Weight Loss

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

Acute Abdomen

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

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

Acute Aortic Dissection

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 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 Leukemia

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 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 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 Rhinosinusitis

Rule in:SHAcute Rhinosinusitis, IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps +2 more

Rule out:IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps, IEGranulomatosis with Polyangiitis +1 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

Adrenal Insufficiency

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Adverse Short-term Outcome in Confirmed Pulmonary Embolism

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Allergic Rhinitis

Rule in:SHAcute Rhinosinusitis, IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps +2 more

Rule out:IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps, IEGranulomatosis with Polyangiitis +1 more

Amyloidosis

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Anaphylaxis

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

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

Aortic Coarctation

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Aortic Dissection

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Aortic Regurgitation

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

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:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 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

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

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:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 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

Appendicitis (Pediatric)

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

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:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 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

Autonomic Failure

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Autonomic Neuropathy

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 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

Behçet Disease

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +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

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

Bullous Emphysema

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

Cardiac Tamponade

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

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:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Cardiomegaly

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Carotid Artery Stenosis

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Carotid Dissection

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Carotid Embolism

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 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

Central Retinal Artery Occlusion

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Central Retinal Vein Occlusion

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Cervical Spine Injury

C Spine and Neck Palpation

Rule in:IECervical Spine Injury, IEMalignant Cervical Lymphadenopathy (Metastasis or Lymphoma), IEMediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

Rule out:IECervical Spine Injury, IEMalignant Cervical Lymphadenopathy (Metastasis or Lymphoma), IEMediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

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 Hypertension

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

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 Rhinosinusitis with Nasal Polyps

Rule in:SHAcute Rhinosinusitis, IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps +2 more

Rule out:IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps, IEGranulomatosis with Polyangiitis +1 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

Circulatory Shock (Undifferentiated)

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +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

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

COPD with Hyperinflation

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

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

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

Deconditioning

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 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

Delirium

Rule in:VHDelirium, HDementia (Major Neurocognitive Disorder), HMajor Depressive Disorder

Mental Status Assessment

Rule out:VHDementia (Major Neurocognitive Disorder), VHMajor Depressive Disorder, HDelirium

Dementia (Major Neurocognitive Disorder)

Rule in:VHDelirium, HDementia (Major Neurocognitive Disorder), HMajor Depressive Disorder

Mental Status Assessment

Rule out:VHDementia (Major Neurocognitive Disorder), VHMajor Depressive Disorder, HDelirium

Dextrocardia

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Diabetic Retinopathy

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Diaphragmatic Paralysis

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

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:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

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

Essential (Primary) Hypertension

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 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

Foreign Body Aspiration

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

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

Giant Cell Arteritis (Temporal Arteritis)

Temporal Artery Palpation

Rule in:SHGiant Cell Arteritis (Temporal Arteritis)

Glaucoma

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Goiter (Thyroid Enlargement)

Rule in:SHGoiter (Thyroid Enlargement), NHThyroid Nodule

Thyroid Inspection

Rule out:SHGoiter (Thyroid Enlargement), NHThyroid Nodule

Goiter or Thyroid Nodule

Rule in:IEGoiter or Thyroid Nodule

Thyroid Palpation

Rule out:IEGoiter or Thyroid Nodule

Granulomatosis with Polyangiitis

Rule in:SHAcute Rhinosinusitis, IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps +2 more

Rule out:IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps, IEGranulomatosis with Polyangiitis +1 more

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:SHCirrhosis, IEAcute Hepatitis, IECongestive Hepatopathy +6 more

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

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

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

Hemorrhage

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Hemothorax

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

HIV Retinopathy

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

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

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Hypertensive Emergency

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 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

Hypertensive Retinopathy

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Hyperthyroidism (Thyrotoxicosis)

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 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

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Hypoalbuminemia

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

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

Hypoglossal Nerve Palsy

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Hypothyroidism

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 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:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 more

Hypoxemia

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Idiopathic Intracranial Hypertension

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Immunosuppression

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 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:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 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

Infective Endocarditis

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 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

Kawasaki Disease

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 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

Large Pleural Effusion

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

Lead Poisoning

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 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

Left Ventricular Dilation

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Left Ventricular Hypertrophy

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Leukemia

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 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:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

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

Low-output State (Low Cardiac Index) Within Established Chronic Heart Failure

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 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

