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Mnemonics for USMLE Step 2 CS cases

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HPI (history of present illness)

Ask for: LIQOR AAA

Code:

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

Code:

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

mnemonic:

CLITORIS:

Code:

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

Differential diagnosis checklist

mnemonic:

DIRECTION:

Code:

Drugs
Infection
Rheumatologic
Endocrine
Cardiovascular
Trauma
Inflammatory
Other
Neoplasm

For Social History

mnemonic:

TIA SHOE

Code:

T obacco

I llicit drigs

A lcohol

S exual

H ouse life

O ccupation

E ating (diet)

premenopausal symptoms

mnemonic:

HAVOC

Code:

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

Depression.

mnemonic:

SIGEMCAPS

Code:

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

Fatigue…

mnemonic:

IMP ADH

Code:

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

Insomnia counselling

mnemonic=

ABCDEFGHJKLMN

Code:

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

mnemonic=

SMILE SAM

Code:

Supportive (of the child)
Monitor Intake (@ Day)
Limit (@ Night)
Encourage Washroom( @ bedtime)
Sheets ( Rubber flannel sheets)
Alarms ( >5yrs )
Motivate (thru Rewards)

Conselling DM & HTN

mnemonic=

MEDOWS

Code:

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

mnemonic=

SPANCSTER

Code:

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)
Exercise Programs ( eg Swimming )
Rewards ( reward urself, treat urself with a dinner 4m money saved off of quitting)

STD / HIV Counselling

mnemonic:

STRIP BIMBO !

Code:

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

mnemonic:

FINISHED PUBS

Code:

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 before 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

mnemonic:

OBESITY-DISC

Code:

Osteoarthritis
Breathing problems
Excess Cholesterol
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

mnemonic:

CAMPUS

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

D/D Confusion

mnemonic =

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

mnemonic =

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

mnemonic=

A MOPING

  • Anorexia
  • Metabolic( DKA)/Meds
  • Obstruction (pyloric /Intestinal)
  • Pregnancy
  • Inflammation( Pyelo/Cholecysto/Appi/Pancreas/PID)
  • Neurological (BETA)= Bleed/Encephalitis/Tumor/Abscess
  • Gastroenteritis

Dizziness

mnemonic:

DENTAL CAMPUS

  • Diabetic comp ( Orthostatic )
  • Ear problems (Meniere’s/ BPV)
  • Neural tumors/Neuropathy
  • Thyroid
  • Anemia
  • L leave me
  • CAMPUS is same as is for SPELLS/LOC/SYNCOPE

Mnemonic for orderly HOPI questions

mnemonic=

ABCDF- SIQOR AA ROS

  • Appear/Begin=Duration
  • Context= Precipitation (wht were u doin b4, during ?Anythin different?)
  • Development = Progression (sudden / progressive, Any changes overtime)
  • Frequency= persistent/intermittent ( how often/how long)
  • Site
  • Intensity= 0-10/10
  • Quality = character
  • Other sympt = ROS
  • Radiation= move
  • Aggravation
  • Alleviation
  • ROS

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