOSIS; S KAKIM ZABALIVANIEM VI STOYALI NA UCHOTE?

PREVENTIVE TREATMENT; WHAT/ WHEN/ DURATION;

POLUCHALI LI VI PROFILAKTICHESKOE LECHENIE?, KAKOE?, KOGDA?, KAK DOLGA?

POMOGLA LI VAM LECHENIE?

CURRENT MEDICATION; SHTO VI SEYCHAS PRINIMAETE IZ LEKARSTV?

7.THE LAST ACUTE EPISODE/ SYMPTOMS; KOGDA NACHALOS’ POSLEDNEE OBOSTRENIE? KOGDA VAM STALO XUJE V POSLEDNIY RAZ?, V CHEM ETO PROYAVLYALOS’?, SHTO STALO VAS BESPOKOIT?

8.CAUSE OF HOSPITALIZATION; IZ ZA CHEVO VAS POLOJILI V BOLNITSU?/ SHTO PROVILO VAS K VRACHU?/ IZ ZA CHEVO VI OBRATILIS K VRACHU?

SHTO VAS BOLSHE VSEVO BESPOKOIT?

PERSONAL HISTORY (ANAMNESIS VITAE)

1.WHERE/ WHAT FAMILY THE CHILD WAS BORN; KOGDA VI RODILIS?; KEM BILI VASHI RODITELI?

PATIENTS’SIBLINGS; SKOLKA U VAS BILO BRAT’EV I SISTER?

2.FINANCIAL AND LIVING CONDITIONS IN CHILDHOOD; KAKIE USLOVIYA BILI V DETSVE?, JILISHNIE I MATEREALNIE?

DISEASES IN CHILDHOOD; KAKIMI BOLEZNYAMI VI BOLELI V DETSVE?

PHYSICAL DEVELOPMENT; KAK VI RAZVIVALIS’?

3.EDUCATION; KOGDA VI NACHALI UCHITSYA?

SKOLKA VREMENI VI UCHILIS’?

KAKOE UCHEBNOE ZAVEDENIE VI ZAKONCHILI?

KAKUYU VI POLUCHILI SPETSIALNOST’?

4.WORKING ANAMNESIS; RASKAJITE PAJALSTA KEM VI RABOTALI S SAMOVA NACHALA?

KAKAYA U VAS BILA RABOTA?

NE BILA LI U VAS VREDNOSTEY NA RABOTE?

KAKIE VREDNOSTI?, PIL’, IZLUCHENIE, TYAJELIE METALLI, KISLOTI, SHTO NIBUD ESHO?

5.LIVING CONDITIONS; XOROSHIE LI U VAS JILISHNIE USLOVIYA?

NA KAKOM ETAJE VI JIVYOTE?

EST’ LI U VAS V KVARTIRE UDOBSTVA?, KAKIE?

EST’LI U VAS TSENTRALNOE OTEPLENIE?

DOMA U VAS TEPLO ILI XOLODNA, SUXO ILI SIRO?

6.FAMILY AND INCOME; SKOLKA U VAS SEYCHAS CHELOVEK V SEM’E?

DOSTATOCHEN LI DOXOD, POLUCHAEMIY NA CHLENOV SEM’I?

7.NUTRITION; VI REGULYARNO PITAETES’?

SKOLKA RAZ V DEN’?

GDYE VI OBICHO PITAETES’?, DOMA, NA RABOTE, V STOLOVOY?

PITANIE U VAS XOROSHIE?

VI NE VEGITERIANETS?

KAKUYU PISHI VI PREPODCHITAETE?

8.MORNING EXERCISE AND PHYSICAL TRAINING; FIZKULTUROY VI ZANIMAETES’?, A RANSHE?/ SPORTOM VI NE ZANIMALIS’?, A KAKIM VIDOM?

9.HABITUAL INTOXICATIONS;

VI KURITE?, S KAKOVA VOZRASTA?

KURITE LI VI NA GOLODNIY JELUDOK ILI PO NOCHAM?

SKOLKA SIGARET V DEN’ VI VIKURIVAETE?

KOGDA VI BROSILI KURIT’?

VI VIPIVAETE?/ A KAK U VAS S ALKOGOLEM?

SKOLKA RAZ V MESYATS VI VIPIVAETE?

SKOLKA ZA ODIN DEN’ VI MOJETE VIPIT’?

ESHO SHTO NIBUD VI UPOTREBLYAYTE?

KAKIE LEKARSTVA ESHO VI IZPOLZUYTE?

10.PAST MEDICAL ANAMNESIS; DISEASES, TRAUMAS, OPERATIONS SINCE CHILDHOOD;

CHEM VI ESHO BOLELI?

U VAS BILI TRAVMI, OPERATSII?, KAKIE, KOGDA, SKOLKA?

RANSHE BILI ZABOLIVANIYA, POXOJIE NA NASTOYASHEE ZABOLIVANIE?

11.BEING IN THE ARMY; ANY WOUNDS OR CONTUSIONS;

V ARMII VI SLUJILI?, KOGDA, DOLGA LI?

ESLI NE SLUJIL, PACHEMU VI NE SLUJILI V ARMII?

U VAS BILI RANENIYA, KONTUZII?

FAMILY HISTORY

1.MARITAL STATUS; VI ZAMUJEM/ JENATI?/S KEM VI JEVYOTE

PREGNANCIES; BILI LI U VAS BEREMENNOSTI?

DELIVERIES; ABORTIONS; STILLBIRTHS; HOW MANY; REASONS; CAUSE AND TIME OF CHILD’S DEATH; SKOLKA U VAS BILO BEREMENNOSTEY, RODOV, ABORTOV?

HOW MANY CHILDREN NOW;

KAK ZDOROV’E VASHIX DETEY?

ONI CHEM NIBUD BOLEYUT?

SKOLKA IM LET SICHAS?

2.INFORMATION ABOUT CLOSE RELATIVES;

CHEM BOLELI VASHI RODETELI, BRATYA, SESTRI?

OT CHEVO UMERLI VASHI RODITELI?

NET LI U KAVO IZ VASHIX RODNIX TAKOVA JE ZABOLEVANIYA KAK U VAS?

3.ALLERGY; BIVAET LI NA SHTO NIBUD U VAS ALLERGIYA?

KAK ONA PROYAVLYAETSYA?

4.TRANSFUSIONS; KROV’, PLAZMU VAM KOGDA NIBUD’ PERELIVALI?

KOGDA, PO KAKOY PRICHINE?

KAK VI ETO PERENESLI

5.INFECTIONS; U VAS BIL PONOS, LIXORODKA V TECHENIE POSLEDNEVO MESYATSA?

VI BOLELI TUBERKULOZOM, VENERICHESKIMI ZABOLIVANIYAMI, VICH, GEPATITOM?

NE BILI LI VI ZA GRANITSEY V MECHENIE POSLEDNIX 3 LET?

NE VIEZHJALI LI VI ZA PREDELI OBLASTI V TECHENIE POSLEDNIX 3 LET?

KUDA VI VIEZHJALI?, KOGDA?

6.IMMUNIZATION; KAKIE PRIVIVKI U VAS BILI?, KOGDA?

Vweightlifting Queenslandv July 2002 The Official Journal of
Vweightlifting Queenslandv nov 2002 the Official Journal of
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