Most Important Mnemonics for Step 2 Cs

HISTORY & PHYSICAL trial run HPI ( explanation of present illness) ALL CASES OPD CSF AAA PAIN OPD CSF LIQR AAA OPD CSF ABCDO FLUIDS ( vomit up, profligacy, constipation, cough, vaginal discharge) O Onset of the symptom + precipitating factors P Progression D distance C immutable /Intermittent S Settings F Frequency L Location of the symptom (forehead, wrist ) I Intensity of the symptom (scale 1-10, 6/10) Q Quality of symptom..BCDSPP(burning,Cramping,dull,Sharp,pulsating,pressure resembling) 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, handsome meals) A Amount B Blood C Color C Consistency C Content D Duration O aroma UG Hx OPD-CSF-AAA + FINISH PUBC F Frequency (How frequent do u squander to pass piss? ) I Incontinence (Do u get distressingness in the ass holding Ux until u get to BR? ) N Nocturia ( do u have 2 wake up Night to go to BR? I Incomp permite emptying (do u nip richness even aft(prenominal) Ux) S Stream (How is ur flow of urine? is it cont. or is there all(prenominal) dribbling after Ux? ) Strain (Do u have to strain during Ux) Stone (have u passed stones in the past? ) H haematuria (did u notice any cable), Hesitancy (do u have 2 wait b4 starting Ux) P Pyuria (was there any pus in ur Ux? ) U Urgency (do u have 2 rush to BR to Ux? ) B Burning (dysuria) (does it burn) C COLOR 1 emailprotected com PMH (past medical history) PAM HUGS FOSS P Previous presence of the symptom (same CC), Past Medical troubles (BP, BS,U , idney prob. Rhinitis,Sinusitis, sthma,) A Allergies ( doses, foods, chemicals, distribute ) M Medicines (R U taking any prescription medications/any nonprescription(prenominal) med. ), H Hospitalization for any illness in the past (Trauma, surgery) U Urinary changes ( esp if diabetic, elderly ) G Gastrointestinal complains (diet changes, bowel movement s ) S Sleep pattern(difficulties tumbleing/maintain asleep,wake up,snoring,med. to supporter sleep, how many hour, nightm ares) F Family history (similar chief complaints/serious illness)/ Fal officess, Chills/ Fatigue O OB/GYN history (LMP, abortions, conservation of parity LMP RTV CS titty S fireual habits (active/preferences/STD/no. of partners/contraception/ pregnancy/ make it pap smear) Q 1. Mr. John, Are you Sexually Active? Q 2. How Many Partners are you active with? Q 3. Are your partners male or female or both? Unless the SP says wife or hubby in Q 2 Q 4. Do you social function justification during intercourse? Q 5. If yes in Q. 4 What kind of protection do you use? Q 6. Ask about anal intercourse in male homosexuals Q 7. h/o STDs Rx for STDs S Social Hx (job/house/smoking/ inebriant/ unskilled drugs/.. ) WAD SAD TOES Social Hx WAD SAD TOESW Weight A Appetite D Diet S Smoke (cigarettes, marijuana, how much, how many years) A Alcohol (what type of alcohol, how often, how much ,consider doing CAGE question. ) D recreational Drugs (what drug, how do you use it, any IV drug use? ) T croak /Trauma O Occupation (what do you do for victuals? ) E Exercise S Stress HEADACHE OPD CSF LIQRAA + DIAGRAM Head combat injury/Seizure/Weak,Numb Tears / visual changes Flu Vomit/ Speech recognize stiffness 2 emailprotected com Ped Hx (Child with fever) CUB FEVERS + PAM IF BIG DEALS-T C Colds-runny nose,cough,chest pain, fast respirations,SOB-CRYhow is promulgate of baby? U Urination-increased or decreased urination, of diapers, any odour, colour of urine Ulcers in mouth B gut changes Diarrhea-frequency, barrage, mucus/pus/blood in stool, any crying during defecation Discharge Qs (ABCD-O Amount, Blood, Content, Consistency, Color, Constant/Intermittent, Duration, Odor/Onset) F Fever & chills E Ear pulling V Vomiting E Ear/eye discharge, Ear hearing, Eye mint R flower S Seizure-any jerky movements, which part of body? whatever leakage of urine or st ool during fits, and postictal irritability or loss of consciousness. Stress (bet wet, DM) P Past medical/Past functional Hx / Previous Hospitalizations.A Allergies, effect