MNEMONICS FOR STEP 2 CS

HPI (history of present illness)

Ask for: LIQOR AAA

L Location of the symptom (forehead, wrist...)

I Intensity of the symptom (scale 1-10, 6/10)
Q Quality of the symptom (burning, pulsating pain...)
O Onset of the symptom + precipitating factors
R Radiation of the symptom ( to left shoulder and arm)
A Associated symptoms ( palpitations, shortness of breath)
A Alleviating factors (sitting with my chest on my knees)
A Aggravating factors (effort, smoking, large meals)

PMH (past medical history)

Search for: PAM HUGS FOSS

P Previous presence of the symptom (same chief complaint)

A Allergies (drugs, foods, chemicals, dust ...)
M Medicines (any drugs the patient used)

H Hospitalization for any illness in the past

U Urinary changes ( esp if diabetic, elderly...)
G Gastrointestinal complains (diet changes, bowel movements...)
S Sleep pattern (waking up/going to sleep...)

F Family history (simmilar chief complaints/serious illness)

O OB/GYN history (LMP, abortions, para...)
S Sexual habits (active/preferences/STD...)
S Social life (job/house/smoking/alcohol.....)

WAD SAD TOES for social history.

W-Weight
A-Appetite
D-Diet
S-Smoke
A-Alcohol
D-Drugs
T-Travel
O-Occupation
E-Excercise
S-Stress

Differential diagnosis checklist

DIRECTION:

Drugs
Infection
Rheumatologic
Endocrine
Cardiovascular
Trauma
Inflammatory
Other
Neoplasm
For Social History I use TIA SHOE:

T obacco

I llicit drigs

A lcohol

S exual

H ouse life

O ccupation

E ating (diet)

LIQOR AAAAA
last 2 A = associated q for d/d like weight lifting, travel history
A= associated effect on sleep,diet & functioning

FOR PEDIATRIC HISTORY.

F E V E R C U D Seizure + P A M I F B I G D E A L S.

FEVER- Fever, Ear pulling, Vomiting, Ear discharge,eyes discharge,

Rash, CUD- Chest symptoms n Cold-runny nose,cough,chest painfast
respirations,shortness of breath, Urination-any increased or decreased
urination,no. of wet diapers,any odour,colour of urine, Diarrhea-
frequency,onset,mucus in stool,blood in stool,any cryin during
defecation , Seizure-any jerky movements,any leakage of urine or
stool during fits,ant post ictal irritability,or loss of consciousness.

PAM - P-Past medical,past surgical hx, previous hospitalizations. A-

Allergies, M-Medications, IF I-Ill contacts, F -family history, BIG -B-
birth hx, I-Immunizations, G-Growth n development,ht,wt,milestones.
D-DEALS- Day care, E-Eating habits,feeding of da baby, A-Appetite, L-
Look of tha baby or appearance, S- Sleep

in addition to pamshugsfoss (of course you would modify it according

to your patient)...

i used BINDER - birth history, immunization history, nutrition,

development, Eating, Rash... also it's good to ask where the child is
during the day - (i.e. day care, school, grandmother's house, etc...)
good luck

premenopausal symptoms

HAVOC

H- hotflahes
A-atropy of vagina
V-vaginal dryness
O- osteoporosis
C- coronary artery diseases
FOR all Discharges.... including Diarrhoea,Cough ...............ACCOD

A-amount
C -consistency
C- color
O- odor
D- duration
Depression.SIGEMCAPS

S-sleep
I-interest
G-guilt,gun
E-energy
M-mood
C-concentration
A-appetite
P-psycomotor
S-suicide

want to add few more to these.......

M- mood ( already in list )

D - Delusion / hallucination
M - memory
A- attitude towards life ( positive negative frame of mind)
T - thyroid dysfunctions

also need to ask ----- do u realize that u have problem ?????

and do u want help ??????

( if patient was sent or asked by anyone to consult doc )fatigue...IMP
ADH
I-infectin
M -malignancy
P-ptsd
A-abuse
D-depression
H-hypothyroidism
For Spousal abuse, I have read the acronym SAFEGARDS some
where.Can some complete it for me or give more add ons

S= Safety inquiry (Do you feel safe at home?)

