07-13-2009, 10:52 PM
1) premenopausal symptoms HAVOC ( hotflashes, atrophy of the vagina, vaginal dryness, C: ? )
2) BINDER ( birth history, immunization history, nutrition, growth and development, eating, rash)
3) Pain LIQORAAA ( location, intensity, quality, onset, rash, aggravating symptoms, assosciated symptoms, alleviating symptoms)
4) Discharges ABC3DO (amount, blood, color, consistency, content, duration , odor)
5) Depression SIGEMCAPS ( sleep, interest, guilt , energy , mood, concentration, appetite , psychomotor symptoms, suicidal ideation) MDMAT ( mood , delusion and hallucination, memory, attitude towards life, thyroid problems)
6) Fatigue IMP ADH ( infection , malignancy, PTSD, abuse, depression, hypothyroidism)
7) Abuse SAFEGARDS (safety inquiry, alcohol abuse , friends and family , emergency plan , guns at home, A:? , relationship with husband, depression , suicidal ideation
8) Insomnia ABCDEFGHIJKLM (avoid , bed time ,concern, exercise and excitement , follow, good, habits, keep list , monitor naps)
9) Enuresis SMILE SAM (supportive, monitor intake, limit , encourage washroom, sheet, alarm and motivate)
10) Blood pressure and diabetes MEDOWS (meadows , exercise , diet modification , ophthalmoscope exam, weight management , sugar check ups
11) Smoking cessation SPANCSTER (stressor , problem , advantages, nicotine patch, councilor, support system , taper down, exercise program , rewards )
12) STD / HIV COUNCLING ( strip bimbo) ( safe sex practices, transmissions, risks , immunizations, prevention counseling, behavior counseling, interventional counseling, medication , barrier methods, opportunistic infections)
13) HOPI for a CC of urinary complaints FINISHED PUBS ( frequency , incontinence , nocturia, incomplete emptying, stream, hematuria, hesitancy, dysuria, pyuria, urgency, burning, strain)
14) CC complain of memory loss ,dementia , alzheimers, MID, crutzfeld Jacobs, etc
DEATH SHAFT ADL (dressing , eating , ambulating, toileting, house keeping )
IADL ( shopping , house keeping , accounting , food , transportation)
15) shoulder pain case DEFORMS ( dislocation, elderly abuse , fracture, osteoporosis/ osteoarthritis, rotator cuff tear, multiple myeloma , subacromial bursitis)
16) OBESITY “(obesity disc) osteoarthritis breathing problems , excess cholesterol, sleep apnea, increased incidence of carcinoma, type 2 diabetes mellitus , hYpertension , depression , incontinence, stress, cholilithiasis/ cycle disturbance/ cardiac)
17) Psychiatric history MISS SPEAR PAD MATCHED (mood, idea, stress, support , sleep, plan, energy, aim, routine, suicide, pills, appetite, duration, memory, alone, concentration, hopes, hallucination, delusions
18) Obesity counceling (A2BC3DEF) (Avoid advice , advantages advice, books , coucel , cholesterol, consult, dietian, exercise , fatty food,
19) Syncope / loss of conciousness/ spells ( CAMPUS) ( CAD, arrhythmia, aortic stenosis, migraine, meds, psychiatric , personality disorder, unexplained syncope , seizure,stroke)
Like wise checklist can be
CAD ,Arrythmis , aortic stenosis, ( chest pain , palpitation , past history of MI)
MIGRAINE ( nausea , vomiting , headache)
PSYCHIATRIC ( breathing problem , anxiety, fear of death etc)
SEIZURES ( jerky movements, weakness numbness and tingeling, vision , speech
Bowel and bladder)
FAMILY HISTORY ( heart , htn , diabetes, migraine, stroke)
20) d/d of confusion DEMENT2I2A2 ( diabetes/ dementia / drugs
epilepsy , multinfarct dementia. , ethanol (with drawl toxicity, neurologic defecit diseases (BETA) Bleed , enchapilitis, tumor, enchapilitis , meningitis) TIA, trauma , insulin , infection alzeimers , abscess
CHECK LIST ACCORDINGLY
Numbeness, weakness/ headache , flashes, N/V , jerky movements / LOC / insulin use / past history/ trauma/ FHx of alzeihmers + risk factor for screen / ( choloestrol , HTN , diabetes etc)
For suspected dementia instrumental inquiry SHAFT
Daily activity inquiry DEATH
21) D/D of back pain LIMCOTS
Lumbar spinal stenosis, intervertebral disc herniation , multiple myeloma/mets , cauda equine syndrome. Cancer, osteoprosis / osteoarthritis, trauma . TB strain( muscle)
Checklist
SIQORAAA and then ROS
Age , bone pain , constipation,
Multiple myeloma, bowel bladder relieving factors, hx of trauma , surgical hx (prostate ) / chest pain , hemoptysis / fever and chills with bone and joint problems/ functional impairment (SOS = help) Qs I.e sleep . occupation. Support
22) NAUSEA AND VOMITING
A moping ( anorexia, metabolic( dka) meds, obstruction ( pyoleric/ intestinal) pregnancy , inflammation( pyelo. Chole, appendix, pancrease, PID)
Neurologic BETA ( bleeds , enchapilitis, tumor, abscess) gastroenteritis
23) dizziness DENTAL CAMPUS
diabetic complication ( orthostatic ) ear problems (meneirs / BPV) neural tumors . neuropathy, thyroid , anemia, leave me ,
CAMPUS is for spells / LOC / SYNCOPE
24) NEURO CASES HISTORY
HV U SW C THN GLL FF VD?