on child/parents (bet wet, DM), Activities M Medications, Menstruating (female child 10yo) I Ill contacts F family history B Birth Hx I Immunizations G Growth n development, ht, wt, milestones SSC-WTD S(1), S(6),C(9),W(12),T(15), D(30) smile, sit, crawl, walk, talk, dress wks 1,6,9,12,15,30 D Day care / unwieldy swallowing E Eating habits, feeding of baby A Appetite L Look of the baby or appearance, Last check-up S Sleep T Travel recently Premenopause H Hot flashes A Atrophy of vagina D Dryness of vagina O Osteoporosis (council) C Coronary artery disease HADOC emailprotected com ObGyn Hx LMP RTV CS PAP L LMP (when was ur LMP? ) M Menarchae (how old were u when u had ur beginning(a) period? P Period (how many days ur period last? ) R Reglarity ( R ur periods regular? ) T Tampoons (how many pads do u use in a heavy day? ) V vaginal DID discharge, itching , dryness (have u ever had any vag discharge? ABCDO. do u have any vag. Itching? ) C Cramps (Dysmenorrhea) do u have abd cramp with ur period? S Spotting ( intermenstrual / post copulatory ) have u ever bled (. ) ur cycles?Did u ever notice any bleeding after intercourse? P Pregnency ( Hx & complications) have u ever been pregnant? How many times? A Abortion/miscarriage (Any miscarriages or abortions? In ? month of ur pregnancy? ) P PAP smear(have u been get regular PAP sm ? when did u have the last PAP sm ) (any Female50 yo have about1-R u taking vit D & Ca,2-have u ever tried HRT? ) If suspect abuse SAFE GARDS S Safety inquiry (Do you feel safe at home? ), Sex ever forced? A Alcohol abuse (does your hubby abuses alchol? ), Attacked Children?F Friends/Family who are aware( Dos any1 f ur friend/Fam know of this) Fractures (Abuse ever resulted in fractures? ) E Emergency plan (u have emergency plan? ), ever tried to leave/divorce? why not? G Guns at home (are there any weapons home? Attacked with it? ) A Afraid of husband R Relationships with husband (how is ur relationship with husband? do you feel imperil when he is around? For how long? D Depression (lost wt/appetite/sleep), Drugs (does husband use recreational drugs) S Suicidal (idea/plan/attempt) (ever felt like ending it all up? ) 4 emailprotected com Diabetic pt FU/Med fill again D Duration of disease I Insulin government/ oral hypoglyemics regimen A A1c hg - Gluc. monitoring (fast, home, HgA1c) B Blurry vision (retinopathy) E Extremity (foot ulcer/infection T Tingling/numbness (neuropathy) I Infections (resp/urinary) C Cardio Risk Factors (HTN, CHOL, Heart disease) Counseling DM & HTN M Medications (regularity) E Exercise ( for obese/sedentary life styles) D Diet Modification( salinity/Fatty foods) O Opthalmoscopic exams (annual routine) W Weight Management (/control) S moolah Check upsDIABETIC MEDOWS Neuro cases LOC P Palpitations A Aura b4 hassle S vibration (duration) S Spinning/ lightheaded B Bladder incontinence / Bowel incontinence L Loss of consciousness (duration) T Tongue blistering/ tinnitus & hearing loss S Speech difficulties/ Sleep disturbance A Ataxia gait N Numbness/nausea & vomit D Difficulty breathing W helplessness I Injury (trauma) & fall C wonder after the event / Visual disturbance H fear PASS BLT SANDWICH -And to make sure you got it altogether dont forget the MinMental Stat.Exam 5 emailprotected com MINI MENTAL O Orientation X3 time, place, persons R Registration Im going to say 3 objects because repeat A Attention spell world backwards R Recall what were those 3 items again? L Language Repeat after me.. No, ifs, ands, or buts 2 Identify two objects what is this.. pen.. and this make-up 3 result 3 commands take a piece of paper, fold in ? , place on floor R Read 3 commands on this paper and do what it says W Write a sentence D Draw, simulate the image ORARL23RWDForgetfulness/ Memory Loss / D ementia/ Alzheimers FORGETS HIM + DEATH prick F FAINTING / Flashes/ FHx of Alzheimer 0 ORTHOSTATIC HYPOTENSION R RUNNING URINE incontinency G GAIT E EYEVISION T TRAUMA, TINGLING S STRENGTH,SEIZURES H HEADACHE I INFECTION SYPHILIS, MENINGITIS M MOOD ADL Activities of daily living D Dressing E Eating A Ambulation (can you find your way thru home) T Toiletry (do you manage your toiletry unassisted) H Hygiene IADL instrumental activities of daily living S Shopping H Housekeeping A Accounting F Food prep (do u do your readiness ) T Transportation (do you drive? How is your sight, hearing? 