Abdominal Distension

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Abdominal Hernia

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Abdominal Malignancy

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Abdominal Wall Pain

Rule in:SHAbdominal Wall Pain, SHPsychogenic Abdominal Pain, IEAcute Abdomen +2 more

Rule out:HPsychogenic Abdominal Pain, SHAbdominal Wall Pain, IEAcute Abdomen +2 more

Acute Abdomen

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rule in:SHAbdominal Wall Pain, SHPsychogenic Abdominal Pain, IEAcute Abdomen +2 more

Rule out:HPsychogenic Abdominal Pain, SHAbdominal Wall Pain, IEAcute Abdomen +2 more

Acute Coronary Syndrome (Atypical Presentation)

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Acute Hepatitis

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Acute Myocardial Infarction

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Acute Neurologic Event or Severe Pain

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Acute Pericarditis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Acute Thoracic Aortic Dissection

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Alcohol-related Cerebellar Degeneration

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Anaphylaxis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Anterior Cutaneous Nerve Entrapment Syndrome (ACNES)

Rule in:SHAbdominal Wall Pain, SHPsychogenic Abdominal Pain, IEAcute Abdomen +2 more

Rule out:HPsychogenic Abdominal Pain, SHAbdominal Wall Pain, IEAcute Abdomen +2 more

Aortic Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Aortic Sclerosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Aortic Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Appendiceal Mass

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Appendicitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rule in:SHAppendicitis, MHPeritonitis, IEDiverticulitis +1 more

Rule out:SHAppendicitis, SHPeritonitis, IEDiverticulitis +1 more

Rule in:SHAppendicitis, IERight-sided Peritoneal Irritation

Rovsing Sign

Rule out:IERight-sided Peritoneal Irritation

Ascites

Rule in:VHBowel Obstruction, SHAscites, IEPortal Hypertension +1 more

Rule out:SHAscites, IEBowel Obstruction, IEPortal Hypertension +1 more

Shifting Dullness

Rule in:SHAscites

Rule out:SHAscites

Atelectasis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Atelectasis with Patent Airway

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Atrial Fibrillation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Atrial Septal Defect

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Atrioventricular Dissociation

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Baker Cyst Rupture

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Bicuspid Aortic Valve

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Bilateral Hip Arthritis or Disease

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Blunt Abdominal Trauma with Intra-abdominal Injury

POCUS

Rule in:IEBlunt Abdominal Trauma with Intra-abdominal Injury

FAST Exam

Rule out:IEBlunt Abdominal Trauma with Intra-abdominal Injury

Bowel Obstruction

Rule in:MHBowel Obstruction, IEGastric Outlet Obstruction, IEParalytic Ileus +1 more

Rule out:IEGastric Outlet Obstruction, IEParalytic Ileus, IEPortal Hypertension

Rule in:VHBowel Obstruction, SHAscites, IEPortal Hypertension +1 more

Rule out:SHAscites, IEBowel Obstruction, IEPortal Hypertension +1 more

Bronchial Obstruction

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Bronchiectasis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Bronchitis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Cardiac Tamponade

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Cecal Diverticulitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Cellulitis

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Cerebellar Disease

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Cerebral Palsy

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Charcot-Marie-Tooth Disease

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Cholangitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Cholecystitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Chronic Kidney Disease

Chronic Myeloid Leukemia

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Chronic Obstructive Pulmonary Disease

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Chronic Obstructive Pulmonary Disease (COPD) Exacerbation

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Chronic Venous Insufficiency

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Cirrhosis

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Skin Inspection and Palpation

aka Total body skin exam, TBSE

Rule in:SHCirrhosis

Rule out:MHCirrhosis

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Cirrhosis with Portal Hypertension

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Common Peroneal Nerve Palsy

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Complete Heart Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Congestive Hepatopathy

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Constrictive Pericarditis

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight Heart Failure

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

COPD with Hyperinflation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Cor Pulmonale

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Crohn Disease (Terminal Ileitis)

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Croup

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Cyanotic Congenital Heart Disease

Cystic Fibrosis

Cystitis or Urinary Tract Infection

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Deep Vein Thrombosis

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Lower Extremity Inspection and Palpation

Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis

Rule out:MHDeep Vein Thrombosis, MHHeart Failure

Digital Clubbing (Acropachy)

Diverticular Abscess

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Diverticulitis

Rule in:SHAppendicitis, MHPeritonitis, IEDiverticulitis +1 more

Rule out:SHAppendicitis, SHPeritonitis, IEDiverticulitis +1 more

Drug-induced Parkinsonism

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Ectopic Pregnancy

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Endocarditis

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Endometritis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Epiglottitis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Esophageal Rupture

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Fatty Liver Disease

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

First-degree AV Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Fitz-Hugh-Curtis Syndrome

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Foot Drop or Distal Weakness

