Crack the Code of Medical Interviews and Physical Exams with Mnemonics
A
Abdomen assessment: To assess abdomen, palpate all 4 quadrants for GERM:
- Distension: liver problems, bowel obstruction
- Rigidity (board like): bleeding
- Guarding: muscular tension when touched
- Eviseration/ Ecchymosis
- Rebound tenderness: infection
- Masses
- Author: Lyssa Lenske Mount Saint Mary’s College BSN Program
Abdominal swelling causes: 9 F’s:
- Fat
- Feces
- Fluid
- Flatus
- Fetus
- Full-sized tumors
- Full bladder
- Fibroids
- False pregnancy
- Author: Richard Thompson and Alex Queens University, Belfast, NI and Not Specified
B
Breast history checklist: LMNOP:
- Lump
- Mammary changes
- Nipple changes
- Other symptoms
- Patient risk factors
- Author: Gajan Rajeswaran Final Year Medical Student, Imperial College School Of Medicine, London
C
Clinical examination: initial Inspection of patient from end of bed: ABC:
- Appearance (SOB, pain, etc)
- Behaviour
- Connections (drips, inhalers, etc connected to patient)
- Author: Jamal Khan Birmingham University Medical Student
D
Differential diagnosis checklist: “A VITAMIN C“
- A and C stand for Acquired and Congenital
VITAMIN stands for:
- Vascular
- Inflammatory (Infectious and non-Infectious)
- Trauma/ Toxins
- Autoimmune
- Metabolic
- Idiopathic
- Neoplastic
- Example usage: List causes of decreased vision: Central retinal artery occlusion, Retinitis pigmentosa, Perforation to gobe, Chronic
- Gentamycin use, Ruematoid arthritis, Diabetes, Idiopathic, Any eye tumor, Myopia.
- Author: Nizaar Lilla University Of Cape Town Medical School
Differential diagnosis checklist: “I VINDICATE AID“:
- Idiopathic
- Vascular
- Infectious
- Neoplastic
- Degenerative
- Inflammatory
- Congenital
- Autoimmune
- Traumatic
- Endocrinal and metabolic
- AllergicIatrogenic
- Drugs
- Author: Michael A. Chaplin SUNY-HSCB Downstate College of Medicine
F
Family history (FH): BALD CHASM:
- Blood pressure (high)
- Arthritis
- Lung disease
- Diabetes
- Cancer
- Heart disease
- Alcoholism
- Stroke
- Mental health disorders (depression, etc.)
- Author: Michael Waddell University of Wisconsin Medical School
Four point physical assessment of a disease: “I‘m A People Person”:
- Inspection
- Auscultation
- Percussion
- Palpation
- Reference: http://medicalmnemonics.com/
V
Vomiting: non-GIT differential: ABCDEFGHI:
- Acute renal failure
- Brain [increased ICP]
- Cardiac [inferior MI]
- DKA
- Ears [labyrinthitis]
- Foreign substances [Tylenol, theo, etc.]
- Glaucoma
- Hyperemesis gravidarum
- Infection [pyelonephritis, meningitis]
- Author: Ken Evans Saskatchewan Health, Acute and Emergency Services
H
Heart valve auscultation sites: “All Patients Take Meds”:
Reading from top left:
- Aortic
- Pulmonary
- Tricuspid
- Mitral
- Alternatively: All Prostitutes Take M
- Alternatively: APe To M
- Author: Raarsi and Dana M. Not specified and University of Birmingham Medical School and MCC Michigan
G
Glasgow coma scale: components and numbers: Scale types is 3 V‘s:
- Visual response
- Verbal response
- Vibratory (motor) response
- Scale scores are 4,5,6:
- Scale of 4: see so much more
- Scale of 5: talking jive
- Scale of 6: feels the pricks (if testing motor by pain withdrawl)
- Author: Rinku Uberoi and Robert O’Connor
M
Mental state examination: stages in order: “Assessed Mental State To Be Positively Clinically Unremarkable”:
- Appearance and behaviour [observe state, clothing…]
- Mood [recent spirit]
- Speech [rate, form, content]
- Thinking [thoughts, perceptions]
- Behavioural abnormalities
- Perception abnormalities
- Cognition [time, place, age…]
- Understanding of condition [ideas, expectations, concerns]
- Author: Hafizur Rahman MRI-Manchester Med School
Medical history: disease checklist: MJ THREADS:
- Myocardial infarction
- Jaundice
- Tuberculosis
- Hypertension
- Rheumatic fever/ Rheumatoid arthritis
- Epilepsy
- Asthma
- Diabetes
- Strokes
Aside: “History” album was by Michael Jackson (MJ).
-
- Author: Soumendra Datta University College London Medical School
P
Pain history checklist: SOCRATES:
- Site
- Onset
- Character
- Radiation
- Alleviating factors/ Associated symptoms
- Timing (duration, frequency)
- Exacerbating factors
- Severity
Alternatively, Signs and Symptoms with the ‘S’.
-
- Author: Piyush and Shirish Toshniwal and Jonathan Round and Neil Mckeon Cambridge and Smt. NHL Medical College, Ahmedabad and RFUCMS
Past medical history (PMH): VAMP THIS:
- Vices (tobacco, alcohol, other drugs, sexual risks)
- Allergies
- Medications
- Preexisting medical conditions
- Trauma
- Hospitalizations
- Immunizations
- Surgeries
- Author: Michael Waddell University of Wisconsin Medical School
Patient examination organization: SOAP:
- Subjective: what the patient says.
- Objective: what the examiner observes.
- Assessment: what the examiner thinks is going on.
- Plan: what they intend to do about it.
- Author: Richard Rathe, MD University of Florida
Patient profile (PP): LADDERS:
- Living situation/ Lifestyle
- Anxiety
- Depression
- Daily activities (describe a typical day)
- Environmental risks/ Exposure
- Relationships
- Support system/ Stress
- Author: Michael Waddell University of Wisconsin Medical School
Physical exam for ‘lumps and bumps’ : “6 Students and 3 Teachers go for CAMPFIRE“:
- Site, Size, Shape, Surface, Skin, Scar
- Tenderness, Temperature, Transillumination
- Consistency
- Attachment
- Mobility
- Pulsation
- Fluctuation
- Irreducibility
- Regional lymph nodes
- Edge
- Author: Lau Yue Young Geoffrey
Physical examination – correct order: “I Palpate People’s Abdomens”:
- Inspection
- Palpation
- Percussion
- Auscultation
- Author: Jim McHugh St George’s, London
S
Short statue causes: RETARD HEIGHT:
- Rickets
- Endocrine (cretinism, hypopituitarism, Cushing’s)
- Turner syndrome
- Achondroplasia
- Respiratory(suppurative lung disease)
- Down syndrome
- Hereditary
- Environmental (postirradiation, postinfectious)
- IUGR
- GI (malabsorption)
- Heart (congenital heart disease)
- Tilted backbone (scoliosis)
- Author: Lau Yue Young Geoffrey Medical Student ’03, Hong Kong University
Sign vs. symptom
- sIgn: something I can detect even if patient is unconscious.
- sYMptom is something only hYM knows about.
- Reference: http://medicalmnemonics.com/
Surgical sieve for diagnostic categories: INVESTIGATIONS:
- Iatrogenic
- Neoplastic
- Vascular
- Endocrine
- Structural/ Mechanical
- Traumatic
- Inflammatory
- Genetic/ Congenital
- Autoimmune
- Toxic
- Infective
- Old age/ Degenerative
- Nutritional
- Spontaneous/ Idiopathic
- Author: Neil Curran Medical Student, Otago University New Zealand
