Patient complains of abdominal pain.
Onset [text] prior to evaluation
Onset while: [text]
Associated Pain (0=none, 10=severe)
Location: [text]
Radiation: [text]
Severity now (0-10): [text]
Severity at worst (0-10): [text]
Duration: [text]
Characterized as: [text].
The pain is relieved with [text]
[select value="no|YES"] <-- worse with standing
[select value="no|YES"] <-- pleuritic pain
Associated Symptoms:
[select value="no|YES"] <-- decreased appetite (last ate at [text])
[select value="no|YES"] <-- nausea
[select value="no|YES"] <-- vomiting [text]
[select value="no|YES"] <-- diarrhea
[select value="no|YES"] <-- constipation (last stool at [text])
[select value="no|YES"] <-- black or bloody stool
[select value="no|YES"] <-- fever
[select value="no|YES"] <-- Dysuria
[select value="no|YES"] <-- Frequency
[select value="no|YES"] <-- Hematuria
Pertinent PMH
[select value="no|YES"] <-- Gall Bladder or liver disease
[select value="no|YES"] <-- GERD
[select value="no|YES"] <-- Peptic ulcer
[select value="no|YES"] <-- Pancreatitis
[select value="no|YES"] <-- Kidney stones
[select value="no|YES"] <-- Urinary tract infections
[select value="no|YES"] <-- Diverticulitis
[select value="no|YES"] <-- Inflammatory Bowel Disease
[select value="no|YES"] <-- Pelvic Infection
[select value="no|YES"] <-- Vascular disease
Pertinent Past Surgeries:
[select value="no|YES"] <-- Appendectomy
[select value="no|YES"] <-- Cholecystectomy
Pertinent Medications:
[select value="no|YES"] <-- NSAIDs
[select value="no|YES"] <-- Excessive Alcohol
Pitfalls:
[select value="no|YES"] <-- aortic aneurysm history or risk (age over 60, tobacco history)
[select value="no|YES"] <-- pregnancy risk
[html]<hr>[/html][checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"][html]
reference: contributed by Dr. Scott Moses, creator/author of the <a href="http://www.fpnotebook.com" target="_blank">Family Practice Notebook</a>.[/html][/conditional]
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