Name: Ian Thorpe

DOB: DD/MM/YYYY

Age: 68

• You are very unbothered, you think this is just a small infection
• You are very polite and apologetic if you cannot remember things from your medical history
• You have very high respect for doctors

• I: You have no particular ideas on what could be causing the yellowing of the eyes. You wondered initially whether you should see an optician but your friend suggested you should see your GP
• C: You are not concerned at all, you think it is probably just a passing thing
• E: You would be grateful for an explanation, and also some advice with regards to the itching, such as any helpful creams

• White part of your eyes look yellow compared to normal and your friends insisted you went to see your GP

Positive symptoms:

• Symptoms started few weeks ago -- noticed by friends
• Constant itching entire body -- changed your soaps, but it did not help
• Using creams suggested by pharmacist -- no relief
• Pale stool ongoing -- noticed a week ago (thought it was due to heavy meal after pub lunch)
• Poor appetite recently -- put down to being busy
• Lost weight according to sister -- weight loss put down to running around fixing flat
• General tiredness recently

• Darker 'brown-like' urine in past week

• Pain:

       - **Top of abdomen** -- more **discomfort** than pain
       - Comes and goes 
       - **No association** with food or bowel movements 
       - Associated with** nausea** -- avoiding food settles it
       - **4/10** severity
       - **Dull** in character

Negative symptoms:

• No vomiting
• No changes to bowel habits
• No other symptoms of note eg: headaches, chest pain, cough, urinary changes, sensory/ motor symptoms, rashes, etc.

• Type 2 diabetes
• Hypertension
• High cholesterol
• Prostate enlargement -- benign prostatic hyperplasia
• Previous gallbladder removal
• Bilateral knee replacements -- osteoarthritis

• Insulin before meals and at night
• Blood pressure medication -- cannot remember names
• Statin
• Tamsulosin and finasteride
• Ibuprofen gel when needed for knee pain
• No known allergies

• Maternal father had fatty liver -- likely due to poor diet
• Paternal grandfather died from bowel cancer 65y/o
• No other family history of note

• Used to be a heavy smoker -- about 30 a day for 35 years, stopped 5 years ago after a friend died from lung cancer
• Few beers a day at local pub
• No recreational drug use
• Retired lorry driver
• Live alone -- partner passed about two years ago
• Sister visits often, and have a close friends group from the local pub that provide support if needed
• Poor diet -- ate a lot of ready in meals in past
• More fruit and vegetables now but often still eat in the pub
• No recent tattoos