Constructing Differential Diagnoses : Mnemonic

doctor differentials

Think of VITAMINS ABCDEK

V: Vascular (bleed or blocked), or anything related to hematology

I: Infective or Post-infective

T: Trauma or mechanical factors such as obstructions or pressure.

A: Autoimmune-related or Allergy

M: Metabolic

I: Idiopathic or Iatrogenic

N: Neoplasia

S: Social reasons – child abuse and social deprivation

A: “Alcohol”-related issues

B: Behavioral or psychosomatic disorders

C: Congenital problems (entire VITAMINSABCDEK could be applied again in the congenital causes)

D: Degenerative disorders or Drug-related problems

E: Endocrine or exocrine problems

K: Karyotype or genetic disorders. 

Reference:

Zabidi-Hussin ZA. Practical way of creating differential diagnoses through an expanded VITAMINSABCDEK mnemonic. Adv Med Educ Pract. 2016 Apr 22;7:247-8. doi: 10.2147/AMEP.S106507. PMID: 27217805; PMCID: PMC4853007.

CHOPPED MINTS

1. Congenital

2. Hematologic or Vascular

3. Organ disease

4. Psychiatric or Psychogenic

5. Pregnancy related

6. Environmental

7. Drugs (prescription, over the counter, herbal, illicit)

8. Metabolic or endocrine

9. Infections, Inflammatory, Iatrogenic or Idiopathic

10. Neoplasm related

11. Trauma

12. Surgical or procedure-related

Reference:

Saint-Frances Guide: Clinical Clerkship in Outpatient Medicine
By Stephen Bent, Lianne S. Gensler, Craig Frances

MINT

Go with anatomic approach using this mnemonic. Think MINT (Malformations, Inflammation, Neoplasm, Trauma) with skin, muscle, bursa, bone or organs for pain or lump.

Example: For a lump in back

Skin

  • M—Malformations include pilonidal cysts and sebaceous cysts.
  • I—Inflammation suggests carbuncles and furuncles.
  • N—Neoplasms include hemangiomas, neurofibromas, lipomas, and metastatic tumors.
  • T—Trauma, suggests contusions.

Subcutaneous tissue and fascia

  • M—Malformations include hernias of Petit triangle.
  • I—Inflammation suggests lesions such as rheumatoid nodules and abscesses.
  • N—Neoplasms as mentioned above.
  • T—Trauma includes contusions and lacerations.

Muscle: nodular fibromyositis, bursal swelling, strains or spasm

Bone

  • M—Malformations include spina bifida, which may be occult or manifest as a swelling such as meningocele or meningomyelocele.
  • I—Inflammation suggests the gibbus of Pott disease (tuberculosis of the spine).
  • N—Neoplasm suggests metastatic neoplasm and multiple myeloma of the spine which may protrude from beneath the skin.
  • T—Trauma suggests the obvious mass of a fracture dislocation or hematoma of the periosteum of the spine.

Retroperitoneal structure: Wilms tumors of the kidney and perinephric abscesses may present as a mass in the back.


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