CASE DIAGNOSED! A Great New Mnemonic for Coming Up with a Differential Diagnosis

MNEMONICS

“I once sat through an hour lecture on why children fail to thrive, and every possible differential diagnosis was discussed except the possibility that maybe they didn’t have enough food.”1 Sandra Hoyt Stenmark, MD, Pediatrician.

I think that social determinants of health belong on our differential diagnosis. As we know, they contribute more to premature death than inadequate health care.2

Building on some of the other mnemonic devises already out there for creating a differential diagnosis, I created the following mnemonic which I find easier to remember and is very comprehensive as well.

I have intentionally left out congenital and idiopathic. I think we don’t need a mnemonic for “we don’t know”. Also, all diseases are either congenital(present at birth) or acquired (developed later in life). From that base, we can use the following mnemonic. The mnemonic can be applied to tease out both congenital and acquired conditions.

My mnemonic is CASE DIAGNOSED!

  1. Circulatory (or cardiovascular) system causes. The key elements of the CV system are the heart, blood, and blood vessels. Hematology falls under the circulatory system. You see “bleeds and blocks” in vessels, clotting problems, etc.
  2. Autoimmune.
  3. Structural (architectural) causes e.g. in the heart, HOCM, HF, heart valve abnormalities, congenital structural abnormalities; in the back, musculoskeletal causes; in the nervous system, brain or spinal cord injury, carpal tunnel syndrome, etc.
  4. Endocrine and metabolic causes
  5. Drugs & Diet (deficiencies + excesses), ingestions. In short, everything we put into our bodies.
  6. Infection + inflammation  (includes infective and post-infective processes)
  7. Accidents/trauma – including iatrogenic accidents and all types of trauma.
  8. Growths (primary or metastatic tumors).
  9. Neurologic and electrical disorders. E.g. in the brain, seizures; in the extremities, neuropathic pain; in the heart, arrhythmias;
  10. Occupational and environmental causes. Eg. work-related injury, carpal tunnel in secretaries, irritant contact dermatitis in farmers, etc.; Environmental causes like allergies, exposures, etc.
  11. Social causes e.g. child abuse, social deprivation, alcohol, drugs, tobacco, etc. Also forces us to think about the social determinants of health.
  12. Emotional and behavioral disorders. i.e. mental disorders. Stress is the root of the overwhelming majority of PCP office visits.
  13. DNA defects (inherited and acquired genetic d/o).

I created a version for CASE DIAGNOSIS as well. In it, the last two letters are changed to:

  • Inheritance (Instead of DNA).
  • Stress and mental disorders (instead of emotional and behavioral disorders)

 

 

 

Resources/References

1. https://www.aamc.org/download/460392/data/sdoharticles.pdf, Last Accessed, 5/28/2019

2. https://www.nejm.org/doi/10.1056/NEJMsa073350, Last Accessed, 5/28/2019

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