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16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

If memorization isn't your thing and you'd rather not pull out your phone for a hasty Google, then Nick Love's medical mnemonics could save the day. At the very least, his colorful and quirky artwork will entertain and enchant.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Patients often present to the emergency department (ED) in pain. In this case, it's important to take a good history, including questions about the pain's Onset (acute vs gradual), Location (radiation?), Duration (acute vs gradual), Characteristics, Aggravating factors, Relieving factors, Treatments (previously tried and details), and Severity (on a scale from 0 to 10).

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

After taking the history, as you think about potential diagnoses, it's ideal to approach the chief complaint with a broad differential diagnosis (DDx). This may include categories that are Infectious, Neoplastic, Degenerative, Iatrogenic/intoxication, Congenital, Autoimmune, Trauma related, Endocrine/metabolic, or Vascular in nature.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Depending on the patient's diagnosis and illness severity, the patient may be admitted to the hospital. Remember to write admission orders that include: Admit to [the floor/the unit/***], Diagnosis, Condition, Vitals, Activity, Nursing instructions, Diet, Allergies, Labs, IV Fluids, Specialists/consults, Medications/monitoring.

NB, please make sure there are no ***s in your H&P before signing.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

At shift's end, it is important to pass off your patients with a proper signout to the oncoming team. A systematic approach to the verbal signout is helpful: Illness severity, the Patient summary, your Action list, and Situation awareness (aka contingency planning). Allow enough time to ensure that Synthesis by the receiver was attained.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

On rounds, physicians often discuss evidenced-based medicine and patient care algorithms. If a patient presents to the ED with syncope, it's wise to assess for Congestive heart failure, Hematocrit < 30%, ECG/cardiac monitor abnormalities, Shortness of breath, or a Systolic blood pressure < 90 mm Hg at triage. If so, there's an increased chance that in the next 7 days, the patient will have a serious event that necessitates a return visit to the ED, admission to the hospital, or the morgue.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

When the exact cause of a presentation is unclear, the initial workup is focused on assessing which potential cause is most likely. For instance, when a patient presents with altered mental status, potential causes include Metabolic (eg, electrolyte, ammonia, glucose), Infectious (eg, urinary tract infection, pneumonia, sepsis, meningitis), Structural (eg, cerebral hemorrhage, stroke, pain, retention, constipation), or Toxin related (eg, alcohol, drugs, poisons).

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

If a patient presents in diabetic ketoacidosis (DKA), assess (and address) these potential precipitating causes: Initial diagnosis of type 1 diabetes mellitus, Infection (pneumonia, urinary tract infection, etc.), Insulin (too little/none), Infarction (eg, stroke or myocardial infarction), Incision (surgery), Infant (pregnancy), Iatrogenic, or Intoxication (eg, alcohol or drugs).

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

A patient who complains of intense, postprandial pain that radiates to the back might have pancreatitis. Recall that the cause of pancreatitis may be Idiopathic, Gallstones, Ethanol, Trauma, Steroids, Malignancy (ie, pancreatic cancer), Autoimmune, Scorpion sting (although rare), Hypercalcemia/hypertriglyceridemia (typically > 1000 mg/dL), Endoscopic retrograde cholangiopancreatography induced, or Drugs (many different).

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Many patients will present with new-onset or newly uncontrolled atrial fibrillation. In this case, assess for potential Pulmonary causes (obstructive sleep apnea, pulmonary embolism, chronic obstructive pulmonary disease, pneumonia), Ischemia (infarction/coronary artery disease), Rheumatic heart disease, mitral Regurgitation, Anemia (ie, high-output heart failure), Thyrotoxicosis/Toxins (eg, stimulants, caffeine, tobacco, alcohol), Endocarditis/Electrolyte abnormalities, Sepsis/infection, or Sick sinus syndrome.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

When a patient presents with headache, vision changes, and even nausea/vomiting, it may be wise to screen for pseudotumor cerebri (aka idiopathic intracranial hypertension). The risk factors include female sex, Tetracyclines, Obesity, excess intake of vitamin A, and Danazol use.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Learning symptomatology is an important part of training. For example, if a patient presents with elevated Calcium, evidence of Renal failure, Anemia, evidence of Bone disease, and/or Back pain, keep multiple myeloma in the differential.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Drug-induced inhibition of cytochrome p450 metabolism can sometimes underlie a patient's presentation. In addition to Acute alcohol ingestion, screen the patient for recent use of Gemfibrozil, Ciprofloxacin, Isoniazid, Grapefruit juice, Quinidine, Amiodarone, Ketoconazole, Macrolides, Sulfonamides, Cimetidine, or Ritonavir.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Admitting a patient with cirrhosis? The initial management may include assessing Volume status, possible Infection (eg, spontaneous bacterial peritonitis), a risk for Bleeding (think varices), and Encephalopathy as well as Screening for other diseases (eg, hepatitis). One may also consider whether the patient may benefit from Surgery (eg, transjugular intrahepatic portosystemic shunt or liver transplant).

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Have you ever needed to recall information rarely utilized in common clinical practice? For example, if a patient presents with renal stones and hexagonal crystals are seen on urinalysis, keep cystinuria in your differential. In this rare, autosomal recessive disorder, the amino acids Cystine (two cysteines linked by a disulfide bond), Ornithine, Lysine, and Arginine fail to be reabsorbed by the proximal convoluted tubule of the nephron.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

Attending physicians and supervising residents are fond of asking about facts and conditions studied primarily during medical school. For example, can you name some picornaviruses? Try Poliovirus, Echovirus, Rhinovirus, Coxsackieviruses, or Hepatitis A virus.

16 Mnemonics All Docs Can Use

Nicholas R. Love, MD, PhD | August 16, 2021 | Contributor Information

When presenting a patient on rounds, discussion of the physical exam is key. The finding of a "continuous machine-like murmur" heard at the second left intercostal space or the immediate left infraclavicular space may suggest a Patent Ductus Arteriosus (PDA).

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21 Clinical Mnemonics

Physician-artist Nick Love's latest creations are whimsical and memorable. Who could forget four Mr Ts?Medscape Features Slideshows, June 2020
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