Clinical exam · History taking and the interview
Review of systems !
- History
The review of systems is a quick head-to-toe check for symptoms the patient did not mention.
Updated 2026-11-01
What it is
The review of systems is an ordered list of short questions about each body system, asked after the present illness and the past history. It looks for symptoms the patient forgot or did not connect with the visit. It is not the physical exam: it records what the patient reports, not what the examiner finds. Symptoms related to the main problem are moved into the present illness.
What it must include
- General or constitutional symptoms.
- Skin and appendages; head, eyes, ears, nose, mouth and throat; neck.
- Respiratory, cardiovascular and digestive.
- Genitourinary and gynaecologic.
- Musculoskeletal, neurological, endocrine, haematological and mental.
- Negatives of the systems reviewed are also recorded ('denies dyspnoea, chest pain...').
How to ask
- Announce it: 'Now I'll ask several quick questions about the rest of your body.'
- General: 'Have you had fever, night sweats or lost weight without trying?'
- Head and senses: 'Headaches, changes in your vision or hearing?'
- Heart and lungs: 'Cough, shortness of breath, chest pain, palpitations or swollen feet?'
- Digestive: 'How is your appetite? Nausea, vomiting, diarrhoea, constipation, blood in your stools?'
- Genitourinary: 'Burning when you pass urine, blood in the urine, getting up at night to pass urine?'
- Musculoskeletal, skin and neurological: 'Joint pain, rashes, weakness, tingling or dizziness?'
- Mental: 'How has your mood been? How are you sleeping?'
Test yourself
Think of the answer, then tap the question to see it.
How does the review of systems differ from the physical exam?
The review of systems records symptoms the patient reports (subjective data); the physical exam records the signs the examiner finds (objective data).
What happens to a review-of-systems symptom that relates to the chief complaint?
It is moved into the present illness, where it is analysed by its attributes.
Which triad of general symptoms should raise concern for a systemic disease such as tuberculosis or lymphoma?
Fever, night sweats and unintentional weight loss.
Related
- The clinical history: its parts and their order
- Chief complaint and history of present illness
- Respiratory symptoms: cough, sputum, hemoptysis and dyspnea
- Urinary symptoms: dysuria, frequency, oliguria and hematuria
Related conditions
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: 12.3 Collection of Assessment Data - Fundamentals of Nursing | OpenStax (OpenStax, Rice University, 2024).
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Representative model, for educational purposes only.