Step 2 CS

MY MNEMONICS

      This is a compilation of different mnemonics I obtained from different blogs and forums.  It helped me tremendously in preparing for my Step 2CS...

NEURO:

M- mental status

C-cranial nerves

M- motor

C-coordiantion/gait

           

R- reflexes

S- sensory

S- special tests

For general exam: follow PICKLE

Pallor

Icterus

Cyanosis

Clubbing

Koilonychia

Lymphadenopathy

Edema of the feet

Sore Throat Case:

S- swallowing food is painful

O- origin, duration, progression

R- runny nose

E-ear problems

T- temperature/chills

H- headache

R- resp. symptoms, cough, SOB, chest pains

O- occupation

A-spiration, nausea and vomiting

T- tiredness/fatigue, Touch with ill people

Diagnostic tests: THROAT

T- throat culture

H- HIV antibody testing and viral load

R- rapid streptococcal antigen test

O- monOspot test

A-Anti-EBV antibody test

T- routine Tests: CBC, peripheral smear

Cough:

P- pneumonia (atypical/typical)

L- lung cancer

E-exacerbation of COPD (bronchitis)

U- URI

R- reactive airway disease

A-abscess

L-Lymphoma

C-CHF

A-asthma

P- postnasal drip

Shoulder Pain:   DEFORMS

D-dislocation

E-elderly abuse

F-fracture

O-osteoporosis/osteomyelitis

 R-rotator cuff injury

M-myositis

 S-sac inflammation (bursitis) + sprain

Knee Pain:

S-septic arhritis

P-pseudogout, patella-femoral pain syndrome, psoriatic arthritis

O-osteoarthritis

R-rheumatoid arthritis, reactive arthritis

T-tophi (gout), trauma (fall, elderly abuse, sports)

S-sac inflammation (bursitis)

Chest Pain: LIQOR AAA CHEST PAIN

C-cough, cocaine

H-hemoptysis, heart burns

E-emesis, diarrhea, edema (ankle)

S-SOB, sweating, syncope, sense of impending doom

T-temperature (fever), tenderness in the chest, tenderness of the legs, trauma

P-palpitaions/positional (pericarditis) relieved by leaning forward?lying?

Impotence:

L-libido changes

I-injury

M-medications

P-past/present medical history DM, HTN

P-previous prostate symptoms

P-performance anxiety

P-peyronie’s disease

E-erection at all (are you able to have an erection at all?)

N-nocturnal erection

I-incontinence

S-stress/depression

Vaginal Bleeding:

A-abortion and adenomyosis

P-PID and PCOS

V-vaginal injuries

B-bleeding diathesis

L-leiomyomas (uterine fibroids)

E-ectopic pregnancy

E-endometriosis, endocrine cases (thryroid, prolactin), endometrial hyperplasia/cancer

D-DUB (anovulatory cycle)

Vaginal discharge:

D-duration, dyspareunia, dysuria

I-itch (vaginal itching)

S-smell

C-color

H-high fever

A-abdominal pain

R-recurrent episodes

G-general health and symptoms

E-endocervical swabs

Amenorrhea:

P-pregnancy

A-absent ovulation

M-menopause

E-eating d/o (anorexia nervosa), excessive exercise

N-nursing mom (lactational amenorrhea)

O-OCP’s

R-Raised prolactin

R-raised adrenal hormones

H-hypothyroidism, hemorrhage

E-?

A-anxiety, asherman’s syndrome

Hematuria:

H-hematologic/coagulation disorders

I-infection (cystitis)

T-tumor: RCC, bladder cancer, prostate cancer

E-exercise

R-renal disorder (glomerulonephritis)

S-stones

Fellow Has DARK Pee:

F-food like beets, blackberry

H-hematuria

D-dehydration, drugs like rifampicin, Vit. B

A-alkaptunuria

R-rhabdomyolysis

K-kernicterus (hyperbilirubinemia)

P-PNH

Hematochezia:

D-diverticulosis, drugs, (warfarin)

R-rectal bleed (hemorrhoids, fissures)

A-angiodysplasia, anal sex

I-IBD (UC, crohn’s), infectious diarrhea, infectious colitis, injury)

N-neoplasm (colorectal cancer)

Dyspareunia: ask about onset, intensity.

D-discharge

I-irritation

S-smell

P-periods (investigate about menstrual periods) pap smear

A-alleviating

R-residency (living with whom?)

E-emotions

U-urinary problems

N-new partner

I-infertility, fertility

A-abuse

A-allergies

Forgetfulness and Confusion: DEATH SHAFT

D-dressing

E-eating

A-ambulation

T-toilet

H-hygiene

S-shopping

H-housekeeping

A-accounting

F-finances, food preparation, who’s cooking

T-transportation, driving

           

Depressed patient:  FACE SLIPS

F-Feeling of guilt, anger, worthlessness

A-Appetite

C-Concentration

E-Energy levels and daily activities

S-Sleep disturbance

L-Libido levels and loneliness

I-Interests, hobbies

P-Psychomotor retardation? Pleasure levels.

