Do you have a cough that does not produce mucus (a 'dry cough')?
Don't know
No
Recent problem for less than a month
Problem for over a month but less than a year
Problem for more than a year
557.
Do you have Chronic Obstructive Pulmonary Disease (COPD), also known as Emphysema or chronic Bronchitis?
Don't know
No - definitely not
Mildly
Moderately
Severely
558.
Do you have a history of Acute Infectious Bronchitis? Symptoms may include chest pain on coughing, difficulty breathing, mild fever and a cough with mucus produced later in the course of the infection.
Do you ever have shortness of breath that is not associated with significant exertion? In other words, do you experience a sensation of difficult or uncomfortable breathing or a feeling of not getting enough air?
Have you experienced any kind of chest pain, burning, tightness, pressure or discomfort within the past year?
Don't know
No
Yes More questions later...
Add any additional information here for the questions above:
Please mention the question number(s) if possible.
SYMPTOMS: SLEEP
568.
How often do you take a nap outside of normal sleeping hours?
Never / don't know
Once a month or less
Once a week or less
A few times per week
Daily or almost daily
569.
Roughly how often do you yawn, on average?
Never / a few times per year perhaps
I'd say less than average
Average / a few times per day / don't know
Many times during the day
Several times every hour
570.
Drowsiness. Not including after meals, do you find yourself often falling asleep in situations such as boring meetings, watching TV or while driving?
Never / don't know
Once a month or less
Once a week or less
A few times per week
At least daily
571.
Do you generally become sleepy after eating?
Rarely / don't know
No
Occasionally
Often
572.
Do you have difficulty staying awake after midnight?
Yes, always
Usually / I only stay up for special occasions
Sometimes / I'm about average / don't know
No, I regularly stay up into the small hours
Not at all, I'm a real "night person"
573.
How is your quality of sleep when you are able to sleep without interruption or pain?
Usually broken up / difficult
Sometimes broken up / difficult
Average/sound / don't know
Generally deep
Always deep
574.
Sleep. On average, how many hours of sleep do you get per night?
Fewer than 5
5 to 6
7 / don't know
8
9 or more
575.
Do you sweat at night? Only include sweating that is not the result of an overly warm environment or too many bed covers.
Don't know
No
Only slightly
Moderately, sheets are damp or moist
Profusely, sheets are soaked
576.
If you suffer from night sweats (severe/drenching sweating that is not due to heat or humidity), for how long has it been a problem?
Not applicable / don't know
Recent onset only - less than 2 weeks' duration
2 weeks to 2 months
2 to 6 months
Longer than 6 months
577.
Do you experience bizarre, vivid or nightmarish dreams?
Never / don't know
Occasionally
Quite often, quite bad
Often and awful/recurring nightmares
578.
Do you remember your dreams when you wake up?
I almost always remember my dreams clearly
Average - sometimes I remember / don't know
I almost always forget them quickly
579.
Do you have any other sleep problems? Examples include insomnia, restless legs, snoring, apnea, other sleep disorders, grogginess and problems that are present upon waking up.
Don't know
No
Yes More questions later...
Add any additional information here for the questions above:
Please mention the question number(s) if possible.
Have you had an enlarged artery called an aneurysm or experienced a ruptured aneurysm? Sometimes cerebral aneurysms are the cause of stroke, although most strokes are caused by clotting rather than by a rupturing aneurysm.
Don't know
No
Possible enlargement being watched for progression
Yes, may require surgery
Yes, ruptured or required surgery
582.
Do you have Raynaud's phenomenon (extreme loss of circulation to fingers and/or toes)?
Add any additional information here for the questions above:
Please mention the question number(s) if possible.
SYMPTOMS: SKIN: GENERAL
608.
Do you have calluses on your heels and, if so, are they cracked?
No / don't know
Light callus without significant cracking
Light callus with cracking
Thick callus without significant cracking
Thick callus, cracked
609.
Do you have a problem with cracking skin, typically on the fingers, toes or in skin creases? Do not include cracked heel calluses.
No / don't know
Occasionally / moderate
Often / severe
610.
Do you have small bumps on the backs of your arms?
No / don't know
Yes, some/minor
Yes, many/definite
611.
What is your skin color prior to suntan, compared to others of your race, or family members?
Significantly lighter/paler
A little lighter/paler
Average / don't know
A little darker/redder
Significantly darker/redder
612.
What is your facial coloring prior to suntan, compared to others of your race, or family members?
Noticeably pale
Slightly pale
Average / don't know
Slightly dark
Noticeably dark, pink, flushed or ruddy
613.
Not counting blushing during embarrassing situations, do you experience facial blushing, flushing or redness more frequently or intensely than would be considered normal?
