MNEUMONICS for CS

HPI-System based
PMH
ROS

LIQOR AAA

L-Location of symptom
I-Intensity scale 1-10
Q-Quality SBCD PP (Sharp, burning, cramping,
dull, pulsing, pressure like)
O-Onset (F,T,D)
R-Radiation does it move?
A-Associated(System based)
A-Alleviating factors
A-Aggravating factors (effort, smoking, large
meals)
PMH (past medical history)
PAM HUGS FOSS

P-PMH+Previous HPI s/s
A-Allergies
M-Meds (drugs/when/SE)
H-Hospitalization for any illness in the
past+surgeries
U-Urinary changes ( esp if diabetic,
elderly...)
G-GI complaints (diet changes, bowel
movements...)
S-Sleep pattern
FHx
O-Occupation
Female: OB/GYN history (LMP, abortions,
para...)
S-Sexual (active?partners?protection?STD?)
S-Social (WASTED DADS)

Social Hx
WASTED DADS

W-Weight(how much?how long? Intentional
A-Appetite
S-Smoke/tobacco (pk/yrs)
T-Travel
E-Exercise
D-Diet

D-Drugs
A-Alcohol-CAGE
D-Depression - SIGECAPS
S-Stress/Anxiety



ROS
Review of Systems

THE JC DFRS

T-Trauma
H-Hdche
E-Edema

J-Joint Pain
C-Chest Pain/Cough

D-Dizziness/Vision
F-Fever
R-Rash
S-SOB
Spousal abuse
SAFEGARDS

S-Safety at home?
A-Afraid of Attacker?
F-Family/Friends aware?
E-Emergency plan?
G-Gun at home?
A-Alcohol?
R-Relationship with spouse?
D-Drugs? Depression?
S-Suicidal ideation/plan?

Ob/Gyn Hx :
LMP RTV CS PAP

L- LMP !!
M- Menarche
P- Period (days?)
R- Regularity (interval)
T- Tampons/Pads # per day
V- Vaginal discharge, itching , dryness
C-Cramps (Dysmenorrhea)
S- Spotting (in btw/ post coital )
P-Pregnancy ( Hx & complications)
A- Abortion /miscarriage
P- PAP smear (when? Result?)

DIABETES Follow-up History

Diet
Insulin/oral agents
Acute complications hypo/hyper
Blood Glucose Monitoring
Exercise/activity
Toes/Foot Care/complications?
Education
Special problems psychosocial, financial

Depression SIGE 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- hotflahes
A-atropy of vagina
V-vaginal dryness
O- osteoporosis
C- coronary artery diseases
Discharge
COCAD
C-consistency
O-odor
C-color
A-amount
D-duration

DDx: Loss of Consciousness/Syncope
CAMPUS

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

DDx: Dizziness
DENTAL CAMPUS

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

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

DDx Obesity
OBESITY DISC

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

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

DDx Joint pain
SPLINTER

S-Septic, Spondyloarthropathies
P- Pseudogout/Gout
L- Lyme Dz
I- Infetion
N-Neoplasia
DDx Nasuea & Vomiting
A MOPING
Anorexia
Metabolic(DKA)/Meds
Obstruction (pyloric /Intestinal)
Pregnancy
Inflammation(Pyelo/Cholecysto/Appi/Pancr
eas/PID)
T-Truama
E-Endocarditis
R-Reiters Sy


Neurological (BETA)=
Bleed/Encephalitis/Tumor/Abscess
Gastroenteritis

Pediatric Hx

FEVER CUDS

F-Fever
E-Ear pulling
V-Vomiting
E-Ear discharge, eye discharge?
R-Rash

C-Cold n Chest-runny nose? cough? chest pain?
fast respirations? SOB?

U-Urination-any change urination? # of wet
diapers? Odor? Color?

D-Diarrhea-O/F/D? Mucus? Blood? crying
during defecation?

S-Seizure-any jerky movements? any leakage of
urine or stool during fits? any post ictal
irritability, or LOC?



Pediatric PMHx

PAM BIG DADAS FS

P-PMH,PSH
A-Allergies
M-Meds

B-Birth hx
I-Immunizations
G-Growth n development, ht, wt,
milestones.

