Medical Mnemonics

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The Geeky Medics list of medical mnemonics has been curated to help you remember important medical concepts and facts

Our list of medical mnemonics includes clinical skills, medicine, surgery, paediatrics and psychiatry. For basic sciences, see the Geeky Medics list of anatomy mnemonics


Clinical skills mnemonics

History structure: CHAMPS

  • Complaint (presenting)
  • History of presenting complaint
  • Allergies
  • Medications
  • Past medical history
  • Social history

Assessment of pain: SOCRATES

  • Site
  • Onset
  • Character
  • Radiation
  • Associated symptoms
  • Timing
  • Exacerbating and relieving factors
  • Severity

See our history taking guides for more details.

Significant past medical history: MJ THREADS

  • Myocardial infarction
  • Jaundice
  • Tuberculosis
  • Hypertension
  • Rheumatic fever
  • Epilepsy
  • Asthma
  • Diabetes
  • Stroke

Drug history: PILLS

  • Pills (is the patient taking any regular medications)
  • Injections/insulin/inhalers
  • ILLicit drug use
  • Sensitivities (allergies)

History taking in syncope: “The Five Ps”

  • Precipitant
  • Prodrome
  • Position
  • Palpitations
  • Post-event phenomena

See our syncope overview for more details

Handover: SBAR

  • Situation
  • Background
  • Assessment 
  • Recommendation

See our SBARR overview for more details

Trauma handover: ATMIST

  • Age
  • Time
  • Mechanism of injury
  • Injuries sustained
  • Symptoms and signs
  • Treatments given

See our SBARR overview for more details

VITAMIN CDEF

  • Vascular
  • Infective
  • Traumatic
  • Autoimmune
  • Metabolic
  • Iatrogenic
  • Neoplastic
  • Congenital
  • Degenerative
  • Endocrine
  • Functional

VINDICATE

  • Vascular
  • Infection
  • Neoplasm
  • Degenerative
  • Iatrogenic 
  • Congenital
  • Autoimmune
  • Trauma
  • Endocrine/metabolic

ECG lead placement: “Ride Your Green Bike”

Placement of limb leads, starting clockwise from the right wrist:

  • Red
  • Yellow
  • Green
  • Blue

See our guide to recording an ECG.

Starting a clinical examination: WIPE

  • Wash your hands (and don PPE)
  • Introduce yourself (#HelloMyNameIs)
  • Patient’s name, date of birth and preferred name
  • Explain and gain consent

Check out our clinical examination guides.

Level of consciousness: ACVPU

  • Alert
  • Confused
  • Voice
  • Pain
  • Unresponsive

See our emergency management guides for more details.

General inspection from the end of the bed: ABC

  • Appearance (colour, pain, breathlessness etc)
  • Behaviour (calm, agitated etc)
  • Connections (oxygen, catheters, cannulas, surgical drains etc)

Neurological examination structure: “Is The Physician Really So Cool?”

  • Inspection
  • Tone
  • Power
  • Reflexes
  • Sensation
  • Co-ordination

Tendon reflex nerve roots

Count upwards from the ankles:

  • S1 S2: ankle jerk
  • L3 L4: knee jerk
  • C5 C6: biceps and brachioradialis
  • C7 C8: triceps

Also, as a rhyme: “1,2 buckle my shoe 3,4 kick the door 5,6 pick up sticks 7,8 shut the gate”

Cerebellar signs: DANISH

  • Dysdiadochokinesia & Dysmetria
  • Ataxia
  • Nystagmus
  • Intention tremor
  • Slurred speech
  • Hypotonia

See our guide to cerebellar examination.

Heart valve auscultation sites: “All Physicians Take Money”

From right upper sternal border:

  • Aortic
  • Pulmonary
  • Tricuspid 
  • Mitral

Assessing a cardiac murmur: SCRIPT

  • Site
  • Character
  • Radiation
  • Intensity
  • Pitch and quality
  • Timing (in the cardiac cycle, systolic or diastolic?)