Don't know / I think I'm average
No, definitely not
Mild / occasionally
Moderate / sometimes
Major / often
614.
Does your skin seem to have a more yellowish (jaundiced) tone than previously? It may help to look at untanned areas.
Don't know
No
Probably / somewhat
Definitely
615.
Skin moistness. Without moisturizer, is your skin...?
Very dry
A bit dry
Average / don't know
A bit oily/moist
Definitely oily/moist
616.
Is your skin scaly or flaky in areas other than the top of your head (scalp)?
Don't know
Definitely not
Yes, somewhat
Yes, significantly
617.
Does your skin tend to itch often, perhaps worse at night?
No / don't know
Moderately
Severely
618.
Do you perspire/sweat...?
Very little / not easily
Less than average
About average / don't know
More than average
Lots / easily
619.
Do the palms of your hands sweat excessively?
No / don't know
Moderate problem of less than 1 year
Moderate problem of more than 1 year
Major problem of less than 1 year
Major problem of more than 1 year
620.
Body odor. Does your perspiration (sweat) cause a strong odor? This applies mainly to the armpits and feet.
Do you have Telangiectasia (persistent red or blue veins on your face, upper chest or neck)?
Don't know
No
Mild (a few veins)
Moderate
Severe (many veins)
627.
Have you had Eczema? This includes many kinds of red, blistering, oozing, scaly, brownish, thickened and itching skin conditions, and may be known as dermatitis.
Never had it / don't know
Probably had it/minor episode(s) now resolved
Major episode(s) now resolved
Current minor problem
Current major problem
628.
Have you had Psoriasis? It is characterized by frequent episodes of redness and itching, and thick, dry, silvery scales in discrete patches on the skin. It is most common on the scalp, trunk, elbows, knees, skin folds and fingernails.
Never had it / don't know
Probably had it/minor episode(s) now resolved
Major episode(s) now resolved
Current minor problem
Current major problem
629.
Do you have Rosacea (a facial rash usually composed of prominent redness and sometimes also pimple-like bumps that do not become whiteheads or blackheads)?
Have you had lumps or bumps that sometimes hurt or are tender? Do not include sores, bruises or swollen lymph nodes.
Never had one / nothing major / don't know
Major episode(s) now resolved
Current minor problem
Current major problem
637.
Do you tend to get rashes?
It is not a problem for me / don't know
Generally not, but I do have one now
Occasional moderate rashes
Frequent moderate rashes / occasional severe
Frequent severe rashes
638.
Do you have vitiligo (patches of depigmented/lighter skin)?
Never had it / don't know
Probably/minor episode(s) now resolved
Major episode(s) now resolved
Current minor problem
Current major problem
639.
Warts
Never had them / don't know
Probably/minor episode(s) now resolved
Major episode(s) now resolved
Current minor problem
Current major problem
640.
Whether you are male or female, do you have any problems with your nipples, such as itching or a discharge?
Don't know
No
Yes More questions later...
Add any additional information here for the questions above:
Please mention the question number(s) if possible.
GLOSSARY
Acne A chronic skin disorder due to inflammation of hair follicles and sebaceous glands (secretion glands in the skin).
Actinic Keratoses Actinic keratoses are common premalignant skin tumors that appear as small, raised, flaky lesions usually found on heavily sun-exposed skin in older people. They are mainly due to long-term exposure to the sun in susceptible persons and may progress to squamous cell carcinoma.
Acute An illness or symptom of sudden onset, which generally has a short duration.
Anemia (Anaemia, Anemias) A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Arterial (Arteries, Artery) Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Asthma (Asthmatic) A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress. Extrinsic Asthma is triggered by pollen, chemicals or some other external agent; Intrinsic Asthma is triggered by boggy membranes, congested tissues, or other native causes… even adrenalin stress or exertion.
Atherosclerosis Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.
Benign Literally: innocent; not malignant. Often used to refer to cells that are not cancerous; they tend to grow slowly and don't spread (metastasize) like cancer tumors do.
Boil (Abscess, Abscesses, Boils, Carbuncle, Carbuncles, Cystic Acne, Furuncle, Furuncles, Hidradenitis Suppurativa, Pilonidal Cyst, Pilonidal Cysts) A localized infection deep in the skin. A boil generally starts as a reddened, tender area. Over time, the area becomes firm and hard. Eventually, the center of the abscess softens and becomes filled with white cells that the body sends to fight the infection (pus). Finally, the pus forms a "head" and drains out through the skin. A furuncle or carbuncle is an abscess in the skin caused by the bacteria Staphylococcus aureus. It can have one or more openings onto the skin and may be associated with a fever or chills. Cystic acne is a type of abscess formed when oil ducts become clogged and infected. Cystic acne is most common in the teenage years. Hidradenitis suppurativa is an illness in which there are multiple abscesses that form under the arm pits and in the groin area. These areas are a result of local inflammation of the sweat glands. A pilonidal cyst is a special kind of abscess that occurs in the crease of the buttocks. These frequently form after long trips that involve sitting.
