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HPI (history of present illness)

ALL CASES: OCD PSF AAA


PAIN: OCD PSF LIQR AAA
FLUIDS: OCD PSF ABCDO
(Vomiting, Diarrhea, constipation, cough, vaginal discharge)
O Onset of the symptom (sudden/gradual)
ANY C/O:
C COURSE Constant /Intermittent 1-CC
D Duration 2-ASSOC. SYMP SAME
P Progression + precipitating factors SYSTEM
S Settings 3-ROS HEAD TO TOE
F Frequency
CC: OCD,PRECIP.,Av/Ag
-WHEN DID IT START?
L Location of the symptom (forehead, wrist...) -HOW OFTEN DO U
I Intensity of the symptom (scale 1-10, 6/10) HAVE IT?
Q Quality of symptom..BCDSPP -SINCE IT STARTED,
(burning,Cramping,dull,Sharp,pulsating,pressure like) HAVE U NOTICED ANY
R Radiation of the symptom ( to left shoulder and arm) CHANGE IN IT?
-WHAT DO U THINK
A Associated symptoms ( palpitations, shortness of breath) THE CAUSE FOR IT?
A Alleviating factors (sitting with my chest on my knees) -HAVE U NOTICED ANY
A Aggravating factors (effort, smoking, large meals) THING THAT MAKE IT
BETER?
A Amount -HAVE U NOTICED ANY
THING THAT MAKE IT
B Blood WORSE?
C Color
C Consistency
C Content
D Duration
O Odor

UG Hx: OCD PSF AAA + FINISH CUP


F Frequency (How frequent do u have to pass urine?)
I Incontinence (Do u have trouble holding Ux until u get to BR?)
N Nocturia ( do u have 2 wake up @ Night to go to BR?)
I Incomplete emptying (do u feel fullness even after Ux)
S Stream (How is ur flow of urine? is it cont. or is there any dribbling after Ux?)
Strain (Do u have to strain during Ux)
Stone (have u passed stones in the past?)
H Hematuria (did u notice any blood)
Hesitancy (do u have 2 wait b4 starting Ux)
C COLOR
U Urgency (do u have 2 rush to BR to Ux?)
P Pyuria (was there any pus in ur Ux?)
Pain (Burning)
1
PMH (past medical history) PAM HUGS FOSS

P Previous presence of the symptom (same CC)


Past Medical problems (BP,BS,UTI,Kidney prob., Rhinitis,Sinusitis,Asthma,)
A Allergies (drugs, foods, chemicals, dust ...)
M Medicines (R U taking any prescription medications/any over-the-counter med.),

H Hospitalization for any illness in the past (Trauma, surgery)


U Urinary changes ( esp if diabetic, elderly...)
G Gastrointestinal complains (diet changes, bowel movements...)
S Sleep pattern(difficulties falling/maintain asleep,wake up,snoring,med. to help sleep,
how many hour, nightmares)
F Family history (similar chief complaints/serious illness)
Fevers, Chills,Night sweats
Fatigue
O OB/GYN history (LMP, abortions, para...) LMP RTV CS PAP
S Sexual habits (active/preferences/STD/no. of partners/contraception/pregnancy/
last pap smear)
Are you Sexually Active?How Many Partners are you active with?Are your partners male or
female or both? Unless the SP says wife or husband in Q 2,Do you use protection during
intercourse? What kind of protection do you use? Ask about anal intercourse in male
homosexuals, H/ STD's; Rx for STD's

S Social Hx (job/house/smoking/alcohol/recreational drugs/.....) WAD SAD TOES

Social Hx WAD SAD TOES

W Weight / who do u live with?


