GI bleeding history


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Gastrointestinal Bleeding[html]
contributed by Dr. Scott Moses, creator/author of the Family Practice Notebook.[/html]
Onset [text] prior to evaluation
Onset while: [text]

A [text] amount of blood was passed via [text]
Now the bleeding has [text] stopped by the time of this evaluation.

The blood contents is the color [text].

[select value="no|YES"] <-- black or maroon stools
[select value="no|YES"] <-- bright red rectal bleeding
[select value="no|YES"] <-- abdominal pain localized to [text]
[select value="no|YES"] <-- rectal pain
[select value="no|YES"] <-- constipation
[select value="no|YES"] <-- diarrhea
[select value="no|YES"] <-- hematemesis
[select value="no|YES"] <-- nausea/vomiting

[select value="no|YES"] <-- lightheadedness on standing or near-syncope/syncope
[select value="no|YES"] <-- weakness
[select value="no|YES"] <-- fever

[select value="no|YES"] <-- history of peptic ulcer
[select value="no|YES"] <-- history of diverticulitis
[select value="no|YES"] <-- history of Cirrhosis or other portal hypertension
[select value="no|YES"] <-- history of other bleeding sites (genitourinary, epistaxis, hemoptysis)
[select value="no|YES"] <-- history of known bleeding disorder

[select value="no|YES"] <-- Warfarin use
[select value="no|YES"] <-- Aspirin or NSAID use
[select value="no|YES"] <-- Excessive alcohol use

[select value="no|YES"] <-- history of serious CNS risks (e.g. active cancer, immunosuppression, HIV)
[select value="no|YES"] <-- History of rectal trauma (e.g. intercourse)
Gastrointestinal Bleeding
contributed by Dr. Scott Moses, creator/author of the Family Practice Notebook.

Onset prior to evaluation
Onset while:

A amount of blood was passed via
Now the bleeding has stopped by the time of this evaluation.

The blood contents is the color .

<-- black or maroon stools
<-- bright red rectal bleeding
<-- abdominal pain localized to
<-- rectal pain
<-- constipation
<-- diarrhea
<-- hematemesis
<-- nausea/vomiting

<-- lightheadedness on standing or near-syncope/syncope
<-- weakness
<-- fever

<-- history of peptic ulcer
<-- history of diverticulitis
<-- history of Cirrhosis or other portal hypertension
<-- history of other bleeding sites (genitourinary, epistaxis, hemoptysis)
<-- history of known bleeding disorder

<-- Warfarin use
<-- Aspirin or NSAID use
<-- Excessive alcohol use

<-- history of serious CNS risks (e.g. active cancer, immunosuppression, HIV)
<-- History of rectal trauma (e.g. intercourse)
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