Macular Degeneration

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Mainstem Bronchus Intubation

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

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

Major Depressive Disorder

Rule in:VHDelirium, HDementia (Major Neurocognitive Disorder), HMajor Depressive Disorder

Mental Status Assessment

Rule out:VHDementia (Major Neurocognitive Disorder), VHMajor Depressive Disorder, HDelirium

Malignant Cervical Lymphadenopathy (Metastasis or Lymphoma)

C Spine and Neck Palpation

Rule in:IECervical Spine Injury, IEMalignant Cervical Lymphadenopathy (Metastasis or Lymphoma), IEMediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

Rule out:IECervical Spine Injury, IEMalignant Cervical Lymphadenopathy (Metastasis or Lymphoma), IEMediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

Measles

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Mediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

C Spine and Neck Palpation

Rule in:IECervical Spine Injury, IEMalignant Cervical Lymphadenopathy (Metastasis or Lymphoma), IEMediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

Rule out:IECervical Spine Injury, IEMalignant Cervical Lymphadenopathy (Metastasis or Lymphoma), IEMediastinal Shift (Tension Pneumothorax or Large Pleural Effusion)

Medication Effect

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 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

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

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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

Mixed Aortic Valve Disease

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 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

Nasal Bone Fracture

Rule in:SHAcute Rhinosinusitis, IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps +2 more

Rule out:IEAllergic Rhinitis, IEChronic Rhinosinusitis with Nasal Polyps, IEGranulomatosis with Polyangiitis +1 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

Nutritional Deficiency

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 more

Obesity

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Optic Atrophy

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Oral Cancer

Rule in:SHMeasles, IEAcute Leukemia, IEAdrenal Insufficiency +9 more

Rule out:SHHypovolemia, MHMeasles, IEAcute Leukemia +10 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

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

Pericardial Effusion

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 more

Peritonitis

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

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

Pleural Effusion

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

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

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

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Pneumothorax

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

Postural Orthostatic Tachycardia Syndrome

Rule in:VHAutonomic Neuropathy, VHHemorrhage, VHHypovolemia +5 more

Rule out:VHAutonomic Failure, VHHemorrhage, MHAutonomic Neuropathy +4 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

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:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

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

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

Pulmonary Mass

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

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

Pulmonary Mass or Tumor

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 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

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-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:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Septic Shock (Severity Stratum Within Established Sepsis)

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Severe Anemia

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Rule in:HAtrial Fibrillation, SHHypothyroidism, SHPneumonia +7 more

Rule out:VHAtrial Fibrillation, MHAdverse Short-term Outcome in Confirmed Pulmonary Embolism, IECardiac Tamponade +5 more

Severe Aortic or Mitral Regurgitation

Rule in:VHLeft Ventricular Dilation, HLeft Ventricular Hypertrophy, SHCardiomegaly +7 more

Rule out:VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy, MHCardiomegaly +7 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:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

Severe COPD

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 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

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Sigmoid Diverticulitis

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

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

Subarachnoid Hemorrhage

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Subclavian Artery Stenosis

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Takayasu Arteritis

Rule in:HAortic Stenosis, HTakayasu Arteritis, SHAortic Dissection +7 more

Rule out:SHAortic Stenosis, IEAortic Regurgitation, IECarotid Artery Stenosis +5 more

Thyroid Nodule

Rule in:SHGoiter (Thyroid Enlargement), NHThyroid Nodule

Thyroid Inspection

Rule out:SHGoiter (Thyroid Enlargement), NHThyroid Nodule

Thyroid Storm (Thyrotoxic Crisis)

Rule in:SHPneumonia, IEInfective Endocarditis, IESepsis +1 more

Rule out:MHAppendicitis (Pediatric), MHPneumonia, IEInfective Endocarditis +2 more

Tricuspid 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

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

Tuberculosis or Sarcoidosis

Rule in:VHGlaucoma, SHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

Rule out:SHGlaucoma, MHDiabetic Retinopathy, MHIncreased Intracranial Pressure +13 more

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

Rule in:HLarge Pleural Effusion, HPleural Effusion, SHLobar Pneumonia or Consolidation +10 more

Rule out:IEAtelectasis, IEBullous Emphysema, IECOPD with Hyperinflation +8 more

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

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

Volume Depletion From Significant Blood Loss

Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more

Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more

Volume Overload