A= Alchol abuse (does your hubby abuses alchol?)
F= Friends/Family who are aware/Fractures ( Dos any1 f ur friend/Fx
knw f dis/Abuse ever resulted in fractures?
E=Emergency plan (do u hav an emergency plan?/Ever tried to leave/
divorce? why not?
G=Guns at home (are dere any weapons @ home?
A=any escape plan ?
R=Relationships with husband (how is ur relationship wid hubby? -->
do you feel threatened wen he is around?
D=Depression/Drugs (hav u lost wt appetite sleep ) does hubby dos
drugs
S=Suicidal ideation (ever felt like ending it all up? )
Insomnia counselling =ABCDEFGHJKLMN
Avoid
Bedtime
Concerns (worries)
Drugs (nicotine/caffeine/Alcohol)
Excercise/Excitement (TV Shows)

Follow
Good
Habits for sleep.
Jetlag
Keep
List (Diary)
Monitor
Naps (day time)
Enuresis Counselling = SMILE SAM
Supportive (of the child)
Monitor Intake (@ Day)
Limit (@ Night)
Encourage Washroom( @ bedtime)
Sheets ( Rubber flannel sheets)
Alarms ( >5yrs )
Motivate (thru Rewards)

Conselling DM & HTN= MEDOWS

Medications (regularity)
Excercise ( for obese/sedentary life styles)
Diet Modification( Salt/Fatty foods)
Opthalmoscopic exams (annual routine)
Weight Management (/control)
Suger Check ups

-
Smoking Cessation counselling = SPANCSTER
Stressor ( any stress in life/tension etc )
Problems ( Heart /Lung/ CA)
Advantages ( Improved breathing & Increased energy)
Nicotine Patch ( I can offer you reading materials )
Counsellors ( I can refer u/ give # )
Support systems ( I can refer u /give #)
Taper down ( if u cant do cold turkey den just taper down a bit)
Excercise Programs ( eg Swimming )
Rewards ( reward urself, treat urself with a dinner 4m money saved off
of quitting)
STD / HIV Counselling
STRIP BIMBO !
SAFE SEXUAL PRACTICES
TRANSMISSION ( to partners )
RISKS ( acquiring more STD's)
IMMUNIZATIONS ( for Influenza/ Pneumococcal )
PREVENTION COUNSELLING ( REFER TO SW /CAN GIVE #)
BEHAVIOUR COUNSELLING (REFER / CAN GIVE #)
INTERVENTIONAL COUNSELLING ( REFER /CAN GIVE #)
MEDICATIONS
BARRIER METHODS (CONDOMS
OPPURTUNISTIC INFECTIONS/OBSERVATION (FOR LABS)
HOPI For A CC OF URINARY COMPLAINT
(b)FINISHED PUBS(/b)
Frequency ( How frequent do u Ux)
Incontinence( Do u hav trouble holding Ux)
Nocturia ( do u hav 2 wak up @ Night)
Incomplete emptying ( do u feel fullnes after Ux)
Stream (How is ur stream?)
Hematuria ( did u notic any blood)
Hesitancy (do u hav 2 wait b4 starting Ux)
Dysuria (Did u hav diff Ux)
Pyuria ( did u pus in Ux)
Urgency (do u hav 2 rush)
Burning (dysuria) (does it burn)
Strain (Do u hav to strain during Ux)

CC of Memory Loss/Dementia/Alzheimers/MID/Creutfeldt jakob/

Pseudotumor cerebrii etc
HOPI Particularts to ask -ADL = Activities of daily living = DEATH
Dressing
Eating
Ambulation (can u find ur way thru home)
Toiletry (do u manage ur toiletry un assisted)
Housing
IADL - Instrumental acitivities of daily living =SHAFT
Shopping
Housekeeping? unsure about that
Accounting
Food (do u do ur cooking ,etc)
Transportation (do u drive )
Shoulder pain case ( I read this one somewhere)
DEFORMS
Dislocation ( Ant/Post)
Elderly Abuse
Fracture ( Head/Shaft)
Osteoporosis /Osteoarthritis
Rotator Cuff Tear
Multiple myeloma
Subacromial Bursitis

OBESITY
OBESITY-DISC
Osteoarthritis
Breathing problems
Excess Cholestrol
Sleep Apnea
Increased Incidence Ca's (Endomet/Breast/Colon)
Type 2 DM
hYpertension
Depression
Incontinence
Stress
Cholelithiasis/Cycle disturbances/Cardiac

Psychiatric Hx Checklist

MISS SPEARS PAD MATCHED

Mood, Idea ( abt de problem?), Stress, Support,
Sleep ,Plan,Energy ,Aims, Routine , Suicide, Pills
(drugs),Apetite ,Duration,Memory, Alone,Concentration, Hopes,
Hallucinations , Delusions
Obesity counseling

ABCDEF

Avoid Advice (Eg.Sedentary/Steroids) /Advantages Advice (Low Heart/

Brain/Ca etc risk)

Books (self help reading material)

Counseling/Consult/ Cholesterol checks

Dietitian

Exercise
Fatty Food (cut backs)