Headache, visual disturbance, urinary/ incontinence, sleep disturbance, weakness/ numbness/ confusion / convulsion tinnitus. Hearing loss/ nausea/ gait / loss of conciousness/ lightheadedness/ falls trauma , fullness of ear , vomiting , discharge ear
25) MC LOPE
Memory, concentration/conciousness, language, object recognition/ orientation/ paraxial/ executive function ( abstraction / planning / organizing / sequencing)
26) obs and gynae history mnemonic LMP RTV CS PAP
LMP , menarche , period, regularity , tampons, pads, vaginal discharge, itching , dryness, cramps( dysmenorrheal) spotting ( intermenstrual / post coital) pregnancy ( hx and complication ) abortion / miscarriage, PAP smear ( last time result ? history of past abnormal result?)
27) assosciated symptoms of amenorrhea
HAG V FWL HiDC
Hair and skin changes ( for hypothyroidism/ hirsuitism of PCOS) headaches
Anorexia nervosa/ anxiety and depression / galactorrhea/ visual disturbance / virlization / fatigue , weight changes, appetite and diet , libido , hot flashes , insomnia, deep voice changes, cold intolerance, constipation
28) dysparunia DATIVE
Domestic abuse . atrophic vaginitis, ( don™t forget to ask about sigh and symptoms of menopause) tumor , pelvic , infection, vaginismus , endometriosis ( don™t forget to ask about cyclic pelvic pain)
29) dermatology aRENT SIMMBEL
rash , nail changes, temperature, sensation , itching , masses , moles, bleeding , bruises, edema, lesions
30) GI HISTORY
ABCDEFGHIJ + MNOP
Appetite, bowel habits, constipation, diaherrea, eating habits, fever, haem in stool, incontinence, jaundice, medication ( iron tablets causing constipation ) nausea of course followed by vomiting followed by Pain in the abdomen
31) paeds history FEVER COULD SEIZURE + PAM IF BIG DEALS
fever , ear pulling, vomiting , ear discharge, eye discharge CUD, chest symptoms , cold , runny nose , cough, chest pain , respiration, shortness of breath URINATION ( any increased or decresed urination ) no of wet diapers any odor , color of urine , diarrhea, frequency onset , mucus in the stool , blood In the stool any crying during defecation
SEIZURE jerky movements any leakage of urine or stool during fits any p
postictal irritability or loss of conciousness
PAM “past medical past surgical , previous hospitalization , Medication,
IF “ ill contacts , family history ,
BIG- birth history, immunization , growth and development ht wt milestones
DEALS “ day care . eating habits, feeding of the baby, appetite, look of the baby or appearance Sleep
32) trauma patients AMPLE
allergy , medication , past medical history, last mead , events before accident
33) menstrual history FMDIAL
frequency , menarche, duration , intensity , amount , LMP
34) pain with intercourse
VC VED CANCER
Vaginitis , cervicitis, vaginismus, endometriosis , domestic abuse, cancers of the pelvis like cervix and uterus
35) FOOT PAIN ( WET SURF)
Work , eye infection , redness, trauma to the foot , stiffness in other joint , urethral discharge, rash / reiter syndrome , fever
36) obstructive or irritative symptoms
WINSURF
Weakness of stream , intermittency and driblling, nocturia , straining urgency, retention , frequency
37 ) general physical PICKLE
pallor , icterus , cyanosis ., koilonychias, lymphadenopathy , edema
37) paeds history BJM CHILDREN
birth history , jaundice( neonatal) milestones, crying, check up , headache, immunization, lethargy , day care, rash, eye,ear, nose , nutrition
38 ) headache MM IT ACHES
migraine , meningititis , inreased intracranial pressure, tension headache, tension headache, temporal arthritis, av malformation cluster headache, hypertension , eye disorder ( refacratory error + glaucoma) sinusitits , sub arachemoid haemorrage, most systemic illeness
39) sore throat ( SORE THROAT WAS BAD)
Swallowing food was painful , origin duration progression , Runny nose , Ear problems , Temp chills , headache, resp symptoms ( cough, shortness of breath, chest pain ) occupation , aspiration + abdominal symptoms ( nausea , vomiting , pain ( esp LUQ) tiredness ( fatigue) touch with ill people ( boy friend or girl friend)