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Foreign Body Aspiration

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Frailty

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Frontal Lobe Gait Disorder

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Functional Gait Disorder

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Gastric Outlet Obstruction

Rule in:MHBowel Obstruction, IEGastric Outlet Obstruction, IEParalytic Ileus +1 more

Rule out:IEGastric Outlet Obstruction, IEParalytic Ileus, IEPortal Hypertension

Gastritis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Gastroenteritis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Heart Failure

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight Heart Failure

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Lower Extremity Inspection and Palpation

Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis

Rule out:MHDeep Vein Thrombosis, MHHeart Failure

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Neck Vein Inspection

Rule in:HHeart Failure

Rule out:MHHeart Failure

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Heart Failure (Bedbound Patient)

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Heart Failure (When Wheezing Is the Dominant Auscultatory Finding)

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Heart Failure with Tachycardia

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hematologic Malignancy

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Hepatic Encephalopathy

Hepatitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Hepatocellular Carcinoma

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Hepatomegaly

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rule in:NHHepatomegaly, IEPerforated Viscus, IEUrinary Retention

Abdomen Percussion

Rule out:NHHepatomegaly, IEPerforated Viscus, IEUrinary Retention

Liver Percussion

Rule in:NHHepatomegaly

Rule out:NHHepatomegaly

Hereditary Hemolytic Anemia

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Hypercapnic Respiratory Failure

Hyperdynamic State

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hypertensive Heart Disease

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hypertrophic Cardiomyopathy

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hypertrophic Cardiomyopathy with Obstruction

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Hypoalbuminemia

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Hypothyroidism (Myxedema)

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Hypovolemia

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Incarcerated or Strangulated Hernia

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Increased Intracranial Pressure

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Infectious Mononucleosis

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Inflammatory Bowel Disease

Interstitial Lung Disease

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Intussusception

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

L5 Radiculopathy

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Large Pericardial Effusion

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Left Bundle Branch Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Lipedema

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Liver Abscess

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Lobar Pneumonia or Consolidation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Lower Extremity Pain

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Lung Cancer

Lymphedema

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Lymphoma

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Mainstem Bronchus Intubation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Medication Effect (Calcium Channel Blockers, NSAIDs)

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Metabolic Encephalopathy

Metastatic Liver Disease

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Mitral Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Mitral Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Mitral Valve Prolapse

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Multiple Sclerosis

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Myelofibrosis

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Nephrotic Syndrome

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Normal Pressure Hydrocephalus

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Opioid Intoxication / Overdose

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Ovarian Cancer

Rule out:MHOvarian Cancer

Pelvic Bimanual Exam

Rule in:VHOvarian Cancer

Ovarian Cyst, Torsion, or Mass

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Pancreatitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Paralytic Ileus

Rule in:MHBowel Obstruction, IEGastric Outlet Obstruction, IEParalytic Ileus +1 more

Rule out:IEGastric Outlet Obstruction, IEParalytic Ileus, IEPortal Hypertension

Parkinson Disease

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Patent Ductus Arteriosus

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pelvic Inflammatory Disease

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Peptic Ulcer Disease

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Perforated Viscus

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rule in:NHHepatomegaly, IEPerforated Viscus, IEUrinary Retention

Abdomen Percussion

Rule out:NHHepatomegaly, IEPerforated Viscus, IEUrinary Retention

Rule in:SHAppendicitis, MHPeritonitis, IEDiverticulitis +1 more

Rule out:SHAppendicitis, SHPeritonitis, IEDiverticulitis +1 more

Peripheral Arterial Disease

Lower Extremity Inspection and Palpation

Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis

Rule out:MHDeep Vein Thrombosis, MHHeart Failure

Peripheral Artery Disease

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Peritonitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rule in:SHAppendicitis, MHPeritonitis, IEDiverticulitis +1 more

Rule out:SHAppendicitis, SHPeritonitis, IEDiverticulitis +1 more

Pleural Effusion

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pleural Inflammation

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pneumomediastinum

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pneumonia

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Pneumothorax

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Portal Hypertension

Rule in:MHBowel Obstruction, IEGastric Outlet Obstruction, IEParalytic Ileus +1 more

Rule out:IEGastric Outlet Obstruction, IEParalytic Ileus, IEPortal Hypertension

Rule in:VHBowel Obstruction, SHAscites, IEPortal Hypertension +1 more

Rule out:SHAscites, IEBowel Obstruction, IEPortal Hypertension +1 more

Postpericardiotomy Syndrome

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pregnancy

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Prosthetic Valve

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Proximal Myopathy

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Psychogenic Abdominal Pain

Rule in:SHAbdominal Wall Pain, SHPsychogenic Abdominal Pain, IEAcute Abdomen +2 more

Rule out:HPsychogenic Abdominal Pain, SHAbdominal Wall Pain, IEAcute Abdomen +2 more

