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LIQOR AAAAA
last 2 A = associated q for d/d like weight lifting, travel history
A= associated effect on sleep,diet & functioning
FEVER- Fever, Ear pulling, Vomiting, Ear discharge,eyes discharge, Rash, CUD- Chest symptoms n
Cold-runny nose,cough,chest painfast respirations,shortness of breath, Urination-any increased or
decreased urination,no. of wet diapers,any odour,colour of urine, Diarrhea-frequency,onset,mucus
in stool,blood in stool,any cryin during defecation , Seizure-any jerky movements,any leakage of
urine or stool during fits,ant post ictal irritability,or loss of consciousness.
PAM - P-Past medical, past surgical hx, previous hospitalizations. A-Allergies, M-Medications, IF I-Ill
contacts, F -family history, BIG -B- birth hx, I-Immunizations, G-Growth n
development,ht,wt,milestones. D-DEALS- Day care, E-Eating habits, feeding of da baby, A-Appetite,
L-Look of the baby or appearance, S- Sleep
in addition to pamshugsfoss (of course you would modify it according to your patient)...
Paediatric Hx:
I used BINDER for socioeconomic Hx- birth history, immunization history, nutrition, development,
Eating, Rash... also it's good to ask where the child is during the day - (i.e. day care, school,
grandmother's house, etc...)
good luck
2nd format:
BMJ CHILDREN
Birth history, Breathing difficulty
Milestones
Jaundice( neonatal)
Crying
Check-up
Headache, Neck stiffness/Fever
Immunization
Lethargy
Day care
Rash
Eye, Ear, Environment
Nose , Nutrition
For Spousal abuse, I have read the acronym SAFEGARDS somewhere. Can some complete it for me
or give more add on
S= Safety inquiry (Do you feel safe at home?)
A= Alcohol abuse (does your hubby abuses alcohol?)
F= Friends/Family who are aware (Does anyone of your friend/Family know of this?)
Fractures (Abuse ever resulted in fractures?
E= ED visits ever with serious fights?
G=Guns at home (are there any weapons @ home?
A= Any emergency plan (Do u have an emergency plan? Ever tried to leave/divorce? why not?
R= Relationships with husband (how is your relationship with hubby? --> do you feel threatened
when he is around? SEE WAST above + HITS)
D=Depression/Drugs (have u lost weight appetite sleep ) does hubby dos drugs
S=Suicidal ideation (ever felt like ending it all up? )
Differential diagnosis of tiredness
Failures (CHF, COPD, Liver, Kidney) (if patient was sent or asked by anyone to
Fibromyalgia, Chronic Fatigue Syndrome consult doc ) Fatigue...IMP ADH
Anemia I-infection
ABUSE M -malignancy
Autoimmune disorders (RA etc.) P-PTSD
Thyroid disease A-abuse
Trauma D-depression
Infections (Chronic- TB, HIV, IM-EBV etc.) H-hypothyroidism
Iatrogenic (Drugs)
Immunodeficiency (HIV)
Growth (Malignancy- Solid organ, Leukemia)
Gravid (Pregnant)
Upset (Depression)
Endocrine (DM, Addison’s disease)
Eating disorder (AN?)
Sleep disturbances
Insomnia counselling = ABCDEFGHJKLMN
Avoid
Bedtime
Concerns (worries)
Drugs (nicotine/caffeine/Alcohol)
Exercise/Excitement (TV Shows)
Follow
Good
Habits for sleep.
