Build your clinical reasoning

Chest Pain

Rule out the six killers first — then risk-stratify the rest.

Shortness of Breath

Lungs, heart, blood, blood-gases, or plumbing?

Hemoptysis

Protect the good lung; find whether this is massive.

Cyanosis

Blue from lung, heart, or the blood itself?

Shock

Name the pump, the tank, the pipes, or the obstruction.

Palpitations & Dysrhythmia

Capture the rhythm, then decide whether the patient or the ECG is unstable.

Peripheral Edema

Bilateral or unilateral? Volume overload, venous disease, thrombosis, or a systemic cause?

Acute Limb Ischemia

A cold pulseless limb is a clock — and sometimes a dissected aorta.

Neurologic 9

Headache

Thunderclap, worst-ever, or any red flag = imaging.

2 critical

Dizziness & Vertigo

The one question: is it the inner ear or the brainstem?

7 critical

Altered Mental Status

Glucose first — then work the list that kills.

8 critical

Coma & Depressed LOC

Protect, correct the two reversible killers, image.

Seizures

Stop the seizure, find the reversible cause, decide if this is status.

Weakness & Fatigue

Focal or diffuse? UMN or LMN? Hours or months?

Syncope

It’s not the faint — it’s what caused it.

Diplopia

Binocular + painful or pupil-involved = the ones that kill.

Focal Neurologic Deficit / Suspected Stroke

Time last known well, glucose, disability, imaging, reperfusion team.

Abdomen, pelvis & GU 12

Abdominal Pain

Age, location, pregnancy status, and the vascular exam.

GI Bleeding

Resuscitate, risk-stratify, find the source.

Nausea & Vomiting

Not a GI complaint until the brain, heart, sugar, and pregnancy are clear.

Diarrhea

Volume first; then blood, fever, antibiotics, and the host.

Constipation

Rarely the disease — often the mask.

Jaundice

Obstructive, hepatocellular, or hemolytic — and is the liver failing?

Acute Pelvic Pain (Women)

Pregnancy status first — then torsion, then the rest.

Vaginal Bleeding

Pregnant or not? Stable or not? Those two answers run the show.

Scrotal Pain & Swelling

Torsion until proven otherwise — imaging must not delay the OR.

Flank Pain & Renal Colic

Confirm the stone—but first exclude infected obstruction, AAA, and the surgical mimics.

2 critical

Urinary Symptoms & Acute Retention

Measure the bladder, relieve obstruction safely, and never miss cord compression or sepsis.

Low Back Pain

Most leave with advice — the task is finding the dangerous few.

Airway, allergy, skin & pediatrics 9

Airway Symptoms & Stridor

Recognize a threatened airway early; call help before the airway becomes impossible.

Anaphylaxis & Angioedema

Airway, breathing, circulation: epinephrine first when anaphylaxis is suspected.

Rash, Purpura & Dermatologic Emergencies

Rash is skin until it is sepsis, necrosis, mucosal disease, or anaphylaxis.

7 critical

Fever & Sepsis

Find the source; respect the host’s risk.

Pediatric Fever

Age decides the workup; appearance decides the urgency.

Child with Respiratory Distress

Appearance and work of breathing matter more than the first saturation.

Sore Throat & Neck

Airway first — then the deep spaces that kill.

Red Eye & Eye Emergencies

Vision + pain + halos = ophthalmology tonight.

Acute Joint Pain

The hot swollen joint is septic until drained otherwise.

Toxic, metabolic & environmental 4

Poisoning & Overdose

Support the airway, find the toxidrome, call the antidote.

Agitation & Suicidal Ideation

Medical first — then safety, then psychiatry.

DKA, HHS & Adrenal Crisis

Sugar, potassium, volume — and never withhold steroids in the crashing steroid-dependent patient.

Heat Stroke & Hypothermia

Cool the hot brain; warm the cold dead — temperature is the treatment.

Trauma, pregnancy & older adults 3

Multiple Trauma / Primary Survey

Treat immediate threats in order; reassess after every intervention.

Pregnancy-Related Emergency

Pregnancy status changes the differential, imaging, medications, destination, and team.