Mnemonics for USMLE Step 2 CS cases

August 13, 2007 | By admin In Usmle |

HPI (history of present illness)
Ask for: 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…)
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)
Search for: 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…..)

Pain history checklist

CLITORIS:

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

Differential diagnosis checklist

DIRECTION:

Drugs
Infection
Rheumatologic
Endocrine
Cardiovascular
Trauma
Inflammatory
Other
Neoplasm

For Social History TIA SHOE:

T obacco

I llicit drigs

A lcohol

S exual

H ouse life

O ccupation

E ating (diet)

————-

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 STD’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 Ca’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

Pneumonic = 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

D/D = BACK PAIN

Pneumonic = LIMCOTS