Jetlag
Keep
List (Diary)
Monitor
Naps (day time)
AAA-
Local- Redness, Itchiness, Blisters/rash/excoriation
Same- Kidney stones/UTI before
Adjacent- STI/PID/Prostatitis, any other abdominal disease
RF- Foreign body/STI/↓immunity/Fecal incontinence
C&C- Reiter’s syndrome (WET SURF), Anatomic abnormalities
Constitutional & ROS
D/D Confusion
Mnemonic = DEMENTIA
Diabetes /Dementia/ Drugs
Epilepsy
Migraine/Multi Infarct Dementia
Ethanol (withdrawal/ Toxicity)
Neurological Deficit diseases= BETA (Bleeds, Encephalitis, Tumors, Abscess, Meningitis)
TIA/Trauma
Insulin/Infections (Sepsis/UTI)
Alzheimer’s/Abscess
My mnemonic for confusion/dementia: DIMS
Drugs (Opiates, Digoxin, Anticholinergic, BDZ, Steroid, NSAIDs, Phenytoin, Theophyllin)
Infections (Lung, UTI, Meningitis, Sepsis)
Metabolic
- Basic: Hypoxia, Anemia, Dehydration, Acidosis/Alkalosis, Electrolytes (Hyponatremia)
- Failures: CHF, Resp. failure, Liver/Renal etc.
- Endocrine: Hypo/Hyperglycemia, Thyroid, Cushing’s/Addison’s, B12
Structural (Stroke, SOL, SAH/SDH/EDH, Seizure, Trauma/Surgery, Fat embolism etc.)
Geriatric checklist: Geriatric Giants: 7 I’s Altered mental status/Coma causes: AEIOU
TIP S5
Impairment of Vision & Hearing
Instability/fall Alcohol/Acidosis
Incontinence & Constipation Endocrine
Iatrogenic (Polypharmacy) pathology/Electrolytes/Encephalopathy
Immobility (DEATH/SHAFT) Infection
Intellect, Memory & Sleep Opiates
Impaired homeostasis (Chronic disease) Overdose/Drugs
Uremia
Toxin
Trauma
Insulin
Psychosis
Poisoning
Porphyria
S - Shock
- SAH/SDH (Subarachnoid/dural Hge)
- SOL
- Stroke
- Seizure
Psychiatric Hx Checklist
Mood, Idea ( abt de problem?), Stress, Support, Sleep ,Plan,Energy ,Aims, Routine , Suicide, Pills
(drugs),Apetite ,Duration,Memory, Alone,Concentration, Hopes, Hallucinations , Delusions
AWC
Anticipatory Anxiety of this kind of attack for
> 1 month
Worry about consequences of the attack
Changes made to lifestyle
GAD
Duration >6mo
What are the things that you are fearing?
Blank mind makes him Irritable, so he gets Keyed up and have Sleep disturbance. So he gets
Muscle Tension and gets Easily Fatigued.
BE SKIM (≥3/6 for 6 mon, 1/6 in children)
Blank Mind
Easily Fatigued
Sleep Disturbance
Keyed Up- Always on the edge?
Irritable
Muscular Tension
Phobic Disorders OCD: WRITE
Fear of anxiety for something specific (e.g. Do you have certain thoughts or behaviours
Height) over and over again that you think you need
HE Avoids to get rid of?
Happens: What happens if you are in these What are they?
places of situations? Repetitive? Thoughts come back again and
Excessive: Is you reaction reasonable or again? (OBSESSION) > Do you feel driven to
excessive? do them? (COMPULSION)
Avoid: Do you avoid these Intrusive & Inapropriate?
place/situations/things? Time: Are they time consuming?
Excessive or not reasonable?
Check list= SIQQOR AAA & then ROS =Age/ Bone pains/ constipation=MM/Bowel, bladder/Relieving
factors/ Phx of trauma/Surgical Hx(Prostate) /Chest pain, hemoptysis, Fever &chills/ With bone &
joint problems =Functional impairment (SOS=Help)Q's i.e Sleep/Occupation/Support
ER VISITS
Fatigue
Libido
Anorexia Nervosa
Anxiety/Depression
Galactorrhea
Hair/Skin changes (Hypothyroid, PCOS-Hirsutism)
Headaches
Hot Flushes
Insomnia
Visual disturbance
Voice change
Wt. change/Appetite/Diet
Cold Intolerance and Constipation
Fever
Intravenous drug use
Steroids for long time
History of cancer
Any MSK pain after asking all OCD PQRST ask WET SURF
Work
Eye infection/redness
Trauma to pertaining organ
Stiffness in other joints
Urethral discharge
Rash/Reiter’s syndrome
Fever