A Appetite
D Diet
S Smoke (cigarettes, marijuana, how much, how many years)
A Alcohol (what type of alcohol, how often, how much ,consider doing CAGE question.)
D recreational Drugs (what drug, how do you use it, any IV drug use?)
T Travel /Trauma
O Occupation (what do you do for living?)
E Exercise
S Stress

HEADACHE OCD PSF LIQR AAA + DIAGRAM


Head trauma/Seizure/Weak, Numb

Tears / visual changes

Flu /Nasal congesion


Vomit/ Speech

Neck stiffness
2
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
Ped Hx (Child with fever) CUB FEVERS + PAM IF BIG DEALS-T

C Colds-runny nose,cough,chest pain, fast respirations,SOB


CRYhow is cry of baby?
U Urination-increased or decreased urination, # of diapers, any odour, colour of urine
Ulcers in mouth
B Bowel changes: Diarrhea-frequency, onset, mucus/pus/blood in stool, any crying
during defecation
Discharge Qs (ABCD-O: Amount, Blood, Content, Consistency, Color,
Constant/Intermittent, Duration, Odor/Onset)
F Fever & Chills& Night sweats/Headache
E Ear pulling
V Vomiting
E Ear/eye discharge, Ear hearing, Eye vision
R Rash /Rigidity Neck
S Seizure-any jerky movements, which part of body? Any leakage of urine or stool
during fits, and postictal irritability or loss of consciousness.
Stress (bet wet, DM)
Smoke @ home
School performance
P Past medical/Past surgical Hx / Previous Hospitalizations. / Pets @ home
A Allergies, effect on child/parents (bet wet, DM), Activities
M Medications, Menstruating (female child >10yo)
I Ill contacts
F family history
B Birth Hx
I Immunizations
G Growth n development, ht, wt, milestones
SSC-WTD smile sit crawl walk talk dress
Month 1 6 9 12 15 30

D Day care / Difficult swallowing


E Eating habits/ feeding of baby/Diet change
A Appetite / Appearance Look of the baby
L Last check-up
S Sleep
T Travel recently

NB:
+Oral Rehydration: Pedialyte or Home-made +in WU: Scheduled PE
1L of water<5 cups> +1/2 tsp. salt+6 tsp. sugar
Premenopause : HADOC
H Hot flashes
A Atrophy of vagina
D Dryness of vagina
O Osteoporosis (council)
C Coronary artery disease 3
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
ObGyn Hx : LMP RTV CS PAP

L LMP (when was ur LMP?)


M Menarchae (how old were u when u had ur 1st period?
P Period (how many days ur period last?)
R Reglarity ( R ur periods regular?)
T Tampoons (how many pads do u use in a heavy day?)
V Vaginal DID: discharge, itching , dryness (have u ever had any vag discharge?ABCDO.
do u have any vag. Itching?)
C Cramps (Dysmenorrhea) do u have abd cramp with ur period?
S Spotting ( intermenstrual / post coital ) have u ever bled (.) ur cycles?
Did u ever notice any bleeding after intercourse?
P Pregnency ( Hx & complications) have u ever been pregnant? How many times?
A Abortion/miscarriage (Any miscarriages or abortions?In month of ur pregnancy?)
P PAP smear(have u been getting regular PAP sm ?when did u have the last PAP sm )
(any Female>50 yo:ask about:1-R u taking vit D & Ca, 2-have u ever tried HRT?)

Associated symptoms of Amenorrhea FLAG HIV WC

F Fatigue
L Libido
A Anorexia nervosa /Anxiety & Depresion
G Galactorrhea

H Hair & skin changes ( for Hypothyroid/Hirsutism of PCOS)


Headaches
Hot flushes
I Insomnia
V Visual disturbance / voice change Deep

W Wt change & Appetite & Diet


C Cold intolerance & Constipation

..If suspect abuse Domestic Abuse SAFE GARDS


S Safety inquiry (Do you feel safe at home?), Sex ever forced?
A Alcohol abuse (does your husband abuse alcohol?)
Addict (does husband use recreational drugs)
F Friends/Family who are aware (Dose any1 f ur friend/Fam know of this)
Fractures (Abuse ever resulted in fractures?)
E Emergency plan (u have emergency plan?), Ever tried to leave/divorce?Why not?
G Guns at home (are there any weapons @ home?)
A Afraid of husband , Attacked Children?Attacked u with Guns?
R Relationships with husband (how is ur relationship with husband? do you feel
Threatened when he is around?, For how long?
D Depression (lost wt/appetite/sleep)
S Suicidal (idea/plan/attempt) (ever felt like ending it all up?)
4
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
Diabetic pt. FU/Med Refill DIABETIC