See our guide to cardiovascular examination.

Breaking bad news: SPIKES

  • Setting up
  • Perception
  • Invitation
  • Knowledge
  • Emotions
  • Strategy and summary

See our guide to breaking bad news.


Medicine mnemonics

Chest X-ray findings in heart failure: ABCDE

  • Alveolar oedema (perihilar/bat-wing opacification)
  • Kerley B lines (interstitial oedema)
  • Cardiomegaly (cardiothoracic ratio >50%) – may be difficult to assess on an AP film
  • Dilated upper lobe vessels
  • Effusions (i.e. pleural effusions – blunted costophrenic angles with meniscus sign)

See our overview of acute heart failure.

Triggers of atrial fibrillation: PIRATES

  • Pulmonary embolism
  • Ischaemia
  • Respiratory disease
  • Atrial enlargement or myxoma
  • Thyroid disease
  • Ethanol
  • Sepsis/sleep apnoea

See our overview of atrial fibrillation.

Features of aortic stenosis: SAD

  • Syncope (exertional)
  • Angina
  • Dyspnoea

See our aortic stenosis examination guide.

Beck’s triad for cardiac tamponade: “Three Ds”

  • Distant heart sounds
  • Distended jugular veins
  • Decreased arterial pressure (low BP)

Features of infective endocarditis: FROM JANE

  • Fever
  • Roth’s spots
  • Osler’s nodes
  • Murmur
  • Janeway lesions
  • Anaemia
  • Nail bed haemorrhage
  • Embolism

See our overview of infective endocarditis.

Management of hypertension: ABCD

  • Angiotensin-converting enzyme inhibitors
  • Beta-blockers (no longer first line)
  • Calcium channel blockers
  • Diuretics

See our overview of hypertension.

Features of asthma: CRAB

  • Chronic inflammation of the airways
  • Reversible airway obstruction
  • Airway hyper-responsiveness
  • Bronchial inflammation

See our overview of asthma to learn more.

Management of tuberculosis: RIPE

  • Rifampicin
  • Isoniazid (+ pyridoxine)
  • Pyrazinamide
  • Ethambutol

See our overview of tuberculosis.

Interpreting a chest X-ray: ABCDE

  • Airway: trachea, carina, bronchi and hilar structures.
  • Breathing: lungs and pleura.
  • Cardiac: heart size and borders.
  • Diaphragm: including assessment of costophrenic angles.
  • Everything else: mediastinal contours, bones, soft tissues, tubes, valves, pacemakers and review areas.

See our guide to chest x-ray interpretation.

Features of thyroid eye disease: NO SPECS

  • No signs or symptoms
  • Only ocular irritation (dryness, gritty sensation)
  • Soft tissue involvement (conjunctival oedema or injection)
  • Proptosis
  • Extraocular muscle involvement
  • Corneal exposure and ulceration
  • Sight loss (due to compressive optic neuropathy)

See our overview of thyroid eye disease.

Diabetic ketoacidosis precipitants: “The 5 Is”

  • Infection
  • Ischaemia
  • Infarction
  • Ignorance (poor diabetic control)
  • Intoxication

See our guide to the acute management of diabetic ketoacidosis.

Features of hypercalcaemia: “Bones, Stones, Groans and Moans”

  • Painful bones
  • Renal stones
  • Abdominal groans (pain)
  • Psychiatric moans (depression, confusion, lethargy)

Indications for renal replacement therapy: AEIOU

  • Acidosis
  • Electrolyte abnormalities
  • Ingested toxins
  • Fluid Overload
  • Uraemia

Management of acute kidney injury: ABCDE

  • Address drugs (nephrotoxics)
  • Boost blood pressure
  • Calculate fluid balance
  • Dip urine
  • Exclude obstruction

See our overview of acute kidney injury.