Bronchitis Inflammation of the mucous membrane of the bronchial tubes, frequently accompanied by cough, hypersecretion of mucus, and expectoration of sputum. Acute bronchitis is usually caused by an infectious agent and of short duration. Chronic bronchitis, generally the result of smoking, may also be known as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema.
Bruise (Bruised, Bruising) Injury producing a hematoma or diffuse extravasation of blood without breaking the skin.
Cancer Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Candidiasis (Candida) Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge. Candidiasis is also known as: Candida; Candida albicans; Candida Related Complex; Chronic Candida Syndrome; (Chronic) Systemic Candidiasis; Monilia; Candidiasis Hypersensitivity Syndrome; Candidosis; (Chronic) Mucocutaneous Candidosis; Thrush (oral or vaginal); Moniliasis; Polysystematic Candidiasis.
Cardiovascular Pertaining to the heart and blood vessels.
Chronic (Chronicity) Usually referring to chronic illness: Illness extending over a long period of time.
Coccidioidomycosis (Valley Fever) A disease caused by inhaling spores of the fungus Coccidioides immitis. It starts out as a respiratory illness and may progress to a persistent infection; disseminated coccidioidomycosis is the most severe form and is often fatal. Anyone who is present near dust-producing activities where soil or other materials contaminated with C. immitis are present can get this disease if enough spores are inhaled. Symptoms: First the lungs are infected, possibly producing no symptoms at all or perhaps a fever, chills, and cough. This infection may heal completely, or result in other complications. Approximately 1-in-1000 cases will progress to the disseminated form, leading to lesions in the lung and abscesses throughout the body. These abscesses tend to form in the subcutaneous tissues, skin, bone and the central nervous system (the brain and spinal cord).
Cysts (Cyst) A closed pocket or pouch of tissue; a cyst may form within any tissue in the body and can be filled with air, fluid, pus, or other material. Cysts within the lung generally are air-filled, while cysts involving the lymph system or kidneys are fluid filled. Cysts under the skin are benign, extremely common, movable lumps. These may develop as a result of infection, clogging of sebaceous glands, developmental abnormalities or around foreign bodies.
Cytomegalovirus (CMV) A member of the herpes virus family which may induce the immune-deficient state or cause active illness, such as pneumonia, in a patient already immune-deficient due to chronic illness, such as cancer or organ transplantation therapy.
Dermatitis A general term used to refer to eruptions or rashes on the skin.
Eczema Swelling of the outer skin of unknown cause. In the early stage it may be itchy, red, have small blisters, and be swollen, and weeping. Later it becomes crusted, scaly, and thickened.
Immune System (Immune Response, Immunity) A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Lesion (Lesions) Any damage to tissue structure or function; an abnormal change in body tissue caused by disease or injury. A scar is a lesion, as is cancer, a stomach ulcer or a pimple.
Lung (Lungs, Pulmonary) Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Lymph Nodes (Axillary Nodes, Inguinal Nodes, Lymph Gland, Lymph Glands, Lymph Node, Lymphatic) Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit (axillary) and groin (inguinal), but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Childrens' nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's. Also known (incorrectly) as lymph glands.
Mole (Moles, Nevi, Nevus) Known more accurately as a "nevus", a mole is a lesion of the skin that may be present from birth, but which most often appears later in life. By three years of age, 40% of children will have at least one nevus. Some varieties are hereditary and most have color. A common nevus in light-skinned people is typically small, round, tan or brown, with a smooth border, and exactly the same throughout. Other types may be very large, or have irregular borders. There are dozens of different types, with many shapes, colors and sizes. While most are benign, malignant changes can occur to turn the benign nevus into a melanoma.
Mucus (Mucous) The viscous, slippery substance that consists chiefly of mucin, water, cells, and inorganic salts and is secreted as a protective lubricant coating by cells and glands of the mucous membranes.
Multiple Sclerosis (MS) Demyelinating disorder of the central nervous system, causing patches of sclerosis (plaques) in the brain and spinal cord, manifested by loss of normal neurological functions, e.g. muscle weakness, loss of vision, and mood alterations.
