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-Reiters 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-Muphys 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, 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 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:

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