6 emailprotected com Foot / firedog / Knee / Back pain OPD-CSF-LIQORAAA +WET SURF-D -CIS W Work /Weakness / Walking habits /Wt loss E Eye infection redness T Trauma to foot /Tingling& Numbness / Tender S Stifness in other joints/leg Swelling /long Standing hours/morning mud/sound U Urethral discharge /ulcer R Rash/ Redness of skin of joint F Fever & chills& night worn spot D Deformity / Dysurea IN CASE OF BACK PAIN attention deficit dis secern CIS Cancer Hx /IV DRUGS/ Steroids 4 long time Depression (Psychiatric Hx Checklist) SIGME CAPS DHAT +2 (+MMSE ORAL23RWD) S Sleep (difficulties falling/maintain asleep, wake up, snoring, med. o help sleep, how many hours, nightmares), Stress, Support I Interest, What do you do in your impoverished time? How are you doing in your job? do you enjoy what you do? G Guilty M Mood. ( anxious, sad, hopeless, lonely? Memory problems E susceptibility C Concentration A Appetite, changes in your Weight P psychomotor agitation/retardation (do you feel easily agitated or gaga/do u feel not to do anything? ) S suicide thoughts, plan, attempts(do u have pills/guns home? D Delusions/Drugs H Hallucinations/Hopes A stance towards life (positive negative frame of mind) T Thyroid dysfunctions (ABCD HV for HYPOTHYROID) also fill to ask Do u realize that u have problem ? Do u want help? ( if unhurried was sent or asked by anyone to consult doc ) HYPOTHYROID APPETITE BOWEL-constipation COLD INTOLERANCE first HAIR FALL VOICE-Hoarseness 7 emailprotected com ABCD HV earreach loss P smart D Discharge F FB I Imbalance N perturbation R Ringing S Spinning T Trauma Dx ABD Signs PDF IN RST CKMG MIOR (MIOR assoc. ith Appendicitis) C Cullen $- periumbilical discoloration (Retroperitoneal He,pancreatitis, AAA rupture) K Kehr $ sever Lt. Shoulder pain- prickly rupture, ectopic pregnancy M Muphys $- Abrupt interruption of ingestion on palp of RUQ- acute cholecystitis G Gray-Turner $, Discoloration of flank (same as Cullen $) M Mc Burneys $- Tenderness 2/3 from ASIS to Rt of umbilicus I Iliopsoas $, Hyperextention of R hip Cx ABD pain O Obturator $- Internal rotary motion of flexed R hip Cx ABD pain R Rovsing $- RLQ pain upon palpation of LLQ DDNasuea & Vomiting A Anorexia M Metabolic( DKA)/Meds O Obstruction (pyloric /Intestinal) P maternalism I Inflammation( Pyelo/Cholecysto/Appi/Pancreas/PID) N Neurological (BETA)= Bleed/Enceph alitis/Tumor/Abscess G Gastroenteritis A MOPING 8 emailprotected com Cranial Nerves 2 oculus 3 4 6 5 7 Oculomotor trochlear nerve Abducent Trigeminal -Test visual acuity -Test pupillary reflexes (direct) -Test accommodation reflexes - prise pupillary reactions to light -Assess corneal reflection -Perform H-test for EOM -Sensory close eyes,touch face where? Motor Assess dominance of muscles of masticationbite down and sense masseter Ask patient to -smile -wrinkle forehead, -blow out cheeks -close eyes -whisper, -Weber -Rinne tests Assess movements of the soft palate swallow and palpate be intimate Assess strength of trapezius & sternocleidomastoid muscles -shrug shoulders up -move neck to side against resistance Ask patient to protrude tongue (assess for fasciculation, shrivel up & Deviations) -stick your tongue up -move it side to side facial 8 Vestibulocochlear 10 vagus 11 accessory 12 hypoglossal 9 emailprotected com Mr. ? broad(a) morning Mr. , I am Dr. Khalil, an attendi ng physician in this hospital. brace HANDS First Ill ask u few Qs. and do brief physical exam. Mean spell if u have any Qs, feel free to ask me, ok? Let me make u more(prenominal) comfortable DRAP PT. Ill be sitting & writing some notes while were