MNEMONICS for CS.docx.doc

MNEUMONICS for CS 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

Back pain TUNA FISH Trauma Unexplained weight loss Neurological signs Age > 50 Fever Intravenous drug use Steroids for long time History of cancer

For Spousal abuse SAFEGARDS S- Safety at home? Afraid of Hubby? F- Family ? Friends aware ? E- Emergency plan? G- Gun at home? Alcohol? R- Relationship with Hubby? D- Drugs? Depression ? S-Suicidal ideation

WAD SAD TOES for social history. W-Weight A-Appetite D-Diet S-Smoke A-Alcohol D-Drugs T-Travel O-Occupation E-Exercise S-Stress

ROMSS R-REFLEXES OCULAR M MOTOR S SENSITIVITY S STRENGTH

Mnemonic for Migraine POUND Pulsatile lasts One day Unilateral Nausea interfere with Daily activities

Depression – SIGEM CAPS S: sleep ( how many hour, nightmares, flashbacks, etc) I: interest, Do you enjoy what you do? G: Guilty/ angry E: Energy C: concentration A: appetite, changes in your weight P: psychomotor agitation/retardation S: suicide , plan , attempts

HAVOC premenopausal symptoms H- hot flashes A-atrophy of vagina

FOR all Discharges.... including Diarrhoea,Cough ACCOD

V-vaginal dryness O- osteoporosis C- coronary artery diseases

A-amount C -consistency C- color O- odor D- duration

DDx: / Loss of Consciousness/Spells CAMPUS

DDx: Dizziness DENTAL CAMPUS

C-CAD A-Arrythmias/ Aortic Stenosis M-Migraine/ Meds P-Psychiatric /Personality disorder( hyperventilation) U-Unexplained Syncope S-eizures/Strokes

D-Diabetic comp ( Orthostatic ) E-Ear problems (Meniere's/ BPV) N-Neural tumors/Neuropathy T-Thyroid A-Anemia L-Leaves me C-CAMPUS

DDx Confusion DEMENTIA

DDx Obesity OBESITY DISC

D-Diabetes /Dementia/ Drugs E-Epilepsy M-Migraine/Multi Infarct Dementia E-Ethanol (withdrawal / Toxicity) N-Neurological Deficit diseases= BETA (Bleeds,Encephalitis,Tumors,Abscess,Mening itis) T-TIA/ Trauma I-Insulin/ Infections A-Alzheimers/Abscess

O-Osteoarthritis B-Breathing problems E-Excess Cholesterol S-Sleep Apnea I-Increased Incidence Ca's (Endomet/Breast/Colon) T-Type 2 DM Y- hypertension

DDx Joint pain SPLINTER

DDx Nasuea & Vomiting A MOPING

S-Septic, Spondyloarthropathies P- Pseudogout/Gout L- Lyme Dse I- Infection N-Neoplasia T-Trauma E-Endocarditis R-Reiter’s Sy

Anorexia Metabolic( DKA)/Meds Obstruction (pyloric /Intestinal) Pregnancy Inflammation( Pyelo/Cholecysto/Appen/ Pancreas/PID) Neurological (BETA)= Bleed/Encephalitis/Tumor/Abscess Gastroenteritis

D-Depression I-Incontinence S-Stress C-Cholelithiasis/Cycle disturbances/Cardiac

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...) SBCD PP (Sharp, burning, cramping, dull, pulsing, pressure like) 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) 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.....)

DDx GI Bleed A-Angiodysplasia B-Bowel Habits C-Constipation D-Diarrhoea E-Esophagus (varicies, CA) Epistaxis F-Fistula (anal) G-Gastritis Hx H- Hemorrhoids I-IBD, Irritable bowel, Infectious Diarrhea

Dx ABD Si CKMG MIOR (MIOR assoc. with Appendicitis) C-Cullen Si- peri-umbilical discoloration (rectal hemorrhage –pancreatits, AAA rupture) K-Kehr –severe L shoulder pain- Splenic rupture, ectopic preg M-Muphy’s Si- Abrupt interruption of inspiration on palp of RUQ- acute cholecystitis G-Gray-Turner Si, Discoloration of flank (same as Cullen_ M-Mc Burney’s Si- Tenderness 2/3 from iliac spine to R of umbilicus I-Iliopsoas Si, Hyperextention of R hip Cx ABD pain

O-Obturator- Internal rotation of flexed R hip Cx ABD pain R-Rovsing Si- RLQ pain upon palpation of LLQ ObGyn Hx : LMP RTV CS PAP

Psych Hx ABC STAMP LICKER

L- LMP !! M- Menarche P- Period ( lasts .... days?) R- Regularity ( every .... wks?) T- Tampons/Pads # per day V- Vaginal DID: discharge, itching , dryness C-Cramps (Dysmenorrhea) S- Spotting ( intermenstrual / post coital ) P-Pregnancy ( Hx & complications) A- Abortion /miscarriage P- PAP smear ( last time result ?, Hx of past abnormal result ? )

