past medical

PAST/CURRENT MED HX
Cardiovascular history:
Chest pain/angina
Congestive Heart Failure
Hypertension
Hypotension
Hyperlipidemia
Coronary Artery Bypass Graft
Stent Placement
Pacer
Defibrillator
Pacer / Defib
Deep Vein Thrombosis
Coronary Artery Disease
Transplant
Previous Myocardial Infarction
Cardiac Arrest
Valve Replacement
Atrial Fibrillation or other  arrhythmia


Respiratory history:
asthma
Chronic Obstructive Pulmonary Disease
bronchitis
sleep apnea
Emphysema
Pleurisy
pneumonia (frequent or persistent)
tracheostomy

Communicable Disease:
Hep A
Hep B
Hep C
HIV/AIDS
Tuberculosis
Meningitis


Neurological History:
Chronic Pain
Head Injury / Concussion
Seizure Disorder
Chronic headache
Stroke
Loss of Consciousness
Numbness
Tremors
Weakness
Headaches / Migraines
Frequent / Recent Falls
Fainting / Dizziness


Medical Device History:
Bipap
CPAP
Oxygen
Pacemaker
Insulin Pump
Cane
Walker
Dentures
Glasses

Musculoskeletal history:
arthritis
amputation
back/neck problems
congenital abnormalities
fibromyalgia
osteoporosis
metal implants

Endocrine/Metabolic:
Acromegaly 
Addison's Disease 
Adrenal Disorders 
Cushing's Syndrome 
De Quatrain's Thyroiditis 
Diabetes 
Gestational Diabetes 
Goiters 
Graves' Disease 
Growth Disorders 
Growth Hormone Deficiency 
Hashimoto's Thyroiditis 
Hyperglycemia 
Hyperparathyroidism 
Hyperthyroidism 
Hypoglycemia 
Hypoparathyroidism 
Hypothyroidism 
Low Testosterone 
Menopause 
Metabolic Syndrome 
Obesity 
Osteoporosis 
Parathyroid Diseases 
Pheochromocytoma 
Pituitary Disorders 
Polycystic Ovary Syndrome 
Prediabetes 
Silent Thyroiditis 
Thyroid Diseases 
Turner Syndrome 
Type 1 Diabetes 
Type 2 Diabetes 

Integumentary:
Ulcers
eczema
psoriasis
skin breakdown
Cancer
Lupus
Fibromyalgia
Multiple Sclerosis
Arthritis
Shingles


EENT history:
ear problems
eye problems
nasal/sinus problems

Sexual/Reproductive history:
Abnormal bleeding/discharge
birth control
menopause
sexually active
sexually transmitted disease
recent pregnancy
currently pregnant

GI:
Appendicitis
Bowel obstruction
Esophagitis
Food poisoning
Hemorrhoids
Kidney disease
Kidney stones
Peptic ulcer
Peritonitis
Ulcer
Urinary tract infections (frequent or persistent)
Pancreatitis
Crohn's
Gastric Esophageal Reflux Disease
colostomy
Parkinson's
Gallstones
gastric bypass
rectal bleeding
Colitis
Diverticulitis
Liver failure