Functions of the kidney (and complications of CKD): A WET BED

  • Acid-base balance: metabolic acidosis
  • Water removal: pulmonary oedema
  • Erythropoiesis: anaemia
  • Toxin removal: uraemia
  • Blood pressure control: hypertension
  • Electrolyte balance: hyperkalaemia
  • Vitamin D activation: bone-mineral disorder of chronic kidney disease (CKD-BMD)

Causes of pancreatitis: I GET SMASHED

  • Idiopathic
  • Gallstones
  • Ethanol
  • Trauma
  • Steroids
  • Mumps/malignancy
  • Autoimmune disease
  • Scorpion sting (very rare…)
  • Hypertriglyceridemia/hypercalcaemia
  • ERCP (endoscopic retrograde cholangiopancreatography)
  • Drugs: commonly azathioprine, thiazides, septrin, tetracyclines

Glasgow score for pancreatitis: PANCREAS

  • PaO2 <8 kPa 
  • Age > 55
  • Neutrophils (white cell count) > 15
  • Calcium < 2 mmol/L
  • Raised urea >16 mmol/L
  • Enzyme (LDH) >600 IU/L
  • Albumin <32 g/L)
  • Sugar (glucose) >10 mmol/L

See our overview of acute pancreatitis.

Conditions associated with coeliac disease: “I Don’t Take Apples, I Take Oranges”

  • IgA deficiency
  • Down’s syndrome
  • Turner’s syndrome
  • Autoimmune thyroid disease and autoimmune hepatitis
  • IgA nephropathy
  • Type 1 diabetes mellitus
  • Other autoimmune conditions (e.g. Sjögren’s, myasthenia gravis, Addison’s disease)

See our overview of coeliac disease.

Features of myeloma: CRAB

  • HyperCalcaemia
  • Renal failure
  • Anaemia
  • Bone lesions

See our overview of multiple myeloma.

Vitamin K-dependent clotting factors: “2 + 7 = 9, not 10”

Causes of microcytic anaemia: TAILS

  • Thalassemia
  • Anaemia of chronic disease
  • Iron deficiency anaemia
  • Lead poisoning (rare)
  • Sideroblastic anaemia (rare)

See our guide to full blood count interpretation.

Drugs that potentiate warfarin (increase INR): O DEVICES

Cytochrome P450 inhibitors:

  • Omeprazole
  • Disulfiram
  • Erythromycin
  • Valproate
  • Isoniazid
  • Ciprofloxacin/Cimetidine
  • Ethanol (acute intoxication)
  • Sulphonamides

Drugs that decrease the effectiveness of warfarin (decrease INR): PC BRAS

Cytochrome P450 inducers:

  • Phenytoin
  • Carbamazepine
  • Barbiturates
  • Rifampicin
  • Alcohol (chronically)
  • Sulphonylureas

See our guide to warfarin prescribing.

Features of migraine: POUND

  • Pulsating
  • One to three days duration (4 – 72 hours)
  • Unilateral
  • Nausea and/or vomiting
  • Disabling

Features of Parkinson’s disease: SMART

  • Shuffling gait
  • Mask facies
  • Akinesia
  • Rigidity
  • Tremor

See our guide to Parkinson’s disease examination.

Features of normal pressure hydrocephalus: “Wet, Wobbly and Wacky”

  • Wet: urinary incontinence
  • Wobbly: wide-based gait
  • Wacky: cognitive impairment

See our neurosurgery topic summaries.

Features of limited cutaneous systemic sclerosis: CREST

  • Calcinosis: deposits of calcium in soft tissue
  • Raynaud’s: characterised by colour change of the hands, initially white (ischaemic change), then purple (deoxygenated blood) then pink (reperfusion)
  • (o)Esophageal dysmotility: presents as dysphagia most often but there are other oesophageal symptoms
  • Sclerodactyly: thickening and tightness of the skin of the fingers
  • Telangiectasia: red spots around the mouth, nose and sometimes the palms, due to dilated capillaries

See our rheumatology topic summaries.

Features of melanoma: ABCDE

  • Asymmetry
  • Border irregularity (or poorly defined)
  • Colour (varying colours)
  • Diameter (>6mm)
  • Evolving (changing in size, colour or shape

See our dermatology guides.

