12/03/2009

Mnemonic for history taking

Some one said nmemonic is everything for step2CS exam.
In my opinion,it help to arrange lists of questions.
But we must judge to select focus question. Which come form "differential diagnosis"
.

Nmemonic for present illness:
Evaluation phase: OPD
O Onset of symptom ( When did it start)
Open ( Please tell me more about your symptom)
P Progression ( is it getting worse)
Precipitation ( Did anything happend before your symptom start
..Is it relate to any food/activity)
Previous (Have you ever had problem like this before)
D Duration ( Is it constant or does it come and go..How long does it last)


Pain: LIQRAAA
L Location of the symptom ( Can you show me exactly where is your pain)
Intensity of the symptom (On a scale from 1 to 10 with 10 being the worst pain,how would you
rate your pain)
Q Quality of the symptom ( Please tell me what the pain like...burning,clamping or pulsating?)
R Radiation of the symptom ( Does it move to anywhere on your body)
A Alleviating factors ( Does anything make it worse)
Aggravating factors ( Anything make it better?)
Associated symptoms ( Do you have any other symptoms such as.....)

Discharge: ABC
A Amount ( Do you have a lot of it)
B Blood ( Was there any blood)
C Color/Consistency ( Can you tell me what it like)

PMH (past medical history)
Search for: PAM HUG FOS SODA
P Past medical history ( Do you have any other medical problem )
A Allergies (Are you allergic to any drug...any else)
M Medicines (Are you taking any medication)

H Hospitalization ( Have you ever been hospitalized..Have you ever had surgery)
U Underweight Overweight ( Does any change in your weight)
G General daily activity (How about appetite / Sleep/Urine/ bowel movement)

F Family history ( How about your family, are you parents healthy
Are there any medical problem or cancer that run in your family)
O OB/GYN history (Excuse me but I need to ask..when did your last period.look more -> LMPV)
S Sexual habits ( I would like to ask you some personal question..do you use condom regualry. look more -> SACH)

S smoking ( Do you smoke..How much..How long)
O alcOhOl ( Do you drink : if more than 2 drink/day or 4 day/week -> CAGE)
D druge-recreation ( Do you use any recreational drug)
A activity ( Tell me about your diet/ exercise/travel)



I prefer asking Occupation while washing hand before physical exam.

adapted form:http://www.prep4usmle.com/forum/thread/1793/









0 comments: