to get the medals...
to get the save the day medal, you have to beat the game (duh)
to get the brutal medal, once you kill the pink haired dude, shoot him again.
to get theMarc summers medal (the sercret medal) use the urinals untile the piss stains are gone.
to get the overkill medal, kill alucard when he surrenders (shoot the chair out of your way and kill him)
to get the scatman medal, keep on talking to the kid taking a shit.
to get the tap that medal, keep the water running in the boys bathroom.
to get the bruckheimer medal, shoot the giant bomb (the green barrel thing part) and make it explode (this medal is for the bomb behind the boss, cassandra)