weight loss , appetite , alcohol, smoking / sleep changes sexual history
bowel habits , anything else that u want to tell me , Drugs ( IV)
40) throat
throat culture , IV antibody and viral titer rapid strep antigen , monospot test, anti EBV anti body , rouTine tests ( cbc , peripheral smear)
41) d/d of cough
PLUERAL CAP
Pneumonia , lung cancer , exacerbation of COPD , URI , reactive airway disease, abscess , lymphoma , CHF , asthma, post nasal drip
42) knee pains SP3ORTS
septic arthritis, pseudogout , patello femoral syndrome, psoriatic arthritis, osteoarthritis, rheumatoid arthritis, reactive arthritis, tophi , trauma , sac imflammation ( bursitis) septic arthritis
43) foot pain
FOOT PAINS
Fat atrophy ( age related) + foreign body , osteomyelitis , osteoporosis, tarsal tunnel syndrome , tendonitis, tumor, plantar facitis , periostitis, apophysitis , arthritis ( rheumatoid , reactive,) ischemic ( peripheral vascular disease) , nerver entrapment , stress fracture in athletes and spur in bones
44) chest pain CHEST “P
cough , hemoptysis, heart burn, emesis (vomiting ) diarrhea and edema over ankles, temperature , tenderness over ankles tenderness over legs , also trauma , Palpitation
45) impotence LIMP PENIS
libido change , injury , medication ( beta blocker) past/ present medical history ( htn , diabetes , vascular , leriche) previous prostate surgery , performance anxiety, peryonie disease, erection at all , nocturnal erection , incontinence, stress/ depression
46) d/d impotence
DOC MP DG UP
Depression , alcohol , claudication ( leriche syndrome) medication , pressure (HBP) , mellitus gonads ( hypogonadism) , unknown etiology ED, prostate surgery
Drug stoping erection
STOP erection
Ssri , thioridazine , methydopa, propanalol
47) d/d pv bleeds
A PV BLEEDS
Abortion + adenomyosis, PID+ PCOD, vaginal bleeds, bleeding diasthesis, leiomyoma , ectopic pregnancy, endometriosis, endocrine causes, DUB ( anovulatory cycle)
u
duration , dysparunia, dysuria, itch , smell , color, high fever, abdominal pain , recurrent episodes, general health and symptoms , endocervical swabs
49) AMENORRHEA CAUSES
AMENORRHEA
Pregnancy, absent ovulation, menopause, eating disorder, nursing mother, OCP, raised prolactin , raised adrenal harmones, hypothyroidism, hemorrhage, E_? , anxiety , asherman etc
50 ) depression case patient note
I AM SAD
Insight , appearance, mood , MMSE, suicidal intent , speech, affect, delusion , hallucination
51) depressed mood dd
BAD MUDS
Bereavement , bipolar 1 and bipolar 2 disease, adjustment disease , mood disease, dysthemic disease, major depression, menopause, underlying medical condition , drug related ( cocaine , amphetamine) schizophrenia
52) dark urine HITTERS
Hematologic / coagulation disorders, infection , cystitis, trauma , tumors, exercise, renal disorder, stones
53) blood in the stool DRAIN
diverticulosis , drugs ( warfarin ) rectal bleeds ( piles , fissures) angiodysplasia , anal sex, inflammatory bowel disease, infectious diarrhea, ischemic colitis , injury , neoplasms
2) BINDER ( birth history, immunization history, nutrition, growth and development, eating, rash)
3) Pain LIQORAAA ( location, intensity, quality, onset, rash, aggravating symptoms, assosciated symptoms, alleviating symptoms)
4) Discharges ABC3DO (amount, blood, color, consistency, content, duration , odor)
5) Depression SIGEMCAPS ( sleep, interest, guilt , energy , mood, concentration, appetite , psychomotor symptoms, suicidal ideation) MDMAT ( mood , delusion and hallucination, memory, attitude towards life, thyroid problems)
6) Fatigue IMP ADH ( infection , malignancy, PTSD, abuse, depression, hypothyroidism)
7) Abuse SAFEGARDS (safety inquiry, alcohol abuse , friends and family , emergency plan , guns at home, A:? , relationship with husband, depression , suicidal ideation
