Bleeding History

• CC: most likely will present as bruising or bleeding from any site;
  • Site: where?
  • Onset: first time? When? Sudden\gradual? Continuous\intermittent? What were you doing?
  • Timing: day\night? How frequent?
  • Character: color?
  • Aggravating\relieving factors: what triggered it (trauma)? How did it stop?
  • Severity: estimate the amount? Interfering w\ ADL?

• Associated sx:
  • Constitutional: fever, wt loss, loss of appetite, night sweats, chills, lymphadenopathy?
  • Blood loss: Easy bruising? Bleeding from gums or nose? Vomiting or coughing up blood? Blood in stool, urine? Menorrhagia? Joint pain\swelling?
  • Hemolysis: jaundice, dark urine, pale stool, gallstones, abdominal pain?
  • Anemia: headache, palpitations, SOB, fatigue?

• PMHx:
  • Previous bleeding: after tooth extraction, surgery?
    • Diseases:
    • Chronic ds (HTN, DM, DLP)
    • Hematological, renal, liver ds
    • Infections, malignancy
  • Medications: NSAIDs, steroids, aspirin, anticoagulants, antibiotics
  • Surgery, hospitalization, trauma
  • Blood transfusions, IV drug use, tattoos
  • Allergies

• FMHx:
  • Similar complaint?
  • Same diseases as in PMHx?

• Social Hx:
  • Occupation, marital status, children?
  • Smoking, alcohol, recreational drugs?
  • Travel Hx, contact with sick pts?
  • Diet (consumption of green vegetables), exercise

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