A-Appearance B-Behavior C-Cooperation

CC of Memory Loss/Dementia/Alzheimers/MID/Creutzfiel dt jakob/Pseudotumor HPI Particulars to ask ADL = Activities of daily living DEATH SHAFT

MINI MENTAL ORArL23RWD O-Orientation (5)-Country, state, city, hospital, floor R-Registration “I’m going to say 3 objects”… then they repeat A-Attention “spell world backwards, or serial 7’s from 100” (5) r-Recall what were those 3 items again? (3) L-Language “Repeat after me.. “No, ifs, ands, or buts” (1) 2- Identify two objects “what is this.. pen.. and this… paper” 3- Obey 3 commands, “take a piece of paper, fold in ½, put on floor” R-“Read 3 commands on this paper and do what is says” W-Write a sentence D-Draw, copy the image:

DEATH D-Dressing E-Eating A-Ambulation (can you find your way thru home) T-Toiletry (do you manage your toiletry un assisted) H-Housing IADL - Instrumental activities of daily living SHAFT S-Shopping

S-Speech T-Thought (process, content) A-Affect M-Mood P-Perception (AH/VH) L-Level of consciousness X3(person place time) I-Insight C-Cognition K-Knowledge fund/base E-Endings (suicidal, homicidal) R-Reliability

H-Housekeeping? unsure about that A-Accounting F-Food (do u do your cooking ,etc) T-Transportation (do you drive? How is your sight, hearing?) Pain history checklist

For Social History I use TIA SHOE:

CLITORIS:

T obacco

Character Location Intensity Timing Onset Radiating Irritating and relieving factors Symptoms associated

I llicit drugs A lcohol S exual H ouse life O ccupation

E ating (diet) Insomnia counseling =ABCDEFGHJKLMN Counseling DM & HTN= MEDOWS Avoid Medications (regularity) Bedtime Exercise ( for obese/sedentary life Concerns (worries) styles) Drugs (nicotine/caffeine/Alcohol) Diet Modification( Salt/Fatty foods) Exercise/Excitement (TV Shows) Opthalmoscopic exams (annual routine) Follow Weight Management (/control) Good Sugar Check ups Habits for sleep. Jetlag Keep List (Diary) Monitor Naps (day time) Smoking Cessation counseling = All Neuro Imagine an old guy who got SPANCSTER hit on the head , lost his memory and is Stressor ( any stress in life/tension etc ) looking for his imaginary girl friend who Problems ( Heart /Lung/ CA) is thin and cute and he's making a video Advantages ( Improved breathing & Increased of her ! and he asks you : energy) HaVe yoU SaW my Cute THiN GirLL Nicotine Patch ( I can offer you reading FFriend ViDeo ? materials ) Counselors ( I can refer u/ give # ) HV U SW C THN GLL FF VD ? Support systems ( I can refer u /give #) Headaches Taper down ( if u cant do cold turkey den just Visual disturbance taper down a bit) Urinary incontinence

Exercise Programs ( eg Swimming ) Rewards ( reward yourself, treat yourself with a dinner 4m money saved off of quitting)

Sleep disturbance Weakness/Numbness Confusion/Convulsion Tinnitus Hearing loss Nausia Gait Loss of conc. Light headedness Falls/trauma Fullness of ears Vomiting Discharge , Ear

Obesity counseling ABCDEF

And to make sure you got it completely don't forget the Mini Mental State Exam :

Avoid Advice (Eg.Sedentary/Steroids) /Advantages Advice (Low Heart/Brain/Ca etc risk)

MC LOPE ( this is the girls name !! the one who that confused guy is looking for !!! )

Books (self help reading material)

Memory Concentration / Consciousness Language Object recognition / Orientation Praxia Executive function (abstraction / planning / organizing / sequencing )

Counseling/Consult/ Cholesterol checks Dietitian Exercise Fatty Food (cut backs) ObGyn Hx :: LMP RTV CS PAP 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 ? )

Amenorrhea .. a HAG with a Very Fou(W)l Hea(I)DaChe HAG V FWL HiDC ( i know it's kinda lame , but it's the best i could come up with to remind me of a Gyn case (HAG means an old lady) with one possible Amenorhea symptom (Headache in Prolactinoma and Perimenopause ) Hair & skin changes ( for Hypothyroidism/Hirsutism of PCOS) /Headaches Anorexia nervosa /Anxiety & Depresion Galactorrhea Visual disturbance / Virilization Fatigue

Skin review of systems which aReNT SIMMBEL

Wt change , Appetite & Diet Libido Hot flushes insomnia Deep voice change Cold intolerance & Constipation Dry Mouth causes DRI D Drugs/Dehydration

