[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [History taking and the interview](https://durgical.com/en/clinical-exam/areas/history/) › Background history by system: what to ask organ by organ

# Background history by system: what to ask organ by organ

- History

The past illnesses, exposures and family history that matter most when the problem is in the heart, lungs, gut, kidney, glands, blood or nerves.

Updated Nov 13, 2026

## Key points

- Cardiovascular: classic risk factors, rheumatic fever and Chagas exposure, family sudden death.
- Respiratory: pack-years, wood smoke, occupational dusts and tuberculosis contacts.
- Digestive: alcohol, NSAIDs, hepatitis risks and family colorectal cancer.
- Kidney: diabetes, hypertension, nephrotoxic drugs and family kidney disease.
- Blood: bleeding after tooth extraction or surgery is the most useful single question for a bleeding disorder.

## What it is

The general past history (illnesses, operations, medicines, allergies, habits, family) is adapted to the system in question. Each system has its own risk factors and earlier events that change the probability of a diagnosis: rheumatic fever for the valves, tuberculosis contacts for the lungs, transfusions for the liver, diabetes for the kidney, bleeding after tooth extraction for hemostasis. This page lists the background questions system by system so that a focused history does not miss them.

## What it must include

- Each risk factor with its date of diagnosis, treatment and current control.
- Exposures quantified: tobacco in pack-years, alcohol in drinks per week, years in each job.
- Family history with the relative, the disease and the age at onset or death.
- Place of birth, residence and travel, which in Colombia point to Chagas disease, tuberculosis, malaria or parasites.
- Previous studies and their results (ECG, echo, spirometry, endoscopy, biopsies) whenever the patient has them.

## How to ask

- 'Have you ever been told you have high blood pressure, diabetes or high cholesterol? Since when, and how is it treated?'
- 'Have you smoked? How many cigarettes a day, and for how many years? Did you cook with wood at home?'
- 'Have you had tuberculosis or lived with someone who had it?'
- 'Have you had a blood transfusion, a tattoo or an operation? Did you bleed a lot after a tooth extraction or surgery?'
- 'Have you had kidney stones, urine infections or swelling of the legs?'
- 'Did you have seizures as a child, a head injury or meningitis?'
- 'Is there anyone in your family with heart disease, sudden death, cancer, diabetes, kidney disease, epilepsy or a bleeding problem? At what age?'

## Background questions by system and why they matter.

| System | What to ask | Why it matters |
| --- | --- | --- |
| [Heart and vessels](https://durgical.com/en/conditions/arterial-hypertension/) | Hypertension, diabetes, dyslipidemia, smoking, obesity, inactivity; previous infarction, angina, stents or bypass; rheumatic fever and sore throats in childhood; Chagas risk (rural housing, kissing bugs, blood transfusion, mother with Chagas); family history of early cardiovascular disease or sudden death | Defines cardiovascular risk; rheumatic and Chagas heart disease remain frequent in Colombia; sudden death in relatives suggests inherited cardiomyopathies or channelopathies |
| [Lungs](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/) | Tobacco in pack-years, wood or coal smoke at home, occupational dusts (mining, construction, farming), birds and moulds; asthma in childhood; tuberculosis or contact with it; pneumonias; vaccines (influenza, pneumococcal); sleep and snoring | Points to COPD, occupational and interstitial lung disease, tuberculosis and hypersensitivity pneumonitis |
| [Digestive system and liver](https://durgical.com/en/conditions/cirrhosis/) | Alcohol, NSAIDs and other medicines, transfusions, tattoos, injected drugs and sexual risk (viral hepatitis); previous ulcer, bleeding, gallstones or surgery; travel and water source (parasites); family colorectal cancer, polyps or inflammatory bowel disease | Guides to cirrhosis, viral hepatitis, peptic ulcer and hereditary colorectal cancer |
| [Kidney and urinary tract](https://durgical.com/en/conditions/chronic-kidney-disease/) | Diabetes, hypertension, nephrotoxic medicines (NSAIDs, contrast), stones, recurrent urinary infections, prostate symptoms, edema; pregnancy complications (pre-eclampsia); family polycystic kidney disease or kidney failure | Diabetes and hypertension are the main causes of chronic kidney disease; family history suggests inherited kidney disease |
| [Endocrine and metabolism](https://durgical.com/en/conditions/type-2-diabetes-mellitus/) | Changes in weight, appetite, thirst and urine output; gestational diabetes or large babies; thyroid disease, neck radiation or surgery; steroid use; menstrual and fertility history; family diabetes or thyroid disease | Screens for diabetes, thyroid and adrenal disorders and drug-induced endocrine change |
| [Blood and immune system](https://durgical.com/en/conditions/haemophilia-a-and-b/) | Bleeding after tooth extraction, surgery or childbirth; heavy periods; easy bruising; anemia and transfusions; diet and blood loss; recurrent infections; radiation or chemical exposure; family bleeding disorders, sickle cell or anemias | Separates inherited from acquired bleeding disorders and anemias; men affected through the mother's line suggest hemophilia |
| [Nervous system](https://durgical.com/en/conditions/epilepsy-and-seizures/) | Birth and development, febrile seizures, head trauma, meningitis or encephalitis; stroke risk factors; alcohol and toxins; neurocysticercosis risk (pork, sanitation); family epilepsy, migraine, dementia or neuromuscular disease | Helps classify epilepsy, stroke and neuropathy; neurocysticercosis is a common cause of seizures in Latin America |