8) Insomnia ABCDEFGHIJKLM (avoid , bed time ,concern, exercise and excitement , follow, good, habits, keep list , monitor naps)
9) Enuresis SMILE SAM (supportive, monitor intake, limit , encourage washroom, sheet, alarm and motivate)
10) Blood pressure and diabetes MEDOWS (meadows , exercise , diet modification , ophthalmoscope exam, weight management , sugar check ups
11) Smoking cessation SPANCSTER (stressor , problem , advantages, nicotine patch, councilor, support system , taper down, exercise program , rewards )
12) STD / HIV COUNCLING ( strip bimbo) ( safe sex practices, transmissions, risks , immunizations, prevention counseling, behavior counseling, interventional counseling, medication , barrier methods, opportunistic infections)
13) HOPI for a CC of urinary complaints FINISHED PUBS ( frequency , incontinence , nocturia, incomplete emptying, stream, hematuria, hesitancy, dysuria, pyuria, urgency, burning, strain)
14) CC complain of memory loss ,dementia , alzheimers, MID, crutzfeld Jacobs, etc
DEATH SHAFT ADL (dressing , eating , ambulating, toileting, house keeping )
IADL ( shopping , house keeping , accounting , food , transportation)
15) shoulder pain case DEFORMS ( dislocation, elderly abuse , fracture, osteoporosis/ osteoarthritis, rotator cuff tear, multiple myeloma , subacromial bursitis)
16) OBESITY “(obesity disc) osteoarthritis breathing problems , excess cholesterol, sleep apnea, increased incidence of carcinoma, type 2 diabetes mellitus , hYpertension , depression , incontinence, stress, cholilithiasis/ cycle disturbance/ cardiac)
17) Psychiatric history MISS SPEAR PAD MATCHED (mood, idea, stress, support , sleep, plan, energy, aim, routine, suicide, pills, appetite, duration, memory, alone, concentration, hopes, hallucination, delusions
18) Obesity counceling (A2BC3DEF) (Avoid advice , advantages advice, books , coucel , cholesterol, consult, dietian, exercise , fatty food,
19) Syncope / loss of conciousness/ spells ( CAMPUS) ( CAD, arrhythmia, aortic stenosis, migraine, meds, psychiatric , personality disorder, unexplained syncope , seizure,stroke)
Like wise checklist can be
CAD ,Arrythmis , aortic stenosis, ( chest pain , palpitation , past history of MI)
MIGRAINE ( nausea , vomiting , headache)
PSYCHIATRIC ( breathing problem , anxiety, fear of death etc)
SEIZURES ( jerky movements, weakness numbness and tingeling, vision , speech
Bowel and bladder)
FAMILY HISTORY ( heart , htn , diabetes, migraine, stroke)
20) d/d of confusion DEMENT2I2A2 ( diabetes/ dementia / drugs
epilepsy , multinfarct dementia. , ethanol (with drawl toxicity, neurologic defecit diseases (BETA) Bleed , enchapilitis, tumor, enchapilitis , meningitis) TIA, trauma , insulin , infection alzeimers , abscess
CHECK LIST ACCORDINGLY
Numbeness, weakness/ headache , flashes, N/V , jerky movements / LOC / insulin use / past history/ trauma/ FHx of alzeihmers + risk factor for screen / ( choloestrol , HTN , diabetes etc)
For suspected dementia instrumental inquiry SHAFT
Daily activity inquiry DEATH
21) D/D of back pain LIMCOTS
Lumbar spinal stenosis, intervertebral disc herniation , multiple myeloma/mets , cauda equine syndrome. Cancer, osteoprosis / osteoarthritis, trauma . TB strain( muscle)
Checklist
SIQORAAA and then ROS
Age , bone pain , constipation,
Multiple myeloma, bowel bladder relieving factors, hx of trauma , surgical hx (prostate ) / chest pain , hemoptysis / fever and chills with bone and joint problems/ functional impairment (SOS = help) Qs I.e sleep . occupation. Support
22) NAUSEA AND VOMITING
A moping ( anorexia, metabolic( dka) meds, obstruction ( pyoleric/ intestinal) pregnancy , inflammation( pyelo. Chole, appendix, pancrease, PID)
Neurologic BETA ( bleeds , enchapilitis, tumor, abscess) gastroenteritis
23) dizziness DENTAL CAMPUS
diabetic complication ( orthostatic ) ear problems (meneirs / BPV) neural tumors . neuropathy, thyroid , anemia, leave me ,
CAMPUS is for spells / LOC / SYNCOPE
24) NEURO CASES HISTORY
HV U SW C THN GLL FF VD?