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

R Renal/Radiation I Immuno(Sjorgen)/Intense emotion

S (sensation) I (itching) M (masses) M (moles) B (bleeding/bruises) E (edema) L (lesions) 2) BINDER ( birth history, immunization history, nutrition, growth and development, eating, rash) STD / HIV COUNCLING (strip bimbo) ( safe sex practices, transmissions, risks , immunizations, prevention counseling, behavior counseling, interventional counseling, medication , barrier methods, opportunistic infections) general physical PICKLE pallor , icterus , cyanosis ., koilonychias, lymphadenopathy , edema 37) paeds history BJM CHILDREN birth history , jaundice( neonatal) milestones, crying, check up , headache, immunization, lethargy , day care, rash, eye, ear, nose , nutrition 38 ) headache MM IT ACHES migraine , meningititis , inreased intracranial pressure, tension headache, tension headache, temporal arthritis, av malformation cluster headache, hypertension , eye disorder ( refacratory error + glaucoma) sinusitits , subarachnoid hemorrhage, most systemic illness 39) sore throat ( SORE THROAT WAS BAD)Swallowing food was painful , origin duration progression , Runny nose , Ear problems , Temp chills , headache, resp symptoms ( cough, shortness of breath, chest pain ) occupation , aspiration + abdominal symptoms ( nausea , vomiting , pain ( esp LUQ) tiredness ( fatigue) touch with ill people ( boy friend or girl friend) weight loss , appetite , alcohol, smoking / sleep changes sexual historybowel habits , anything else that u want to tell me , Drugs ( IV) 40) throat throat culture , IV antibody and viral titer rapid strep antigen , monospot test, anti EBV anti body , rouTine tests ( cbc , peripheral smear) 41) d/d of cough PLUERAL CAP Pneumonia , lung cancer , exacerbation of COPD , URI , reactive airway disease, abscess , lymphoma , CHF , asthma, post nasal drip 42) knee pains SP3ORTS septic arthritis, pseudogout , patello femoral syndrome, psoriatic arthritis, osteoarthritis, rheumatoid arthritis, reactive arthritis, tophi , trauma , sac imflammation ( bursitis) septic arthritis 43) foot pain FOOT PAINS Fat atrophy ( age related) + foreign body , osteomyelitis , osteoporosis, tarsal tunnel syndrome , tendonitis, tumor, plantar facitis , periostitis, apophysitis , arthritis ( rheumatoid , reactive,) ischemic ( peripheral vascular disease) , nerver entrapment , stress fracture in athletes and spur in bones

44) chest pain CHEST –P cough , hemoptysis, heart burn, emesis (vomiting ) diarrhea and edema over ankles, temperature , tenderness over ankles tenderness over legs , also trauma , Palpitation 45) impotence LIMP PENIS libido change , injury , medication ( beta blocker) past/ present medical history ( htn , diabetes , vascular , leriche) previous prostate surgery , performance anxiety, peryonie disease, erection at all , nocturnal erection , incontinence, stress/ depression 46) d/d impotence DOC MP DG UP Depression , alcohol , claudication ( leriche syndrome) medication , pressure (HBP) , mellitus gonads ( hypogonadism) , unknown etiology ED, prostate surgery Drug stoping erection STOP erectionSsri , thioridazine , methydopa, propanalol 47) d/d pv bleeds A PV BLEEDS Abortion + adenomyosis, PID+ PCOD, vaginal bleeds, bleeding diasthesis, leiomyoma , ectopic pregnancy, endometriosis, endocrine causes, DUB ( anovulatory cycle) uduration , dysparunia, dysuria, itch , smell , color, high fever, abdominal pain , recurrent episodes, general health and symptoms , endocervical swabs 49) AMENORRHEA CAUSES AMENORRHEA Pregnancy, absent ovulation, menopause, eating disorder, nursing mother, OCP, raised prolactin , raised adrenal hormones, hypothyroidism, hemorrhage, E_? , anxiety , asherman etc 50 ) depression case patient note I AM SAD Insight , appearance, mood , MMSE, suicidal intent , speech, affect, delusion , hallucination 51) depressed mood dd BAD MUDS Bereavement , bipolar 1 and bipolar 2 disease, adjustment disease , mood disease, dysthemic disease, major depression, menopause, underlying medical condition , drug related ( cocaine , amphetamine) schizophrenia 52) dark urine HITTERS Hematologic / coagulation disorders, infection , cystitis, trauma , tumors, exercise, renal disorder, stones 53) blood in the stool DRAIN diverticulosis , drugs ( warfarin ) rectal bleeds ( piles , fissures) angiodysplasia , anal sex, inflammatory bowel disease, infectious diarrhea, ischemic colitis , injury , neoplasms