-
Eyes
- DEDSPINSBM
- Double vision
- Excessive tearing
- Discharge
- Sensitivity to Light
- Pain
- Injection
- Narrowing Visual field
- Spots
- Blurred vision
- Meds
-
Head
- HHHFL
- HA
- Hx surgery/tumor
- Hx trauma
- Fainting
- Lightheadedness
-
Mouth and Pharynx
- DDBBSSHEFIG
- Dentist
- Dysphagia
- Brushing/flossing
- Bleeding Gums
- Sores
- Sore tongue
- Hoarseness
- Excessive Salivating and dryness
- Freq sore throats
- Injury/pain
- Growths
-
Psychiatric
- SHHED
- Suicidal attempts
- Hallucinations
- Homicidal attempts
- Excessive tension/anxiety
- Depression
-
PVS
- BUNCHVAC
- Blood clots
- Ulcerations
- Night pain
- Cramping
- Varicose veins
- Achiness while walking
- Color changes in hands or feet
-
Male genitalia
- PPSSSTTD
- Prostate Disease
- PSA
- Self testicular disease
- Scrotum changes
- Testicular masses
- Testicular/penile pain
- Discharge
-
Sex habits
- SCLEEFINGM
- STI
- Change in sex drive
- Last act
- Erection
- Ejaculate
- Frequency
- Intercouse nature
- Gender
- number
- Monogamous
-
Obstetrical
- NATC
- Number of pregnancies
- Abortions
- Type of Delivery
- Complications post partum
- complications delivery
-
Ears
- DIVETD
- Discharge
- Injury
- Vertigo
- Ear pain
- Tinnitus
- Decreased hearing
-
Skin
- CCCLITER
- Change in mole, skin, nails
- Lesions
- Itching
- Texture
- Easy bruising
- Rash
-
Endocrine
- EIEIV
- Excessive nervousness
- Increased glove/shoe size
- Excessive body hair
- Increased hunger/thirst
- Unusual sensitivity to hot/cold
-
Hematologic
- BBBA
- Blood type
- Blood transfusions
- Bleeding in skin
- Anemia
-
Nose/Sinuses
- CHIPSED
- Colds
- Hay fever
- Injury
- Pain
- Sneezing
- Epistaxis
- Discharge/congestion
-
Cardiovascular
- POISSED
- Palpitations
- Orthopnea
- Irregular HB
- Swelling
- Sweating
- EKG
- Difficulty breathing
-
Respiratory
- CCCBSTW
- CXR
- Cough
- Chest Pain
- SOB
- Sputum
- TB
- Wheezing
-
Breasts
- DENTM
- Discharge
- Exam
- Nipple/skin changes
- Tenderness
- Mass
-
Neck
- SGPILL
- Stiffness
- Goiter
- Pain
- Injury
- Lumps/swollen glands
- Limitations to movement
-
Family Hx
- HEART LUNGS BRAIN OTHER
- Heart: HD, HTN, MI, CAD
- Lung: Bronchitis, asthma, emphysema, TB
- Brain: Stroke, depression, anxiety, substance abuse
- Other: Ca, DM, liver/kidney/thyroid
-
Neuro
- NPDNTLOCSSCCMM
- Numbness/tingling
- Paralysis
- Disorientation
- Nightmares
- Tremor
- Loss of consciousness/coordination
- Speech
- Sleep
- Concentration
- Clumsiness
- Memory
- Mood
-
MSS
- JDGEMLBBM
- Joint pain
- deformity
- gout
- edema
- muscle pain
- limitation of movement
- back pain
- bone infection
- morning stiffness
-
GI
- DBOT
- Digestion: dyspepsia, heart burn, borborygmus, gas/belching
- Bowels: color, constipation, pain, frequency, tenesmus
- Overall: Jaundice, N/V/A, hemorroids
- Tests: barium enema, colonoscopy, GI studies
-
Urinary
- UOU
- Urinary: CLUND
- -change in habits, lumbar pain, urgency, difficulty starting/stopping, # times/day
- Other: KUCK
- -kidney stones, UTI, catheter, KUB
- Urine: ENDCHIP
- -excessive, nocturia, dysuria, color, hematuria, incomplete, pyuria
-
Female GYN
- Period: CLIMMP
- -cycle length, last MP, irregular bleeding, menopause, menarche, pain
- Vagina: DIPS
- -discharge, itching, pain, sores/lumps
- Sex: FABCAMPIN
- -change in sex drive, act, monogomous, pain, intercouse nature, number of partners
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