HPI (history of present illness)

Ask for : LIQOR AAA

L Location of the symptom

I Intensity of the symptom (scale 1-10, 6/10)
Q Quality of the symptom
O Onset of the symptom + precipitating factors
R Radiation of the symptom
A Associated symptoms
A Alleviating factors
A Aggravating factors

PMH (past medical history)

Search for : PAM HUGS FOSS

P Previous presence of the symptom (same chief complaint)

A Allergies
M Medicines

H Hospitalization for any illness in the past

U Urinary changes
G Gastrointestinal complains
S Sleep pattern

F Family history
O OB/GYN history
S Sexual habits
S Social life

For Social History

TADERO:

T obacco

A lcohol

Drug[Recreational]

Exercise

Routine-houselife,diet

Occupation
premenopausal symptoms

HAVOC

H- hotflahes
A-atropy of vagina
V-vaginal dryness
O- osteoporosis
C- coronary artery diseases

Depression.
SIGEMCAPS

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

fatigue

IMP ADH
I-infectin
M -malignancy
P-ptsd
A-abuse
D-depression
H-hypothyroidism

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 STDââ⠀šÂ¬Ã¢â €žÂ¢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)

OBESITY
OBESITY-DISC
Osteoarthritis
Breathing problems
Excess Cholestrol
Sleep Apnea
Increased Incidence Caââ⠀šÂ¬Ã¢â €žÂ¢s (Endomet/Breast/Colon)
Type 2 DM
hYpertension
Depression
Incontinence
Stress
Cholelithiasis/Cycle disturbances/Cardiac

Syncope/ Loss of Consciousness/Spells

CAMPUS

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

mneomonic = 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

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)

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
DENTAL CAMPUS

* Diabetic comp ( Orthostatic )

* Ear problems (Meniereââ⠀šÂ¬Ã¢â €žÂ¢s/ BPV)
* Neural tumors/Neuropathy
* Thyroid
* Anemia
* L leave me
* CAMPUS is same as is for SPELLS/LOC/SYNCOPE

Acute cough
A–>Acute Bronchitis; Aspiration
C–>Coxsackie viruses are the culprit for Pleurodynia (uncommon acute illness, which occurs
in
summer and early fall and presents with acute severe paroxysmal pain of the thorax and
abdomen that worsens with cough or breathing)
U–>URI-associated cough (acute cough frequently follows URI)
T–>oTher Pulmonary Problems: Pneumoinia (when the case is respiratory always think of
Bronchitis, Pneumonis, TB, Lung cancer); PCP pneumonia ( if the Pt has STD Hx screen for
HIV)
E–>pulmonary Embolism (check for risk factors like DVTs); pulmonary Edema (signs and
symptoms of heart failure will be present)

Headache cases
wents
weakness,warning signs{aura}
eye/ear complaints-visual changes,tears,red eyes
numbness and tingling,nausea,neck stiffness, nose-runny
trauma, thyroid
stress,similar episodes, sleep changes

git case
dct
diarrhoea, diet-appetite,wt changes, drugs
constipation,cramping pain in belly, colour of skin{jaundice},coming out of rear end
{piles}
thyroid complaints, tenesmus

cns case
nose futh g
numbness tingling
lOss of consciousness
speech changes, seizure, swallowing difficulty, stroke-past history, racing heart,chest
pain
eye or visual changes
fall
urinary incontinence
trauma,thyroid
headache
gait changes

pediatric case {phone case }

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,
C- Chest symptoms n Cold-runny nose,cough,chest painfast respirations,shortness of
breath,
U- urination-any increased or decreased urination,no. of wet diapers,any odour,colour of
urine,
D- 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

obgyn history
LMP RTV CS PAP
last menstrual period
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 ? )

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,thyroid and trauma,caffeine
intake,Concentration, Hopes, Hallucinations , Delusions

following are frm usmletomd website....

Impotence

"LIMP PENIS"
Libido changes?
Injury?
Medications Beta blockers?
Past medical history: HTN, DM, Vasc
Prostate,
performance anxiety?
Erection at all?
Nocturnal erection?
Incontinence?
Stress, Depression?
Hematochezia
"DRAIN"
Diverticulitis
Rectal bleed aka piles fissures
Angiodysplasia + anal sex
Inflammatory bowl disease
Ulcerative Colitis & Crohns,
Ischaemic colitis + injury
Neoplasm

Chest Pain
"CHEST P"
Cough?
Haemoptysis?
Emesis, diahrea, Oedema sacral or ankle?
Temp change, tender chest, tender legs?
Palpitations?

Headache
"MM..IT..ACHES"
Migraine
Meningitis
Increased ICP
Tension headache, Temporal arteritis
AV malformations
Cluster headache
Hypertension
Eye disorders
Sinusitis

Domestic violence
"SAFE GARD"
Safe at home?
Afraid of husband?
Family or friends know?
Emergency plan?
Guns at home?
Alcohol use?
Relationship with husband?
Drugs or depression?

shoulder pain
deforms

dislocation
elderly abuse
fracture
osteoporosis/osteomyelitis
rotator cuff tear
myositis
sac inflammation{bursitis}/sprain

knee pain
sports

septic arthritis/sle
pseudogout/patellofemoral syndrome/psoriatic arthritis
osteoarthritis
rheumatoid arthritis,reactive[reiters]
tophi[gout]/trauma{fall,elderly abuse,sports}
sac inflammation

memory loss
deathshaft
activities of daily living=death, instrumental activities of daily living=shaft

dressing
eating
ambulation
toiletry
housing
shopping
housekeeping
accounting
food
transportation

vaginal bleeding
vagina bleeds

vaginal injuries
adenomyosis,abortion
genital cancer
infection: pid
neoplasms
abruptio placentae
bleeding disorder
leiomyomas
ectopic pregnancy
endocrinopathies,endometriosis
dub
sores-condyloma,trauma

amenorrhoea
p6a5t

pregnancy
prolactinoma
pcod
pills
perimenopausal
pph
anorexia nervosa
anovulatory cycle
anxiety
ashermans syndrome
adrenal hyperfunction
thyroid problems

Hematuria
shitter
stone
hematologic/coag disorder
infection
trauma
tumors:renal cell,bladder,prostate
exercise-rhabdomyolysis
renal disorder-glomerulonephritis

dypareunia
dative
domestic abuse
atrophic vaginitis and s/s of menopause
tumor{pelvic}
infection-vulvovaginitis,cervicitis,endometritis,pid
vaginismus
endometriosis

IF YOU THINK YOU LIKED/DIDNT LIKE THE POST PLEASE TAKE SOME TIME AND POST A COMMENT
Posted by harshit at 1:36 PM
4 comments:

Deepali said...

Awesome work dude..........:)

May 12, 2008 7:10 PM
dr viral doshi said...

well done---good 4 those who can remember all pneumonics

May 13, 2008 5:54 PM
harshit said...
 thanks
May 16, 2008 2:12 PM
vas said...

hey thats a very good work buddy... thanx

May 17, 2008 12:02 PM

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