Mnemonics Flashcards
HPI (history of present illness)
Ask for: LIQOR AAA F/H/N/V
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…..)
social history
WAD SAD TOES W-Weight A-Appetite D-Diet S-Smoke A-Alcohol D-Drugs T-Travel O-Occupation E-Excercise S-Stress
FOR PEDIATRIC HISTORY.
FEVER CUD Seizure + PAM IF BIG DEALS.
FEVER
Fever,
Ear pulling,
Vomiting,
Ear/eyes discharge
Rash
CUD-
Chest symptoms n Cold-runny nose,cough,chest pain, fast respiration’s, 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. DEALS- Day care, E-Eating habits,feeding of da baby, A-Appetite, L-Look of tha baby or appearance, S- Sleep
Premenopausal symptoms
“HAVOC”
H- hot flahes A-atrophy of vagina V-vaginal dryness O- osteoporosis C- coronary artery diseases
FOR all Discharges…. including Diarrhoea, Cough
ACCOD
Amount Consistency Color Odor Duration
Depression
Sleep Interest Guilt,gun Energy Mood Concentration Appetite Psycomotor Suicide
Insomnia counselling
ABCDEFGHJKLMN Avoid Bedtime Concerns (worries) Drugs (nicotine/caffeine/Alcohol) Exercise/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)
Counselling DM & HTN
MEDOWS
Medications (regularity) Exercise (for obese/sedentary life styles) Diet Modification (Salt/Fatty foods) Opthalmoscopic exams (annual routine) Weight Management/control Sugar 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)
Exercise Programs ( e.g. Swimming )
Rewards ( reward yourself: by nice dinner)
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 #)
Behavior counselling (REFER / CAN GIVE #)
Intervention counselling ( REFER /CAN GIVE #)
Meds
Barrier methods (CONDOMS)
Opportunistic infection/Observe (FOR LABS)
CC OF URINARY COMPLAINT
FINISHED PUBS
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)
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
CC of Memory Loss/Dementia/Alzheimers/MID/Creutfeldt jakob/Pseudotumor cerebrii etc
FORGETS HIM I SHAFT DEATH Fall/Fhx of Alz Orthostatic hypotn Running uring (inconitnence) Gait abnormality Eye (visual changes) Trauma/Tingling/numbness/weakness Seizure/Speech/Sleep/Support
Headache Infection (R/o Syphilis, Meningitis) Mood ( R/o Depression) IADL - Instrumental activities of daily living: SHAFT Shopping Housekeeping? Unsure about that Accounting Food (do u do ur cooking ,etc) Transportation (do u drive ) Dressing Eating Ambulation (can u find ur way thru home) Toiletry (do u manage ur toiletry un assisted) Housing
OBESITY problems
“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
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
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
D/D = BACK PAIN
LIMCOTS • Lumbar Spinal stenosis • Intervertebral disc herniation • Multiple Myeloma/ Mets (Prostate, Breast ,Lung) • Cauda equina synd/ Cancer • Osteoporosis/Osteoarthritis • Trauma/ TB • Strain (muscle)
causes of Dyspareunia
“DATIVE”
Domestic abuse
Atrophic vaginitis ( ask about s/s of Menopause)
Tumor ,Pelvic
Infection (lower: Vulvovaginitis - Cervicitis / Upper : PID )
Vaginismus
Endometriosis (ask about Cyclic pelvic pain )
skin review of systems
BREL MMINTS Bruises/Bleeding Rash Edema Lesions
Moles Masses Itch Nail changes Temp Sensation
Nasuea & Vomiting DDx
A MOPING • Anorexia • Metabolic( DKA)/Meds • Obstruction (pyloric /Intestinal) • Pregnancy • Inflammation (Pyelo/Cholecysto/Appi/Pancreas/PID) • Neurological (BETA)= Bleed/Encephalitis/Tumor/Abscess • Gastroenteritis
Dizziness DDx
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
Obs/Gyn Hx
LMP !!
Menarche
Period ( lasts …. days?)
Regularity ( every …. wks?)
Tampons/Pads # per day
Vaginal discharge, itching , dryness
Cramps (Dysmenorrhea)
Spotting ( intermenstrual / post coital )
Pregnancy (Hx & complications)
Abortion /miscarriage
PAP smear (last time result ? Hx of past abnormal result? )
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
AMPLE
Allergy Medication Past med Hx Last meal Events before accident
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
Sore throat
SORE THROAT WAS BAD”
Swallowing food is painful?
Origin, duration, progress
Runny nose
Ear problems?
Temp/Chills?
