Interviewing / Physical Exam Mnemonics

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