Headache, visual disturbance, urinary/ incontinence, sleep disturbance, weakness/ numbness/ confusion / convulsion tinnitus. Hearing loss/ nausea/ gait / loss of conciousness/ lightheadedness/ falls trauma , fullness of ear , vomiting , discharge ear
25) MC LOPE
Memory, concentration/conciousness, language, object recognition/ orientation/ paraxial/ executive function ( abstraction / planning / organizing / sequencing)
26) obs and gynae history mnemonic LMP RTV CS PAP
LMP , menarche , period, regularity , tampons, pads, vaginal discharge, itching , dryness, cramps( dysmenorrheal) spotting ( intermenstrual / post coital) pregnancy ( hx and complication ) abortion / miscarriage, PAP smear ( last time result ? history of past abnormal result?)
27) assosciated symptoms of amenorrhea
HAG V FWL HiDC
Hair and skin changes ( for hypothyroidism/ hirsuitism of PCOS) headaches
Anorexia nervosa/ anxiety and depression / galactorrhea/ visual disturbance / virlization / fatigue , weight changes, appetite and diet , libido , hot flashes , insomnia, deep voice changes, cold intolerance, constipation
28) dysparunia DATIVE
Domestic abuse . atrophic vaginitis, ( don™t forget to ask about sigh and symptoms of menopause) tumor , pelvic , infection, vaginismus , endometriosis ( don™t forget to ask about cyclic pelvic pain)
29) dermatology aRENT SIMMBEL
rash , nail changes, temperature, sensation , itching , masses , moles, bleeding , bruises, edema, lesions
30) GI HISTORY
ABCDEFGHIJ + MNOP
Appetite, bowel habits, constipation, diaherrea, eating habits, fever, haem in stool, incontinence, jaundice, medication ( iron tablets causing constipation ) nausea of course followed by vomiting followed by Pain in the abdomen
31) paeds history FEVER COULD SEIZURE + PAM IF BIG DEALS
fever , ear pulling, vomiting , ear discharge, eye discharge CUD, chest symptoms , cold , runny nose , cough, chest pain , respiration, shortness of breath URINATION ( any increased or decresed urination ) no of wet diapers any odor , color of urine , diarrhea, frequency onset , mucus in the stool , blood In the stool any crying during defecation
SEIZURE jerky movements any leakage of urine or stool during fits any p
postictal irritability or loss of conciousness
PAM “past medical past surgical , previous hospitalization , Medication,
IF “ ill contacts , family history ,
BIG- birth history, immunization , growth and development ht wt milestones
DEALS “ day care . eating habits, feeding of the baby, appetite, look of the baby or appearance Sleep
32) trauma patients AMPLE
allergy , medication , past medical history, last mead , events before accident
33) menstrual history FMDIAL
frequency , menarche, duration , intensity , amount , LMP
34) pain with intercourse
VC VED CANCER
Vaginitis , cervicitis, vaginismus, endometriosis , domestic abuse, cancers of the pelvis like cervix and uterus
35) FOOT PAIN ( WET SURF)
Work , eye infection , redness, trauma to the foot , stiffness in other joint , urethral discharge, rash / reiter syndrome , fever
36) obstructive or irritative symptoms
WINSURF
Weakness of stream , intermittency and driblling, nocturia , straining urgency, retention , frequency
37 ) general physical PICKLE
pallor , icterus , cyanosis ., koilonychias, lymphadenopathy , edema
37) paeds history BJM CHILDREN
birth history , jaundice( neonatal) milestones, crying, check up , headache, immunization, lethargy , day care, rash, eye,ear, nose , nutrition
38 ) headache MM IT ACHES