Pulmonary Edema

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pulmonary Embolism

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Pulmonary Fibrosis

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pulmonary Hypertension

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Rule in:SHPulmonary Hypertension

Precordial Palpation

Rule out:NHPulmonary Hypertension

aka Parasternal heave; left parasternal lift

Right Ventricular Heave

Rule in:SHPulmonary Hypertension

Pulmonary Mass

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Pulmonic Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pulmonic Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Pyloric Stenosis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Rectus Sheath Hematoma

Rule in:SHAbdominal Wall Pain, SHPsychogenic Abdominal Pain, IEAcute Abdomen +2 more

Rule out:HPsychogenic Abdominal Pain, SHAbdominal Wall Pain, IEAcute Abdomen +2 more

Retroperitoneal Hemorrhage

Rule in:VHBowel Obstruction, SHAscites, IEPortal Hypertension +1 more

Rule out:SHAscites, IEBowel Obstruction, IEPortal Hypertension +1 more

Right Bundle Branch Block

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Right Heart Failure

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight Heart Failure

Right Ventricular Infarction

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Right-sided Peritoneal Irritation

Rule in:SHAppendicitis, IERight-sided Peritoneal Irritation

Rovsing Sign

Rule out:IERight-sided Peritoneal Irritation

Right-sided Valvular Lesion

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Sepsis

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Septic Shock

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Severe Aortic Regurgitation

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Severe Asthma Exacerbation

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Severe Hypoalbuminemia

Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more

Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more

Severe Left Ventricular Dysfunction

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Severe Metabolic Acidosis (Any Cause — Diabetic Ketoacidosis, Alcoholic Ketoacidosis, Lactic Acidosis, Salicylate Toxicity, Uremic Acidosis)

Rule in:SHPneumonia, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Rule out:MHPulmonary Embolism, IEHeart Failure, IEIncreased Intracranial Pressure +3 more

Severe Tricuspid Regurgitation

Rule in:VHHypovolemia, HHeart Failure, HRight Ventricular Infarction +8 more

Rule out:HRight Ventricular Infarction, SHHypovolemia, SHPulmonary Hypertension +8 more

Sigmoid Diverticulitis

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Spinal Cord Disease

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Splenic Abscess

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Splenic Infarction

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Splenic Infarction or Rupture

Rule in:VHAbdominal Aortic Aneurysm, VHPyloric Stenosis, VHSigmoid Diverticulitis +29 more

Rule out:SHCholecystitis, SHHepatomegaly, MHAbdominal Aortic Aneurysm +28 more

Splenomegaly

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

aka Castell sign; Nixon sign

Spleen Percussion

Rule in:IESplenomegaly

Rule out:IESplenomegaly

Traube Space Spleen Percussion

Rule in:SHSplenomegaly

Rule out:MHSplenomegaly

Stroke

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Tension Pneumothorax

Rule in:SHPneumonia, IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure +5 more

Rule out:IEChronic Obstructive Pulmonary Disease (COPD) Exacerbation, IEHeart Failure, IEPeripheral Artery Disease +4 more

Tricuspid Regurgitation

Rule in:SHHeart Failure, IEConstrictive Pericarditis, IERight Heart Failure

Rule out:SHTricuspid Regurgitation, IEConstrictive Pericarditis, IERight Heart Failure

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Rule in:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Rule out:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

Tricuspid Stenosis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Unilateral Pulmonary Process (Consolidation, Effusion, Pneumothorax, or Atelectasis)

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Upper Airway Obstruction

Rule in:VHPneumothorax, HMainstem Bronchus Intubation, HPleural Effusion +24 more

Rule out:VHPleural Effusion, SHMainstem Bronchus Intubation, SHPneumothorax +23 more

Uremic Pericarditis

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Urinary Retention

Rule in:NHHepatomegaly, IEPerforated Viscus, IEUrinary Retention

Abdomen Percussion

Rule out:NHHepatomegaly, IEPerforated Viscus, IEUrinary Retention

POCUS

Rule in:IEUrinary Retention

Bladder Ultrasound

Rule out:IEUrinary Retention

Vascular Parkinsonism

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Ventricular Septal Defect

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more

Visceral Leishmaniasis

Rule in:SHCirrhosis, SHInfectious Mononucleosis, IEChronic Myeloid Leukemia +10 more

Rule out:MHInfectious Mononucleosis, IEChronic Myeloid Leukemia, IECirrhosis with Portal Hypertension +9 more

Vitamin B12 Deficiency (Sensory Ataxia)

Rule in:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Rule out:IEAcute Neurologic Event or Severe Pain, IEAlcohol-related Cerebellar Degeneration, IEBilateral Hip Arthritis or Disease +20 more

Volume Overload

Cardiac Auscultation

Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy with Obstruction +34 more

Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy with Obstruction, SHAortic Regurgitation +33 more