D Duration of disease
I Insulin regimen/ oral hypoglyemics regimen
A A1c hg -> Gluc. monitoring (fast, home, HgA1c)
B Blurry vision (retinopathy)
E Extremity (foot ulcer/infection)
T Tingling/numbness (neuropathy)
I Infections (resp/urinary)
C Cardio Risk Factors (HTN, CHOL, Heart disease)

Counseling DM & HTN MEDOWS

M Medications (regularity)
E Exercise ( for obese/sedentary life styles)
D Diet Modification( Salt/Fatty foods)
O Opthalmoscopic exams (annual routine)
W Weight Management (/control)
S Sugar Check ups

Neuro cases LOC CAP HIT NSGB +MMSE

C Confusion after the event


Consciousness LOC;duration? Before LOC:
A Aura b4 problem;Sounds,Lights,Smell + Aura
+ Palpitation
P Palpitations + Dizzy
+ Vision
H Headache/ Lightheaded /Hearing loss &Tinnitus + Nausea/vomit
+ Dif breathing
I Incontinence urine/Bowel
T Tongue biting/Trauma& fall During LOC:
+ Attending person?
N Nausea & vomit + shaking/something
coming from mouth
Numb, Tingling, Weakness + Incontinence urine/stool
S Sleep disturbance + Tongue bitting
Sight Vision
After LOC:
Speech difficulties + Confusion
Seizure Shaking;duration? + Concentration
Spinning + Weakness/ting/numb
+ Gait
G Gait + Headache
B Breathing Difficulty

 And to make sure you got it completely don't forget MMSE


NB: in case of MVA; ask about last meal
5
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
MINI MENTAL ORARL23RWD

O Orientation X3 time, place, person


R Registration Im going to say 3 objects then repeat
A Attention spell world backwards
R Recall what were those 3 items again?
L Language Repeat after me.. No, ifs, ands, or buts
2 Identify two objects what is this.. pen.. and this paper
3 Obey 3 commands take a piece of paper, fold in , put on floor
R Read 3 commands on this paper and do what it says
W Write a sentence
D Draw, copy the image

Forgetfulness/ Memory Loss / Dementia/ Alzheimers


FORGETS HIM + DEATH SHAFT + MMSE ORAR enough!
F Fall/ FAINTING / Flashes/ FHx of Alzheimer
0 ORTHOSTATIC HYPOTENSION Lightheadedness
R RUNNING URINE INCONTINENCE
G GAIT
E EYE VISION
T TRAUMA/TINGLING & Numbness & Weakness
S SEIZURES/ Sleep/ Speech/Support
H HEADACHE
I INFECTION [SYPHILIS, MENINGITIS]
M MOOD feel sad
 ADL - Activities of daily living
D Dressing
E Eating
A Ambulation (can you find your way thru home)
T Toiletry (do you manage your toiletry unassisted)
H Hygiene
 IADL - Instrumental activities of daily living
S Shopping
H Housekeeping
A Accounting pay bills
F Food prep (do u do your cooking )
T Transportation (do you drive? How is your sight, hearing?)
COUNCELLING:
1-I would like to ask ur permission to speak with ur family
2-i would like u&ur family to meet a social worker to assess home safety&supervision
NOTE:
-History: ask for paper with medications
-PE: Auscultate carotid bruit/Fundoscopy/MMSE Recall
-WU: orthostatic V.S. 6
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
Foot/Heel/Knee/Shoulder/Back pain OPD-CSF-LIQRAAA +WET SURF-D - CIS