migraine , meningititis , inreased intracranial pressure, tension headache, tension headache, temporal arthritis, av malformation cluster headache, hypertension , eye disorder ( refacratory error + glaucoma) sinusitits , sub arachemoid haemorrage, most systemic illeness
39) sore throat ( SORE THROAT WAS BAD)
Swallowing food was painful , origin duration progression , Runny nose , Ear problems , Temp chills , headache, resp symptoms ( cough, shortness of breath, chest pain ) occupation , aspiration + abdominal symptoms ( nausea , vomiting , pain ( esp LUQ) tiredness ( fatigue) touch with ill people ( boy friend or girl friend)
weight loss , appetite , alcohol, smoking / sleep changes sexual history
bowel habits , anything else that u want to tell me , Drugs ( IV)
40) throat
throat culture , IV antibody and viral titer rapid strep antigen , monospot test, anti EBV anti body , rouTine tests ( cbc , peripheral smear)
41) d/d of cough
PLUERAL CAP
Pneumonia , lung cancer , exacerbation of COPD , URI , reactive airway disease, abscess , lymphoma , CHF , asthma, post nasal drip
42) knee pains SP3ORTS
septic arthritis, pseudogout , patello femoral syndrome, psoriatic arthritis, osteoarthritis, rheumatoid arthritis, reactive arthritis, tophi , trauma , sac imflammation ( bursitis) septic arthritis
43) foot pain
FOOT PAINS
Fat atrophy ( age related) + foreign body , osteomyelitis , osteoporosis, tarsal tunnel syndrome , tendonitis, tumor, plantar facitis , periostitis, apophysitis , arthritis ( rheumatoid , reactive,) ischemic ( peripheral vascular disease) , nerver entrapment , stress fracture in athletes and spur in bones
44) chest pain CHEST “P
cough , hemoptysis, heart burn, emesis (vomiting ) diarrhea and edema over ankles, temperature , tenderness over ankles tenderness over legs , also trauma , Palpitation
45) impotence LIMP PENIS
libido change , injury , medication ( beta blocker) past/ present medical history ( htn , diabetes , vascular , leriche) previous prostate surgery , performance anxiety, peryonie disease, erection at all , nocturnal erection , incontinence, stress/ depression
46) d/d impotence
DOC MP DG UP
Depression , alcohol , claudication ( leriche syndrome) medication , pressure (HBP) , mellitus gonads ( hypogonadism) , unknown etiology ED, prostate surgery
Drug stoping erection
STOP erection
Ssri , thioridazine , methydopa, propanalol
47) d/d pv bleeds
A PV BLEEDS
Abortion + adenomyosis, PID+ PCOD, vaginal bleeds, bleeding diasthesis, leiomyoma , ectopic pregnancy, endometriosis, endocrine causes, DUB ( anovulatory cycle)
u
duration , dysparunia, dysuria, itch , smell , color, high fever, abdominal pain , recurrent episodes, general health and symptoms , endocervical swabs
49) AMENORRHEA CAUSES
AMENORRHEA
Pregnancy, absent ovulation, menopause, eating disorder, nursing mother, OCP, raised prolactin , raised adrenal harmones, hypothyroidism, hemorrhage, E_? , anxiety , asherman etc
50 ) depression case patient note
I AM SAD
Insight , appearance, mood , MMSE, suicidal intent , speech, affect, delusion , hallucination
51) depressed mood dd
BAD MUDS
Bereavement , bipolar 1 and bipolar 2 disease, adjustment disease , mood disease, dysthemic disease, major depression, menopause, underlying medical condition , drug related ( cocaine , amphetamine) schizophrenia
52) dark urine HITTERS
Hematologic / coagulation disorders, infection , cystitis, trauma , tumors, exercise, renal disorder, stones
53) blood in the stool DRAIN
diverticulosis , drugs ( warfarin ) rectal bleeds ( piles , fissures) angiodysplasia , anal sex, inflammatory bowel disease, infectious diarrhea, ischemic colitis , injury , neoplasms