Headache
Resp. sympt – cough, SOB, chest pain
Occupation
Aspiration + Abd Sympt – nausea, vomiting, pain (LUQ?)
Tiredness (fatgue), touch with ill people (illcontents – boyfriend, girl, friend)
Weight loss?
Appetite change/ alcohol?
Smoking sleep changes? Sexual history
Bowel habits
Anything else do you wanna tell me???
Drugs
Headache DDx
“MM…. IT ACHES”
Migraine
Meningitis
Increased Intracranial Pressure
Tension Headache + Temporal Arteritis
AV Malformations
Cluster Headache
Hypertension
Eye Disorder (Refractory Errors + Glaucoma)
Sinusitis + Sub-Arachnoid Hemorrhage + most Systemis illnesses
Phone Case
“ ON CALL IDIOT”
Onset
Number of Times a day
Consistency/color/content (blood, fat, mucus) + crying/ cramps suggestive
Associated Symptoms (fever, runny nose, rash, cough, ear discharge, vomiting, rash?)
Listless baby? Lethargic, not sleeping?
Liquids not passing?
Immunization up to date?
Diet Change? Dehydration signs? Day care centre? Development milestones
Infections in family? Immunocompromised mom?
ORS counseling
Travel history recently?
Shoulder Pain: ddx
“DEFORMS”
Dislocation Elderly Abuse Fracture Osteoporosis/Osteomyelitis Rotator Cuff Injury Myositis Sac Inflammation (Bursitis) + Sprain
Knee Pain ddx
“SPORTS”
Septic Arthritis
Pseudo-gout + patello – femoral pain syndrome + psoriatic arthritis
Osteoarthritis
Rheumatoid Arthritis, Reactive Arthritis (Reiters Syndrome)
Tophi (gout), trauma (fall, elderly abuse and sports)
Sac Inflammation (bursitis)
Heel Pain ddx
“FOOT PAINS”
Fat Atrophy (age-related) + foreign body
Osteomyelitis (not common)
Osteoporosis ( not common)
Tarsal Tunnel Syndrome, Tendonitis (Achilles) + tumor
Plantar fasciitis (MCC) periostitis (calcaneum)
Apophysitis (calcaneal), arthritis (reiters, rheumatoid, reactive)
Ischemia (peripheral vasculas disease)
Nerve entrapment (jogger’s foot)
Stress fracture in athletes and spurs in bone (calcaneum)
Chest Pain hx
“CHEST P”
Cough Hemoptysis, Heartburn Emesis & Diarrhea & Edema over ankle SOB, Sweating, Syncope Temperature, Tenderness on chest (chondritis – also ask for trauma) + tenderness of legs
Palpitations – “Did you feel your heart pounding or racing?”
Impotence hx
” “LIMP P3ENIS”
Libido changes
Injury
Medications (B-Blockers)
Past/Present medical history (HTN, DM, Vascular – ex Leriche Syndrome)
Previous Prostate Sx Performance Anxiety Peyronie’s Disease Erection at all? ( Are you able to have an erection at all?) Nocturnal erection? Incontinence Stress/Depression
Dark Urine ddx
“Fellow Has DARK Pee”
Foods like beet, blackberry
Hematuria
Dehydration + Drugs like Rifampin, Vit-B
Alkaptonuria
Rhabdomyolysis
Kernicterus ( hyperbilirubinuria)
Paroxysmal Nocturnal Hemoglobinuria
Amenorrhea ddx
“P6 A5”
Pregnancy
Prolactinemia (prolactinoma/hypothyroidism)
PCOD
Pills
Perimenopausal woman (ask for hot flashes/ dry vagina)
Post-Partum hemorrhage
Anorexia nervosa Anovulatory cycles Anxiety Asherman’s syndrome Adrenal hyperfunction
Per-Vaginal Bleeding DDX
“VAGINAL BLEEDS”
Vaginal Injuries Adenomyosis + Abortion Genital Cancer Infections: PID Neoplasms (Malignant (endometrial ca) + benign (fibromas)) Abruptio placentae
Bleeding Disorders Leiomyoma’s Ectopic Pregnancy Endocrinopathies, endometriosis DUB Sores, Condylomas (after trauma)
Blood in Stool (Hematochezia) DDX
“DRAIN”
Diverticulosis (MC Reason), Drugs (warfarin)
Rectal Bleed (Piles, Fissures)
Angiodysplasis + Anal Sex
Inflammatory Bowel Disease (UC + Crohn’s), Infectious diarrhea, Ischemic Colitis + Injury
Neoplasms
