history taking obstetric n gynaecology

Name
Age
Occupation
Gravid Pramida

Chief complaint
LMP last menstrual period
EDD expecting due date
Period of amenorrhea

History of present illness ( pernah jumpe dr benda sama??,pernah masuk hospital benda sama??)

Antenatal history – upt,usg booking,follow ups,problems,medication,hb,blood group,weight,height

Gynaecology history – menarche,mense history,pap smear

Past obstetric history – year,at term??,pre term??,posterm??mode of delivery,sex,weight,complication

Medical n surgical history

Social history- married years,smoking,family income

Family history- same illness??

review

THT
1. Tonsillitis
2. Sinusitis
3. Epitaxis
4. Otitis
5. Rhinitis
6. Perichondritis
7. Tumor in pharynx and larynx
Neuro
1. Paralysis
2. Cranialis nerves
3. Dermatom map
4. Meningitis
5. Cerebral palsy
6. Epilepsy
7. Vertigo
Mata
1. Keratitis
2. Glaucoma
3. Conjunctivitis
4. Blindness
5. Cataract
6. Uveitis
7. Scleritis
Bedah 3
1. Hypospadia
2. Epipasdia
3. Hernia
4. Surgery gallbladder
5. Lymphadenopathy
6. Gout
7. Breast cancer
8. Urolithiasis