Clinical mnemonics

Last Updated:  November 23rd, 2012.

I’m going to try to only list mnemonics that I find helpful enough to actually use.  This has the upside of keeping the list short and to the point, but the downside of potentially making me look like an idiot, since some of them are incredibly basic.  I’m pretty much okay with that, though.

Please feel free to comment with any additions!

History

Differential diagnosis brainstorming:  VINDICATE.  (Vascular, Infectious, Neoplasm, Drugs, Inflammatory/Idiopathic, Congenital, Autoimmune, Trauma, Endocrine/Metabolic)

Depression Screening:  SIG. E. CAPS [signature energy capsules]  (Sleep, Interest [loss of], Guilt, Energy, Concentration, Appetite, Psychomotor symptoms, Suicidality)

Symptom Exploration:  OLD CARTS (Onset, Location, Duration, Character, Alleviating/Aggravating factors, Radiation, Timing, Severity)

Social History:  SAD ONE (Smoking, Alcohol, Drugs —  Occupation, Nutrition, Exercise)

Alcoholism Screening:  CAGE.  (Have you ever felt you should Cut back on your drinking?  Does it Annoy you when other people criticize your drinking?  Do you ever feel Guilty about your drinking?  Do you ever need an Eye-opener in the morning?)

(Note:  When asking about a patient’s consumption of alcohol, two things:  1)   If they occasionally have “a glass or two” of wine, ALWAYS ask how many glasses they can get out of a bottle.
2)  If you have to prompt them to get them to answer how much they drink per day, overestimation is your friend.)

Past Surgical History:  Not a mnemonic, but if the patient says they haven’t had any surgeries, it’s beginning to seem like it’s totally worth it to smile and follow it up with “Still have your tonsils, appendix, and all of your original joints?”

Physical

Heart Auscultation:  All Physicians Take Money (from the med student’s left –> right:  Aortic valve, pulmonary valve, triscuspid valve, mitral valve)

Diastolic vs Systolic Dysfunction:  Count the syllables.  “Systolic” has 3 syllables.  S3 indicates systolic dysfunction.  “Diastolic” has 4 syllables, and so an S4 indicates diastolic dysfunction.

Neurologic Exam:  CNS MD  (Cerebellum and gait, Nerves (cranial), Sensory, Muscles, Deep Tendon Reflexes.)

3 thoughts on “Clinical mnemonics

  1. One I use, that was meant for a ‘pain history’ but can cover everything from sub-arachnoid haemorrhages to cough is SOCRATES – Site, Onset, Character, Radiation, Associated symptoms, Timing, Exacerbating and relieving factors, Severity (/10)
    With alcohol and smoking, if a patient says, “not much” or “a bit”, start by massive overestimation, because then they won’t feel bad about the truth, so…
    “Do you drink alcohol?” Pt: “yeah, a little bit” “So are we talking 15 bottles of wine a week?” Pt. “Oh no, only a couple of bottles of whisky a week, and a 3 or 4 beers a night.” (cue referral to rehab). (this is especially true when talking to little old ladies. They’re the ones that will consistently fool you, you never suspect them.
    I once had a patient that said she didn’t smoke much, – her 30/day wasn’t much compared to some of her friends who smoke 100/day!

  2. Pingback: Anxiety History Mnemonic | Top NewsDay

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