W Weakness / Wt. loss


E Eye infection redness / Exposure to COLD effect
T Trauma /Tender /Tingling& Numbness / Tick bite
S Stiffness in other joints/ Swelling /long Standing hours/morning Stiff/sound
U Urethral discharge /ulcer / USE Work ,Walking habits, sports
R Rash/ Redness of skin of joint / ROM / Rheumatologic dis.
F Fever & chills& night sweat / Fatigue /Foot wear
D Deformity/Disability affect his work, need help @home / Dysuria
CIS Cancer Hx /IV DRUGS/ Steroids 4 long time

Depression: (Psychiatric Hx Checklist) SIGME CAPT +2 (+MMSE: ORAL23RWD)


S Sleep (difficulties falling/maintain asleep, wake up, snoring, med. to help sleep,
how many hours, nightmares),
Suicide: thoughts, plan, attempts (do u have pills/guns @ home? )
Stress
Support
I Interest, What do you do in your free time? How are you doing in your job? do you
enjoy what you do?
G Guilty
M Mood. ( anxious, sad, hopeless, lonely?
Memory problems
E Energy
C Concentration
A Appetite, changes in your Weight
Attitude towards life (positive/negative frame of mind)
P Psychomotor agitation/retardation (do you feel easily agitated or angry/do u feel
not to do anything?)
Psychiatric Delusions, Hallucinations, Hopes
T Thyroid dysfunctions (ABCD HV for HYPOTHYROID)

also need to ask :


Do u realize that u have problem ?
Do u want help? ( if patient was sent or asked by anyone to consult doc )

NB:
THYROID ABCD HV
APPETITE/DIET,BOWEL,COLD INTOLER.,DEPRESSION,HAIR/SKIN,VOICE-Hoarseness
DIZZYNESS:
-ROOM SPINNING>>EAR
-LIGHT HEADEDNESS>>HEART/BRAIN
DIZZINESS / PALPITATION
ANY CASE OF BOTH,ASK ABOUT THE OTHER
7
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
Hearing loss: OPD-CSF-AAA + PDF IN RST

P Pain
D Discharge
F FB
I Imbalance / Infection
N Noise
R Ringing
S Spinning
T Trauma / Tinnitus

Dx ABD Signs CKMG MIOR (MIOR assoc. with Appendicitis)

C Cullen $- periumbilical discoloration (Retroperitoneal He,pancreatitis, AAA rupture)


K Kehr $ sever Lt. Shoulder pain- Splenic rupture, ectopic pregnancy
M Muphys $- Abrupt interruption of inspiration on palp of RUQ- acute cholecystitis
G Gray-Turner $, Discoloration of flank (same as Cullen $)
M Mc Burneys $- Tenderness 2/3 from ASIS to Rt of umbilicus
I Iliopsoas $, Hyperextention of R hip Cx ABD pain
O Obturator $- Internal rotation of flexed R hip Cx ABD pain
R Rovsing $- RLQ pain upon palpation of LLQ

DD Nasuea & Vomiting A MOPING


A Anorexia
M Metabolic( DKA)/Meds
O Obstruction (pyloric /Intestinal)
P Pregnancy
I Inflammation( Pyelo/Cholecysto/Append/Pancreas/PID)
N Neurological (BETA)= Bleed/Encephalitis/Tumor/Abscess
G Gastroenteritis
Erectile dysfunction LIM-PENIS
L Libido
I Injury (back-penis)
M Medications (B#)
P PMH HTN,DM, peripheral vascular dis./ PSH prostate
Pyrenois dis.
Performance anexiety
E Erections at all morning
N Nocturia
I Incontinence urine, stool
S Stress/Depression

8
drkhalilezekiel@yahoo.com KHALILS HIGH YEILD STEP 2 CS MNEMONICS
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

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