S-Suicidal ideation, any plans for suicide

Depression:

B-bereavement, bipolar I and II disorder

A-adjustment disorder + mood disorder

D-dysthymic disorder

M-major depression, menopause

U-underlying medical condition

D-drug related (cocaine, amphetamines)

S-schizophrenia

 ON CALL IDIOT: for diarrhea (peds)

O-  Onset

N-  Number of times a day

    

C-consistency, color, content, (blood, fat, mucus, crying?, cramps?)

A-Associated symptoms (fever, runny nose, rash, cough, pulling of ears, ear discharge,

Vomiting, shaking, nausea, vomiting, crying when urine is passed)

 L-  Listless baby? Lethargic, not sleeping well?

 L-  Liquids not passing? Not urinating?

I-Immunization up to date?

D-  Diet change? Dehydrations signs? Day Care Center exposure? Developmental

        Milestone (“Is baby’s weight, height, and language development normal?”)

I-Infections in the family? Recent URI?

O-   ORS counseling (ask if there’s pedialyte at home or if mom knows how to prepare:

                       Water – 4 cups

                        Salt-     1 teaspoon

                        Sugar-   8 teaspoons

T-  Travel history recently.

ABUSED CLIENT:

S-safety at home

A-afraid of hubby

F-family and friends aware?

E-emergency plan

G-gun at home

A-alcohol

R-relationship with hubby

D-drugs/depression

ENURESIS COUNSELING (SMILE SAM)

S- Supportive of the child
M- Monitor Intake (day)
L- Limit intake (night)
E- Encourage washroom before bedtime

S- Sheets ( use rubber flannel sheets)
A- Abnormal if age is >5 y/o
M- Motivate through rewards

COUNSELING FOR DM AND HYPERTENSION (MEDOWS Foot)

M- Medications
E- Exercise
D- Diet modification (low salt/ non-fat diet)
O- Ophthalmologic exam (annual)
W- Weight management (weight control)
S- Sugar check-ups including HbA1c

F- Foot care and regular foot check-up

URINARY COMPLAINTS (FINISHED PUBS)

F- Frequency
I- Incontinence (trouble holding urine)
N- Nocturia
I- Incomplete emptying
S- Stream
H- Hematuria
E- hEsitancy
D- Dysuria

P- Pyuria
U- Urgency
B- Burning
S- Strain

OB-GYNE HISTORY (LMP RTV CS PAP)

L- LMP
M- Menarche
P- Period (duration... lasts? days??)

R- Regularity (every?)
T- Tampoons/Pads per day
V- Vaginal discharge, itching, dryness

C- Cramps, abdominal pain, dysmenorrhea
S- Spotting (intermenstrual/post coital)

P- Pregnancy (history and complications)
A- Abortion/miscarriage
P- Pap smear (last done? result?)

PEDIA HISTORY (FEVER CUD Seizure + PAM IF BINDER)

F- Fever
E- Ear pulling
V- Vomiting
E- Ear discharge, Eye discharge
R- Rash, Runny nose (description of rash, onset and progression)

C- Chest symptoms, colds, cough, chest pain, fast respiration, sorhtness of breath, crying
U- Urination - any increased or decreased urination?, # of wet diapers, anay odor, color of urine, cry?
D- Diarrhea: frequency, onset, mucus/blood in stool? dry mouth, nausea, vomiting

S- Seizure, any jerky movements or shakes, loss of consciousness, passing our urine/stools?

P- Past medical history, Past surgical history, previous hospitalization
A- Allergies
M- Medications

I- Ill contacts, member of the family who is sick? ill contacts from day care?
F- Family history

B- Birth history (intra, ante and post partum)
I- Immunization history, last check-up w/ pediatrician, result of visit
N- Nutrition history
D- Developmental milestones, use of day care
E- Eating habits, feeding of baby, appetite, appearance, swallowing difficulty
R- Rash
S- Sleeping habits

FOOT PAIN (WET SURF)

W- Work type
E- Eye infection, redness
T- Traums to foot

S- Stiffness in other joints
U- Urethral discharge, Urethritis (dysuria), Ulcers
R- Rash/ oral ulcers
F- Fever, numbness, tenderness

KNEE PAIN OR ANY JOINT PAIN (aside from OPDSFC add CITRUS HPT then LIQRAAA)

C- Chest Problem, cough, chest pain
I- Insect bite
T- Travel, Trauma
R- Rash, Redness
U- Ulcers in the mouth
S- Stiffness, cramps, sweeling, steroid use

H- Hair loss
P- Photosensitivity
T- Temperature (fever)