Nipple (Areola, Nipples, Subareolar) The small projection near the center of the breast containing the outlets of the milk ducts, OR the corresponding projection of the male breast. The areola is the darker tissue that encircles the nipple. Subareolar describes the location beneath the surface of the areola.
Phlebitis Inflammation of a vein. Symptoms of superficial phlebitis include pain, swelling, redness, and warmth around the affected vein. The vein feels hard to the touch because of the clotted blood.
Pneumonia (Pneumonitis) Inflammation, usually infectious, of the lungs. Unless the result of only moderate chemical or smoke irritation, it is a potentially life-threatening condition. There are so many defenses against an infection this deep in the body that the very presence of pneumonia signals a pathogen of great virulence or impaired or exhausted immunity, or all three. Pneumonitis: Inflammation of the lungs, from whatever cause. It may be concurrent with pneumonia or pleurisy.
Polyp (Polyps) A usually nonmalignant growth or tumor protruding from the mucous lining of an organ such as the nose, bladder or intestine, often causing obstruction.
Psoriasis An inherited skin disorder in which there are red patches with thick, dry silvery scales. It is caused by the body making too-many skin cells. Sores may be anywhere on the body but are more common on the arms, scalp, ears, and the pubic area. A swelling of small joints may go along with the skin disease.
Raynaud's Phenomenon (Raynaud's, Raynauds Disease, Raynaud's Disease, Raynauds Phenomenon, Raynauds Syndrome, Raynaud's Syndrome) Raynaud's disease or syndrome is a disorder of blood circulation, mainly in the fingers and toes. It is of unknown cause and characterized by changes of the skin that are aggravated by exposure to cold: first, becoming white with numbness and pain as a result of inadequate oxygenation of the blood, then red/purple with a burning sensation. The sudden constriction of blood vessels causes decreased blood flow to the extremities and can, in extreme cases, lead to gangrene. Also called "white finger", "wax finger" or "dead finger".
Scleroderma (Systemic Sclerosis) An autoimmune disease of the connective tissue, characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body. This leads to thickness and firmness of involved areas.
Seborrhea (Seborrheic) Skin disease characterized by dry or moist, greasy, yellow crusts or scales. A disorder of the sebaceous glands, with changes in the amount and quality of the oils secreted. Although it can occur in any part of the body, seborrhea of the scalp (dandruff) is most common.
Seborrheic Keratoses Seborrheic keratoses are raised growths on the skin. Seborrheic means greasy and keratosis means thickening of the skin. There may be just one or clusters of dozens. They usually start off light tan in color and then may darken to dark brown or nearly black. They may be oval spots a fraction of an inch across, or form long Christmas tree-like patterns on the torso that are inches long.
The consistent feature of seborrheic keratoses is their waxy, pasted-on or stuck-on look. The look is often compared to brown candle wax that was dropped onto the skin.
Shingles (Herpes Zoster) A severe infection caused by the Varicella-Zoster virus (VZV), affecting mainly adults. It causes painful skin blisters that follow the underlying route of brain or spinal nerves infected by the virus. Also know as herpes zoster.
Stroke (Stroke-Type Event) A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.
Syndrome A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Telangiectasia Small, unsightly red, purple or blue blood vessels found along the surface on the face, upper chest, neck and rarely on other parts of the body. Similar veins are found on the legs but called spider veins.
Thrombophlebitis Venous inflammation with formation of clots. It can occur without any symptoms until the clot reaches the lungs. However, in about half of cases, there are warning symptoms including swelling, pain and warmth in the entire calf, ankle, foot, or thigh (depending on where the involved vein is located).
Thyroiditis (Chronic Thyroiditis, Hashimoto's Thyroiditis) Inflammation of the thyroid; there are several forms of thyroiditis, including chronic or Hashimoto's thyroiditis (also called autoimmune or chronic lymphocyctic thyroiditis), subacute thyroiditis, and painless or postpartum thyroiditis. Thyroiditis often results in hypothyroidism.
Tuberculosis Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
Tumor (Tumors, Tumour, Tumours) An abnormal growth of tissue resulting from uncontrolled, progressive multiplication of cells and serving no physiological function; a neoplasm. Literally, a swelling; in the past the term has been used in reference to any swelling of the body, no matter what the cause. However, the word is now being used almost exclusively to refer to a neoplastic mass, and the more general usage is being discarded.
Varicose Veins Twisted, widened veins with incompetent valves.
Vasculitis Inflammation and necrosis of blood vessels, including arteries, veins and capillaries. The damage may be due to infectious agents, mechanical trauma, radiation or toxins; often no specific causative factor is identified. It involves immune mechanisms such as deposition of circulating immune complexes and direct attack by circulating antibodies
Yeast A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.
More questions later...