talking, is that ok? THANK U. Please tell me what brought u in today Mr. ? .. I. C. , can u tell me more about .. c. c. Mr. Id like to ask u few Qs. about ur health in the past, is that ok? Mr. now Id like to ask u few Qs. bout ur habits, is that ok? Now Id like to ask u few personal Qs. I gibe u that all info. Will be kept confed. ok? Now, let me ask u few Qs. about health of your family members, ok? Does any body in ur family have any med. Conditions? Mr. thank u. I am done e history, let me summarize for it, As u mentioned, u have .. Do u have any Qs. for me? Mr. Now I need to examine u. may I proceed? But world-class let me wash my hands. Ok? Mr. Thank u for ur cooperation. I am done e phys. Exam let me give my impression. Ba sed on ur Hx & my PE, it seems that u might have.. ut it could be something else/ or, so to arrive at right D, I ll run some tests & order imaging studies such as .. once Ive result well fit out again discuss various ttt. Options. Do u have any Qs. for me? SHAKE HANDS & LEAVE ROOM 10 emailprotected com HISTORY HPI OB/GYN LMP, regular periods every.. Weeks ,lasting.. Days. Menarche at age Uncomplicated NSVD at all-inclusive term.. Years ago. ROS negative except as above. Allergies NKDA Medications none PMH PSH SH smoke /alcohol / illicit drugs/sex / job /exercise FH noncontributory PHYSICAL EXAM patient role is in no acute distress OR looks .. anxious,tired, ) ( The source of cultivation is the patients mother. the mother of a . -month/year-old female/male c/o her child having .. ) VS WNL (except for temp. Of ) HEENT NC/AT, PERRLA, no conjunctival pallor. No fundoscopic abnormalities. Nose,mouth and pharynx WNL fuck Supple, No LAD, thyroid normal, no carotid bruits. pectus no t enderness, lighten breath sounds bilaterally. Heart RRR, normal S1/S2, no murmurs, rubs or gallops Abdomen soft, non-tender, non-distended, +BS, no guarding, no hepatosplenomegally Extremities no edema, normal DTR in lower extremities Skin no rash NeuroMMSE AOx3, spells backward, recalls 3 objects, Cranial nerves 2-12 grossly intact, Motor strength 5/5 throughout -sensory intact to soft touch and pinprick, DTR stellate 2+ in all extremities (or lower extremities), Babinski bilateral, Gait normal, Cerebellar Romberg, quick alternating movement and heel to chin test normal and stellate 11 emailprotected com UWShort UWLong 1 16-31-37 2 1-13-1925-35-39 24 25 4-5-1822-24 29 15 28 20 21-40 12 7 43 10 FA copious 19 1-2 38 6 3 FA Mini CASE 23-24 piddle problem Alcoholism 19 Abd pain Heel pain Chest pain 13 8 31 5 6 7 4 6-26 10 38 42 34 11 UL pain 31 Shoulder pain 21 Knee pain 27 32 Back pain 37 Calf pain Vomiting liberal 18 Vomiting child-TEL 7-8 33 Fever child 5-28 20-22 Diarrhea Rectal bleeding Constipation 9 Night sweat 21 Hemoptysis 9-10-40 12 Chronic cough 15-16-17 8 Fatigue 15 Wt loss 16 Wt gain 17 dysphagia 18 1 Headache 3 Depression 4 psychosis Anxiety Seizure new onset Amenorrhea Menopause 25 26 Menstrual problems 26 vaginal discharge 12 emailprotected com 12 23 13 30 9 33 14 16 17 18 19 20 21 22 23 12 36 13 27 23 6 2 22 41 30 36 41 3 17 32 34 14 11 39 30 14 15 30 10 5 7 6 27 28 14 8 32 27 29 11 2 emailprotected com 35 33 26 31 4 29 29 11 25 34 Forgetfulness Frequent falls DM New DM drug replenish BA drug refill HTN drug refill HIV drug refill Vaginal bleeding Obesity Spells LOC Terminal cancer Confusion Tremors Pre-employment Domestic violence Sexual assault Insomnia Dizziness Numbness-weakness Jaundice adult Jaundice Neonate Enuresis Palpitations SOB Smoking cessation Hallucinations +ve motherhood test Pain with sex MVA Sore throat Difficult swallowing Hearing loss Blurred vision Erectile dysfunction Behavioral problem child Skin rash 3 FA cases G IT Trauma Resp Cardio Ped Neuro Endo Psych renal ObGyn Pain DM/HTN Jaundice Fever Fatigue 1-2-5-11 3-21-27-31-37-38 4-9-10-41 6-20 7-8-28-30-36-39-40 12-14-18-22-23-29 13-24 15-16-17-34-35 19 25-26-32-33 FA cases 1-2-3-21-38-6-27-37 13-20-36 11-39 7-8 15-16-17 14 emailprotected com