D-Day care
A-Appetite
D-Diet
A-Appearance
S- Sleep

F -FHx
S-Sick contacts


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


DDx ABD Si
CKMG MIOR (MIOR assoc. with
Appendicitis)

C-Cullen Si- per umbilical discoloration
(retro hemorrhage pancreatits, AAA
rupture)
K-Kehr sever L shoulder pain- Splenic
rupture, ectopic preg
M-Murphys Si- Abrupt interruption of
inspiration on palp of RUQ- acute
cholecystitis
G-Gray-Turner Si, Discoloration of flank
(same as Cullen_

M-Mc Burneys Si- Tenderness 2/3 from
iliac spine to R of umbilicus
I-Iliopsoas Si, Hyperextension 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




Jaundice
JAUNDICE B

Journey overseas/Joint pain
Abdominal pain/appetite changes
Up temperature( fever)
Nausea/vomiting
Diarrhea/constipation
Itch(rash)/Immunizations
Color of urine and stool
Eating habits -weight changes
Blood transfusion in the past




Psych case
VOICES HARM MEN

V-Visual hallucinations(onset, duration,
context)
O-Open/close eyes(if patient can see
"writtings" with close and open eyes)
I-Imperative ( voices can control patient)
C-Changes in vision/ vision loss
E-Ear(audio hallucinations- onset, duration,
context)
S-Sleeping problems

H-Headache/head trauma
A-Attacking himself/others
R-Recreational drug use
M-Major changes in life

M-Mental illness in the family
E-Enjoying daily activities
N-Narcolepsy (sleepiness during the day)



CC of Memory Loss/ Dementia/ Alzheimer/
MID/CJD/ Pseudo-tumor

ADL = Activities of daily living

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
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?)


MINI MENTAL
ORArL23RWD
O-Orientation (5)-Country, state, city,
hospital, floor
R-Registration Im going to say 3
objects then they repeat
A-Attention spell world backwards, or
serial 7s 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 !, put on floor
R-Read 3 commands on this paper and do
what is says
W-Write a sentence
D-Draw, copy the image:

HPI CARDIAC/CVS

CARDIAC

C-Chest Pain-LIQORAAA
A-Ankle Swelling
R-Reduced Exercise Tolerance
D-Dyspnea/Orthopnea/PND
I-Irregular HR/Racing Heart
A-Altered Consciousness
C-Cyanosis


HPI URINARY

FINISHED PUBS

F-Frequency(How often)
I-Incontinence(any trouble holding)
N-Nocturia (wake up @ Night)
I-Incomplete
S-Stream (How is stream?)
H-Hematuria (Any color)
H-Hesitancy (waiting to start?)
D-Dysuria (Any difficulty?)
P-Pyuria (Any pus?)
U-Urgency (Any rush)
B-Burning?
S-Straining?
Insomnia counseling =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)
Counseling 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
counseling =

SPANCSTER
S-Stressor ( any stress in life/tension etc )
P-Problems ( Heart /Lung/ CA)
A-Advantages ( Improved breathing & Increased
energy)
N-Nicotine alternatives
C-Counselors ( I can refer u/ give # )
S-Support systems ( I can refer u /give #)
T-Taper down/Cold Turkey
E-Exercise Programs ( eg Swimming )
R-Rewards ( reward yourself, treat yourself with
a dinner w/ money saved)
All Neuro
NUTSHELL VEGT CHEW

N-Nausea
U-Urinary incontinence
T-Tinnitus
S-Sleep
H-Headaches
E-Eye disturbance
L-Loss of conc.
L-Light headedness

V-Vomiting
E-Ear discharge
G-Gait
T-Trips/Trauma

C-Confusion/Convulsion
H-Hearing loss
E-Ear Fullness
W-Weakness/Numbness




Obesity counseling

ABCDEF

Avoid: (Eg.Sedentary/Steroids)
Advantages: (Low Heart/Brain/Ca etc risk)
Books (self help)
Counseling/Consult/ Cholesterol checks
Dietitian
Exercise
Fatty Food (cut backs)


Mini Mental Exam :

MC LOPE


Memory
Concentration / Consciousness
Language
Object recognition / Orientation
Praxia
Executive function (abstraction / planning /
organizing / sequencing )
LOC/Syncope
PASS BLT SANDWICH
Palpitations
Aura Shaking (duration)
Spinning/ lightheaded
Bladder, incontinence
Loss of consciousness (duration)
Tongue biting
Speech difficulties
Ataxia Numbness
Difficulty breathing
Weakness
Injury (trauma) Confusion after the event
Headache

Amenorrhea
a HAG with a Very Fou(W)l Hea(I)DaChe
HAG V FWL HiDC (HAG means an old
lady) with one possible Amenorhea
symptom (Headache in Prolactinoma and
Peri-menopause )

Hair & skin changes ( for
Hypothyroidism/Hirsutism of PCOS)
/Headaches
Anorexia nervosa /Anxiety & Depresion
Galactorrhea
Visual disturbance / Virilization
Fatigue
Wt change , Appetite & Diet
Libido
Hot flashes
Insomnia
Deep voice change
Cold intolerance & Constipation
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)
Dry Mouth causes DRI

D Drugs/Dehydration

R Renal/Radiation

I Immuno(Sjorgen)/Intense emotion

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) peds 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 , sub arachemoid haemorrage, most systemic illeness
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 harmones, 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