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Approache Mnemonics and other stuff

hwilliam50's version from 2018-05-04 16:48


Question Answer
AMSHE STOPS TIPS AEIOU - Hepatic Encephalopathy, Endocrine, Stroke, Trauma, Oxygen, Psych, Seizure, Temperature, Infection, Porphyria, Sepsis, Alcohol,Electrolytes (glucose, Na, K, Ca) , Intoxication, Opiates, Uremia/UTI (also other dudes approach)
Anion GapMULET SACKS - Methanol, Uremia, Lactic Acidosis, Ethylene Glycol, Toluene, Salicylates, Alcohol, Cyanide, Ketones
SyncopeWOMAN PE Wasovagal (situational Dx with tilt table), Orthostatics (Dx with increase HR dec BP, or they feel dizzy), Mechanical (cardiac, valvular Dx with echo and carotid dopler), Arrhythmia, Neuro (stroke seizure), Psych, electrolytes (K, Na, gluc) Pulmonary Embolism
VomitingBIG TIME PIGS - Brain (vomiting center, increased ICP, tumor, migraine, cerebral hemorrhage), Infections (food poisoning, gastritis, meningitis, pyelo), Gastric (gastroparesis, IBS, SBO, cholecystitis, pancreatitis, hepatitis). Toxins (EtOH, lead, organophosphates), Iatrogenic (chemo, opiates, withdraw), Metabolic (adrenal insufficiency, hypo/hyperglycemia, uremia, hypocalcemia) Ear stuff (motion sickness), Pregnant /Pain, Infarct, Glaucoma, Stones (kidney mostly)
Pyramid of dyspnea1) PTX, COPD/Asthma, Pneumonia, PE, PEf, ARDS, Interstitial lung disease, alveolar hemorrhage, aspiration 2) Tamponade, MI, CHF, Arrhythmias 3) Anemia, Bad blood, 4) Resp Alk, Met Acid
Zebras/metabolic causes of Abdominal painPM BAD LUNCH - Porphyria, familial Mediterranean Fever, Black widow spider bite, Adrenal Insufficiency, DKA, Lead toxicity, Uremia, Narrow angle glaucoma, hyperCalcemia, Hereditary angioedma
chest painArrow method - Skin (VZV), Ribs (costochondritis, broken ribs, rib mets), pleural lining (pleuritis, effusion), pleural space (tension pneumo), lung (pneumonia, PE), Pericardial space (pericarditis with tamponade), cardiac (ischemia, myocarditis), esophagus (GERD, esophagitis, rupture), Aorta (disection)
DiarrheaAcute - w/ fecal WBCs MESSY CACA - Medical (IBD, UC, Crohn's, Isch Bowel) and Meds (Abx, Caffeine), E. coli, Shigella, Salmonella, Yersinia, C. Diff. Aoemba, Campylob, Aeromonas, If no WBC's toxin Giardia, Staph, ETEC, viral 2) Chronic Diarrhea MIMOSA - Malabsorbtion will not flush, (celiac, Whipple, Small intestinal bacterial overgrowth, panc insuff), Infectious, Motility tenesmus (IBS, Hyper Thyroid), Osmotic stool osm elvated (laxatives, lactuolose, ceiacs, malabsorption, Mg) Secretory persists at night (cholera), AIDS (cryptosporidium)
Abdominal Pain 12 - 512: esophagus & stomach (GERD, rupture, esophagitis, gastritis, ulcer, cancer, gastroparesis, dudenal ulcer), 1pm (inferior MI, pneumonia, diaphragm irritation), 2am (splenomegally, splenic infarct or abscess 3am retroperitoneal (pancreatitis, renal stones, AAA, ureteral stone) 4am (UC, Crohns, diverticulitis, colitis, LBO, impaction) 5am non pregnancy (PID, endometristis, tuboovarian abscess, ovarian cyst/rupture, PID)
abdominal pain 6-116am (UTI, cystitis, prostatitis, hernias), 7am pregnancy (Spon abortion, ectopic), 8am (appendicitis, illocecal disease/UC/Crohns, mesenteric adenitis), 9am (SBO, ischemic bowel, mecke's, illeus, adhesions, volvulus), 10AM liver galbladder (hepatitis, cholecystitis...), 11am pneumonia and diaphragm
Weakness (central)Cerebral - SPAM (Stroke, PML, Abscess, Mass) Spinal Cord - STEMS (Spinal stenosis, Transverse myelitis, Epidural tumor/abscess, MS, Spinal infarction), Anterior horn (ALS, polio, west nile), NMJ (Lambert-Eaton, Myasthenia gravis, West nile), Electrolytes (K, Mg, Ca, P)
Peripheral Weakness/NeuropathyDANG THERAPIST and MVOSITIS and Delivery of 02 - Diabetes, Alcohol, Nutritional (B12), Guillain-Barre, Trauma, Hereditary (charcot MArie-tooth), Environmental (toxins), Remote cancer, Autoimune, Porhyria, Inflammatory, Syphilis, TB (actually leprosy, 2) Muscle - MVOSITIS - Muscle disease (polymyositis), Viral, Opportunistic (parasites), Statins, Infections (lyme disease), Thyroid, Inflammation (DM/PM), Steroids.
Headache + Red flagsVOMIT - Vascular (SAH, Sub/Epi dural hematoma, intraparenchmal hemorrhage, stroke, venous thrombus, temporal arteritis), Other/Pressure (Malignant HTN, Pseudotumor cerebri, pheo, post LP), Meds (Nitrates, chrnoic analgeisc use, withdraws EtOH/caffeine), Infection (Meningitis, encephalitis, abscess, sinusitis, HSV, fever), Tumor
Back PainMACRUF the back pain dog - Mechanical (musle strain, spondylolisthesis, herniated disc, OA, spinal stenosis), Arthropathies (seronegative arthropathies), Caner (primary or mets), Referred (AAA, endometriosis, tubal pregnancy, kidney stones, pancreatitis, colon cancer), Ugly Infectious (osteo, abscess, TB), Fracture (osteoperosis, steroids, trauma)
Knee painVITAmIN - Vascular (popliteal aneurysm, PVD, hemarthrosis, hematoma, DVT), Infection (Septic arthritis, Gonococcal, Lyme), Trauma (ACL, PCL, MCL, LCL, MM, LM, patellar tendon, plica syndrome), Autoimmune (RA, SLE, Sarcoid, Reactive arthritis), Inflammatory (OA, bursitis, Baker's cyst, IT band, Gout, Pseudogout), Neoplasm (ostosarcoma, adenocarcinoma)

Out patient approaches

Question Answer
Cough acute<3wks - life threatening - pneumonia, COPD/Asthma exacerbation, PE, HF, TB - Non-life threatening, infectious (URI LRI), Exacerbation of pre-existing condition (Asthma, Bronchiectasis, UACS, Environemntal / occupational)
Cough chronic>8wks - Non-asthmatic eosinophilic bronchitis, UACS, Asthma, GERD, smoking, ACEi
Back Painpoop
Knee pain lateral and anteriorLATERAL - LCL tear, lateral meniscus tear, ITB tendonitis ANTERIOR - Paterllar Bursitis, Patellar tendonitis, ACL tear, Osteo Arthritis, Patellofemoral pain syndrome (runner's knee)
Knee pain medial and posteriorMedial - MCL tear OA, Pes Anserine Bursitis, Medial plica syndrome, Posterior - PCL tear, Baker's cyst
Knee pain other causesSeptic joint, septic arthritis, Tick born, chlamydia, gout, pseudogout