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My USMLE Steps
Denzel Allen

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Saturday, April 30, 2011 My Links....

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Blog Archive
▼ 2011 (1)
▼ April (1)
Step 2 CS

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)