Syncope/ Loss of Consciousness/Spells

CAMPUS
• CAD
• Arrythmias/ Aortic Stenosis
• Migraine/ Meds
• Psychiatric /Personality disorder( hyperventilation)
• Unexplained Syncope
• Seizures/Strokes
D/D Confusion

Pneumonic = DEMENTIA
• Diabetes /Dementia/ Drugs
• Epilepsy
• Migraine/Mult Infarct Dementia
• Ethanol (withdrawl / Toxicity)
• Neurological Deficit diseases= BETA
(Bleeds,Encephalitis,Tumors,Abscess,Meningitis)
• TIA/ Trauma
• Insulin/ Infections
• Alzheimers/Abscess
Check list accordingly :- Numbness weakness/Headach ,Flashes, N/V /
Jerky movements, LOC/ Insulin use /PHx Trauma/FHx of Alzheimer +
Risk factor screen (Cholestrol,HTN,DM etc). For Suspected DEMENTIA
=Instrumental inquiry = SHAFT Q's (Shop/Housekeep/Aaccount/Food
prep/ Transport) , & Daily activity inquiry =DEATH Q's (Dress/Eat/
Ambulate/Toilet/Hygiene)
D/D = BACK PAIN

Pneumonic = LIMCOTS
• Lumbar Spinal stenosis
• Intervertebral disc herniation
• Multiple Myeloma/ Mets (Prostate, Breast ,Lung)
• Cauda equina synd/ Cancer
• Osteoporosis/Osteoarthritis
• Trauma/ TB
• Strain (muscle)

Check list= SIQQOR AAA & then ROS =Age/ Bone pains/
constipation=MM/Bowel, bladder/Relieving factors/ Phx of trauma/
Surgical Hx(Prostate) /Chest pain,hemoptysis ,Fever &chills/ With bone
& joint problems =Functional impairment (SOS=Help)Q's i.e Sleep/
Occupation/Suport

Nasuea & Vomiting = A MOPING

• Anorexia
• Metabolic( DKA)/Meds
• Obstruction (pyloric /Intestinal)
• Pregnancy
• Inflammation( Pyelo/Cholecysto/Appi/Pancreas/PID)
• Neurological (BETA)= Bleed/Encephalitis/Tumor/Abscess
• Gastroenteritis
Dizziness is DENTAL CAMPUS
• Diabetic comp ( Orthostatic )
• Ear problems (Meniere's/ BPV)
• Neural tumors/Neuropathy
• Thyroid
• Anemia
• L leave me
• CAMPUS is same as is for SPELLS/LOC/SYNCOPE
Here's a mnemonic for the ObGyn Hx :
LMP RTV CS PAP

LMP !!
Menarchae
Period ( lasts .... days?)
Reglarity ( every .... wks?)
Tampoons/Pads # per day
Vaginal discharge, itching , dryness
Cramps (Dysmenorrhea)
Spotting ( intermenstrual / post coital )
Pregnency ( Hx & complications)
Abortion /miscarriage
PAP smear ( last time result ?, Hx of past abnormal result ? )

Here's one for the causes of Dyspareunia :

DATIVE ! ( u have to be on a date to have sex )

Domestic abuse
Atrophic vaginiyis ( don't forget to ask about s/s of Menopause)
Tumor ,Pelvic
Infection ( lower : Vulvovaginitis - Cervicitis / Upper : PID )
Vaginismus
Endometriosis ( don't forget to ask 'bout Cyclic pelvic pain )

skin review of systems which aReNT SIMMBEL :-)

R (rash)
N (nail changes)
T (temperature)

S (sensation)
I (itching)
M (masses)
M (moles)
B (bleeding/bruises)
E (edema)
L (lesions)
GI hx .ABCDEFGHIJ+.MNOP

A-appetite
B-BOWEL HABITS.,

C-CONSTIPATION

D-diarrhea

E-EATING HABITS.

F-FEVER

H-HAEM IN STOOL

I-incontinence

J-JAUNDICE

M-medications eg iron tabs causin constipation or antibiotics causin

diarrhea

N-nausea

O-OFCOURSE nausea followed by VOMITING

P-pain abdomen
Trauma pt ask for AMPLE

A Allergy

M Medication

P past med Hx

L Last meal

E Events before accident

Menstrual History FM DIAL

F Frequency

M Menarche
D Duration

I Intensity

A Amount

L LMP

For back pain "red flags"

TUNA FISH

Trauma
Unexplained weight loss
Neurological signs
Age > 50

Fever
Intravenous drug use
Steroids for long time
History of cancer

for foot pain after asking all liqoraaa ask WET SURF

Work

Eye infection redness

Trauma to foot

Stifness in other joints

Urethral discharge

Rash/reiter synd

Fever