## Test yourself

Think of the answer, then tap the question to see it.

## Which background question about the heart is especially important in rural Colombia?

Exposure to Chagas disease: housing where kissing bugs live, past transfusions and a mother with Chagas, together with childhood rheumatic fever.

## Which household exposure should be asked about in a Colombian patient with chronic cough?

Cooking with wood or coal smoke, an important cause of COPD in people who never smoked.

## What single history question best screens for a bleeding disorder?

Whether the patient bled heavily or for a long time after a tooth extraction, surgery or childbirth.

## What are the two main background conditions to ask about in a patient with chronic kidney disease?

Diabetes and arterial hypertension, with their duration and control.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/clinical-exam/background-history-by-system-what-to-ask-organ-by-organ/)

## Connections

## Related 6

- [Past medical, surgical, family and social history](https://durgical.com/en/clinical-exam/past-medical-surgical-family-and-social-history/)
- [Medicines, allergies and habits: tobacco, alcohol and other substances](https://durgical.com/en/clinical-exam/medicines-allergies-and-habits-tobacco-alcohol-and-other-substances/)
- [Review of systems](https://durgical.com/en/clinical-exam/review-of-systems/)
- [The clinical history: its parts and their order](https://durgical.com/en/clinical-exam/the-clinical-history-its-parts-and-their-order/)
- [Chief complaint and history of present illness](https://durgical.com/en/clinical-exam/chief-complaint-and-history-of-present-illness/)
- [The periodic health examination: what to check and screen at each age](https://durgical.com/en/clinical-exam/the-periodic-health-examination-what-to-check-and-screen-at-each-age/)

## Related conditions 8

- [Arterial hypertension](https://durgical.com/en/conditions/arterial-hypertension/)
- [Chronic obstructive pulmonary disease (COPD)](https://durgical.com/en/conditions/chronic-obstructive-pulmonary-disease/)
- [Cirrhosis](https://durgical.com/en/conditions/cirrhosis/)
- [Chronic kidney disease](https://durgical.com/en/conditions/chronic-kidney-disease/)
- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)
- [Haemophilia A and B](https://durgical.com/en/conditions/haemophilia-a-and-b/)
- [Epilepsy and seizures](https://durgical.com/en/conditions/epilepsy-and-seizures/)
- [Chagas disease](https://durgical.com/en/conditions/chagas-disease/)

[← All of the clinical exam](https://durgical.com/en/clinical-exam/)

Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis.

Sources: [Heart Disease Risk Factors | Heart Disease | CDC](https://www.cdc.gov/heart-disease/risk-factors/index.html) (Centers for Disease Control and Prevention, 2026); [What Is Chronic Kidney Disease in Adults?](https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease) (National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 2026); [Bleeding Disorders - What Are Bleeding Disorders | NHLBI, NIH](https://www.nhlbi.nih.gov/health/bleeding-disorders) (National Heart, Lung, and Blood Institute (NHLBI), 2026); [Why is it important to know my family health history?](https://medlineplus.gov/genetics/understanding/inheritance/familyhistory/) (MedlinePlus Genetics, U.S. National Library of Medicine, 2026).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/background-history-by-system-what-to-ask-organ-by-organ/