Medical Mnemonics

geekymedics.com/medical-mnemonics

Dr Chris Jefferies March 23, 2022

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.

Want discounted access to all Geeky Medics products? Check out our bundles to save money and supercharge your learning 🔥
Clinical skills mnemonics

History structure: CHAMPS

Complaint (presenting)

1/11
 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

Focused history in emergencies: SAMPLE

Signs and symptoms

Allergies
Medication
Past medical history
Last oral intake
Events leading up to the illness or injury

Handover: SBAR

Situation
Background
Assessment
Recommendation

See our SBAR overview for more details

Trauma handover: ATMIST

Age

2/11
 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

MIDNITE

Metabolic
Inflammation
Degenerative
Neoplastic
Infection
Trauma
Environmental

INVITED MD

Infection
Neoplasia
Vascular
Inflammatory/autoimmune
Trauma
Endocrine
Degenerative
Metabolic
Drugs
Congenital

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.

3/11
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

4/11
 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.

5/11
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

6/11
 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

7/11
 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

8/11
 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.

9/11
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

10/11
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

Copyright © Geeky Medics

11/11