Mnemonic

Systems Review

A memory aid for the screening questions in a systems enquiry.

Expansion

A brief screen of each body system to catch what the history has missed

Expansion

General: weight change, appetite, fever, night sweats, fatigue, sleep

Cardiovascular: chest pain, breathlessness, orthopnoea, paroxysmal nocturnal dyspnoea, palpitations, ankle swelling, claudication, syncope

Respiratory: cough, sputum, haemoptysis, wheeze, breathlessness, pleuritic pain

Gastrointestinal: appetite, dysphagia, nausea, vomiting, haematemesis, abdominal pain, bowel habit change, rectal bleeding, jaundice

Genitourinary: dysuria, frequency, nocturia, urgency, haematuria, incontinence, hesitancy, sexual and menstrual history

Neurological: headache, fits, faints, funny turns, weakness, numbness, visual and speech disturbance, dizziness

Musculoskeletal: joint pain, stiffness and its duration, swelling, rash

Endocrine: heat and cold intolerance, thirst, polyuria, sweating

Skin: rashes, lesions, itch, bruising

The constitutional group is the highest yield and should never be omitted: weight loss, fever and night sweats together suggest malignancy, tuberculosis or lymphoma.

The systems review commonly uncovers the actual diagnosis when the presenting complaint is non-specific, and it is where red flags are most often found.