Causes of delirium: PINCH ME

  • Pain
  • Infection
  • Nutrition
  • Constipation
  • Hydration
  • Medication
  • Environment

See our guide to delirium assessment & management,

Red flags for back pain: TUNA FISH

  • Trauma
  • Unexplained weight loss
  • Neurological symptoms / signs
  • Age > 50
  • Fever
  • Intravenous drug use
  • Steroid use
  • History of cancer

See our back pain history taking guide.

Reversible causes of cardiac arrest: “4Hs and 4Ts”

  • Hypoxia
  • Hypokalaemia/hyperkalaemia
  • Hypothermia/hyperthermia
  • Hypovolaemia
  • Tension pneumothorax
  • Tamponade
  • Thrombosis
  • Toxins

See our emergency guides.

Interpreting a CT head: “Blood Can Be Very Bad”

  • Blood
  • Cisterns
  • Brain
  • Ventricles
  • Bone

See our guide to CT head interpretation.


Surgery mnemonics

Causes of abdominal distension: “The 6Fs”

  • Fat
  • Fluid 
  • Flatus
  • Faeces 
  • Fetus
  • Fatal mass (ie, malignancy)

See our guide to abdominal examination.

X-ray changes in osteoarthritis: LOSS

  • Loss of joint space
  • Osteophytes
  • Subchondral sclerosis
  • Subchondral cysts

See our guide to osteoarthritis.

Management of soft tissue injuries: RICE

  • Rest
  • Ice
  • Compression
  • Elevation

Salter-Harris classification: SALTR

  • Slipped (type I)
  • Above the joint (type II)
  • Lower (Type III)
  • Through (Type IV)
  • Ruined or rammed (Type V)

See our guide to musculoskeletal x-ray interpretation.

Features of acute limb ischaemia: “The Six Ps”

  • Pain
  • Pallor
  • Pulselessness
  • Perishingly cold (poikilothermia)
  • Paraesthesia
  • Paralysis

See our guide to acute limb ischaemia

Assessment of breast lump: LMNOP

  • Lumps
  • Mammary changes
  • Nipple changes
  • Other symptoms
  • Patient risk factors (risk factors for cancer)

See our guides to breast examination and breast cancer.

Management of shoulder dystocia: HELPERR

  • Help: call for help
  • Evaluate for episiotomy
  • Legs (McRoberts’ position)
  • Pressure (suprapubic)
  • Enter manoeuvres (rotational)
  • Remove the posterior arm
  • Roll over onto all fours

See our guide to shoulder dystocia.

Features of nasopharyngeal cancer: NOSE

  • Neck mass
  • Obstructed nasal passage
  • Serous otitis media externa
  • Epistaxis and discharge

See our guide to nasal examination.


Paediatric mnemonics

Pyloric stenosis: “Three Ps”

  • Palpable mass 
  • Peristalsis visible
  • Projective vomiting

Features of croup: “Three Ss”

  • Stridor
  • Subglottic swelling
  • Seal like cough

See our guide to croup.

Paediatric history: BINDS

  • Birth
  • Immunisations
  • Nutrition
  • Development
  • Social history

See our guide to paediatric history taking.


Psychiatry mnemonics

Risk factors for suicide: SAD PERSONS

  • Sex (male)
  • Age (<19 or >45 years)
  • Depression
  • Previous attempt
  • Excess alcohol or substance use
  • Rational thinking loss
  • Social support lacking
  • Organised plan
  • No spouse
  • Sickness

See our guide to suicide risk assessment.

Features of post-traumatic stress disorder: HARD

  • Hyperarousal: persistently heightened perception of current threat (may include enhanced startle reaction)
  • Avoidance of situations/activities reminiscent of the events, or of thoughts/memories of the events
  • Re-experiencing the traumatic events (vivid intrusive memories, flashbacks, or nightmares)
  • Distress: strong/overwhelming fear and physical sensations when re-experiencing

 

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